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Family Behaviors as Unchanging Obstacles in End-of-Life Care: 16-Year Comparative Data.
Beckstrand, Renea L; Jenkins, Jasmine B; Luthy, Karlen E; Macintosh, Janelle L B.
Affiliation
  • Beckstrand RL; About the Authors: Renea L. Beckstrand and Karlen E. Luthy are professors and Janelle L. B. Macintosh is an associate professor at Brigham Young University College of Nursing, Provo, Utah.
  • Jenkins JB; Jasmine B. Jenkins, a former graduate student at Brigham Young University, is now a nurse practitioner in urgent care for Revere Health, Spanish Fork, Utah.
  • Luthy KE; About the Authors: Renea L. Beckstrand and Karlen E. Luthy are professors and Janelle L. B. Macintosh is an associate professor at Brigham Young University College of Nursing, Provo, Utah.
  • Macintosh JLB; About the Authors: Renea L. Beckstrand and Karlen E. Luthy are professors and Janelle L. B. Macintosh is an associate professor at Brigham Young University College of Nursing, Provo, Utah.
Am J Crit Care ; 29(4): e81-e91, 2020 07 01.
Article in En | MEDLINE | ID: mdl-32607570
ABSTRACT

BACKGROUND:

Critical care nurses routinely care for dying patients. Research on obstacles in providing end-of-life care has been conducted for more than 20 years, but change in such obstacles over time has not been examined.

OBJECTIVE:

To determine whether the magnitude scores of obstacles and helpful behaviors regarding end-of-life care have changed over time.

METHODS:

In this cross-sectional survey study, questionnaires were sent to 2000 randomly selected members of the American Association of Critical-Care Nurses. Obstacle and helpful behavior items were analyzed using mean magnitude scores. Current data were compared with data gathered in 1999.

RESULTS:

Of the 2000 questionnaires mailed, 509 usable responses were received. Six obstacle magnitude scores increased significantly over time, of which 4 were related to family issues (not accepting the poor prognosis, intrafamily fighting, overriding the patient's end-of-life wishes, and not understanding the meaning of the term lifesaving measures). Two were related to nurse issues. Seven obstacles decreased in magnitude, including poor design of units, overly restrictive visiting hours, and physicians avoiding conversations with families. Four helpful behavior magnitude scores increased significantly over time, including physician agreement on patient care and family access to the patient. Three helpful behavior items decreased in magnitude, including intensive care unit design.

CONCLUSIONS:

The same end-of-life care obstacles that were reported in 1999 are still present. Obstacles related to family behaviors increased significantly, whereas obstacles related to intensive care unit environment or physician behaviors decreased significantly. These results indicate a need for better end-of-life education for families and health care providers.
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Terminal Care / Family / Critical Care Nursing Type of study: Observational_studies / Prevalence_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Limits: Adult / Female / Humans / Male / Middle aged Language: En Journal: Am J Crit Care Journal subject: ENFERMAGEM / TERAPIA INTENSIVA Year: 2020 Document type: Article

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Terminal Care / Family / Critical Care Nursing Type of study: Observational_studies / Prevalence_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Limits: Adult / Female / Humans / Male / Middle aged Language: En Journal: Am J Crit Care Journal subject: ENFERMAGEM / TERAPIA INTENSIVA Year: 2020 Document type: Article