scholarly journals Nurse-Perceived Barriers to Effective Communication Regarding Prognosis and Optimal End-of-Life Care for Surgical ICU Patients: A Qualitative Exploration

2012 ◽  
Vol 15 (8) ◽  
pp. 910-915 ◽  
Author(s):  
Rebecca A. Aslakson ◽  
Rhonda Wyskiel ◽  
Imani Thornton ◽  
Christina Copley ◽  
Dauryne Shaffer ◽  
...  
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Effective Communication ◽  
Perceived Barriers ◽  
Life Care ◽  
Icu Patients ◽  
Surgical Icu ◽  
Qualitative Exploration

scholarly journals Course and predictors of posttraumatic stress-related symptoms among family members of deceased ICU patients during the first year of bereavement

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Siew Tzuh Tang ◽  
Chung-Chi Huang ◽  
Tsung-Hui Hu ◽  
Wen-Chi Chou ◽  
Li-Pang Chuang ◽  
...  
Keyword(s):  
Social Support ◽  
Posttraumatic Stress ◽  
End Of Life ◽  
End Of Life Care ◽  
Family Members ◽  
Life Care ◽  
Ptsd Symptoms ◽  
Icu Patients ◽  
Clinically Significant ◽  
Bereaved Family

Abstract Background/Objective Death in intensive care units (ICUs) may increase bereaved family members’ risk for posttraumatic stress disorder (PTSD). However, posttraumatic stress-related symptoms (hereafter as PTSD symptoms) and their precipitating factors were seldom examined among bereaved family members and primarily focused on associations between PTSD symptoms and patient/family characteristics. We aimed to investigate the course and predictors of clinically significant PTSD symptoms among family members of deceased ICU patients by focusing on modifiable quality indicators for end-of-life ICU care. Method In this longitudinal observational study, 319 family members of deceased ICU patients were consecutively recruited from medical ICUs from two Taiwanese medical centers. PTSD symptoms were assessed at 1, 3, 6, and 13 months post-loss using the Impact of Event Scale-Revised (IES-R). Family satisfaction with end-of-life care in ICUs was assessed at 1 month post-loss. End-of-life care received in ICUs was documented over the patient’s ICU stay. Predictors for developing clinically significant PTSD symptoms (IES-R score ≥ 33) were identified by multivariate logistic regression with generalized estimating equation modeling. Results The prevalence of clinically significant PTSD symptoms decreased significantly over time (from 11.0% at 1 month to 1.6% at 13 months post-loss). Longer ICU stays (adjusted odds ratio [95% confidence interval] = 1.036 [1.006, 1.066]), financial insufficiency (3.166 [1.159, 8.647]), and reported use of pain medications (3.408 [1.230, 9.441]) by family members were associated with a higher likelihood of clinically significant PTSD symptoms among family members during bereavement. Stronger perceived social support (0.937 [0.911, 0.965]) and having a Do-Not-Resuscitate (DNR) order issued before the patient’s death (0.073 [0.011, 0.490]) were associated with a lower likelihood of clinically significant PTSD symptoms. No significant association was observed for family members’ satisfaction with end-of-life care (0.988 [0.944, 1.034]) or decision-making in ICUs (0.980 [0.944, 1.018]). Conclusions The likelihood of clinically significant PTSD symptoms among family members decreased significantly over the first bereavement year and was lower when a DNR order was issued before death. Enhancing social support and facilitating a DNR order may reduce the trauma of ICU death of a beloved for family members at risk for developing clinically significant PTSD symptoms.

Differences in Utilization of Life Support and End-of-Life Care for Medical ICU Patients With Versus Without Cancer

2017 ◽  
Vol 45 (4) ◽  
pp. e379-e383 ◽  
Author(s):  
Geoffrey Koff ◽  
Urvashi Vaid ◽  
Edward Len ◽  
Albert Crawford ◽  
David A. Oxman
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Life Support ◽  
Life Care ◽  
Icu Patients

scholarly journals Perceived Barriers to Discussing End of Life Care Planning

2019 ◽  
Author(s):  
Karen Bouchard
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Organizational Factors ◽  
Perceived Barriers ◽  
Care Planning ◽  
Life Care ◽  
Related Factors ◽  
Improvement Project ◽  
Included Patient ◽  
Eol Care

