Short Communication
What is Important to Families in Intensive Care Once a Decision has been Made to Withdraw Treatment
Maureen A Coombs*Graduate School of Nursing, Midwifery and Health, Victoria University of Wellington and Capital and Coast District Health Board, Wellington Regional Hospital Wellington, New Zealand
- *Corresponding Author:
- Coombs MA
Graduate School of Nursing
Midwifery and Health Victoria University of Wellington
and Capital and Coast District Health Board
Wellington Regional Hospital, Wellington
6242, New Zealand
Tel: 0064 4 463 5180
E-mail: mo.coombs@vuw.ac.nz
Received date: February 17 2015 Accepted date: February 25 2015; Published date: March 05 2015
Citation: Coombs MA (2015) What is Important to Families in Intensive Care Once a Decision has been Made to Withdraw Treatment. J Palliat Care Med 5:212. doi: 10.4172/2165-7386.1000212
Copyright: ©2015 Coombs MA. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
Abstract
Objective: How doctors and nurses talk with families about decisions that lead to treatment withdrawal in intensive care is important and has been well explored. However less is known about what family members perceive as important once this decision has been made. This study explores the needs of family members during and after treatment has been withdrawn in intensive care. Methods: An interpretive qualitative design was undertaken. Purposive sampling identified 112 deceased patients of whom 62 met the study criteria. From this sample, 17 in-depth interviews were conducted with 21 family members who had been bereaved in the previous 6-12 months. Thematic analysis was performed on the transcribed interviews. Results: Whilst family members were able to broadly recollected conversations with doctors and nurses about the decision to withdraw treatment, there were detailed accounts of what was important to family members after that decision was made. In this, family members recalled wanting to: alleviate further suffering, re-establish identity of, and re-connect relationships with, the dying person.Bereaved family members spoke about the activities they undertook to realize these. At interview, family members demonstrated on-going distress about situations perceived as preventing achievement of these. Conclusions: Families have existential and relational needs during and after treatment withdrawal in intensive care. Doctors and nurses must recognize the importance of assessing these family goals, identifying information that enables families to choose how such needs can be met, and developing skills to manage situations when these needs cannot be met.