Advance care planning (ACP) related to end of life (EOL) care is an often neglected area in primary care. Nurse care managers (NCM’s) are in a unique position to initiate earlier conversations about illness management and patient preferences regarding end of life so patients have the opportunity to make choices and have their wish known while they are still cognitively independent. The purpose of this quality improvement project was to identify barriers to discussions about end of life care with patients in clinical practice. Six NCM’s participated in two focus groups to identify perceived barriers for end of life care discussions and to identify potential solutions to those barriers. Barriers identified included: patient/family factors, organizational factors, and provider related factors. NCM solutions identified included patient related interventions such as normalizing and routinizing EOL/ACP discussion reviewing choices at all ages annually. Organizational solutions recommended include making EOL care discussions a quality measure and training all office staff to support culture change. Provider related recommendations included providers completing their own advance directive as a way to lead the way for patients. Implications for education, practice, policy, and research are identified.

A Qualitative Exploration of Perceived Key Knowledge and Skills in End-of-Life Care in Dementia Patients among Medical, Nursing, and Pharmacy Students

2015 ◽  
Vol 18 (1) ◽  
pp. 56-61 ◽  
Author(s):  
Christopher M. Nguyen ◽  
Bannin De Witt Jansen ◽  
Carmel M. Hughes ◽  
Wendy Rasmussen ◽  
Michelle T. Weckmann
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Pharmacy Students ◽  
Life Care ◽  
Knowledge And Skills ◽  
Dementia Patients ◽  
Qualitative Exploration

scholarly journals Surgeons' Perceived Barriers to Palliative and End-of-Life Care: A Mixed Methods Study of a Surgical Society

2018 ◽  
Vol 21 (6) ◽  
pp. 780-788 ◽  
Author(s):  
Pasithorn A. Suwanabol ◽  
Ari C. Reichstein ◽  
Z. Tuba Suzer-Gurtekin ◽  
Jane Forman ◽  
Maria J. Silveira ◽  
...  
Keyword(s):  
Mixed Methods ◽  
End Of Life ◽  
End Of Life Care ◽  
Mixed Methods Study ◽  
Perceived Barriers ◽  
Life Care

The Experiences of Muslim Family Members of Critically Ill Patients During End-of-Life Care in Saudi Arabia: A Qualitative Phenomenological Study

2018 ◽  
Vol 29 (6) ◽  
pp. 375-381 ◽  
Author(s):  
Abbas Al Mutair ◽  
Abdulaziz Al Shaer ◽  
Fay Al Ghamdi ◽  
Arwa Al Ghamdi
Keyword(s):  
Saudi Arabia ◽  
End Of Life ◽  
Critically Ill ◽  
End Of Life Care ◽  
Phenomenological Study ◽  
Family Members ◽  
Life Care ◽  
Icu Patients ◽  
Loved One ◽  
Muslim Family

The aim of this study was to identify the needs, beliefs, and practices of Muslim family members during the end-of-life care for a family member in the intensive care unit (ICU) in Saudi Arabia. This was a phenomenological study using in-depth individual interviews to gather data. Ten family members of adult ICU patients receiving end-of-life care were interviewed. The experiences of family members during end-of-life care were reflected in four major themes: (a) the spirituality of death, (b) family’s need for information, (c) being there, and (d) the ICU environment. Participants placed high value on religious practices such as prayer, and appreciated when these practices could be accommodated in the ICU. Family participants also detailed their need for frequent communication and opportunities to ask questions about the care of their critically ill loved one. Being able to spend as much time as desired in close proximity to the critically ill patient particularly as the end of life approaches was also important, with participants suggesting that visitation times should be waived. Finally, family participant suggested that changes were needed to the ICU environment to make accommodating large families easier and more comfortable particularly when they wish to spend significant time at the bedside of their loved one. Family should be prioritized as an extension of the care provided to critically ill ICU patients, particularly those approaching end of life. A model of care should be introduced to deliver supportive and holistic care during the end-of-life care journey, supported by appropriate education regarding family care at the end of life.

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