Family centred care before and during life-sustaining treatment withdrawal in intensive care: A survey of information provided to families by Australasian critical care nurses

Aust Crit Care. 2016 Nov;29(4):210-216. doi: 10.1016/j.aucc.2016.08.006. Epub 2016 Sep 9.

Abstract

Background: A core component of family-centred nursing care during the provision of end-of-life care in intensive care settings is information sharing with families. Yet little is known about information provided in these circumstances.

Objective: To identify information most frequently given by critical care nurses to families in preparation for and during withdrawal of life-sustaining treatment.

Design: An online cross-sectional survey.

Methods: During May 2015, critical care nurses in Australia and New Zealand were invited to complete the Preparing Families for Treatment Withdrawal questionnaire. Data analysis included descriptive statistics to identify areas of information most and least frequently shared with families. Cross tabulations with demographic data were used to explore any associations in the data.

Results: From the responses of 159 critical care nurses, information related to the emotional care and support of the family was most frequently provided to families in preparation for and during withdrawal of life-sustaining treatment. Variation was noted in the frequency of provision of information across body systems and their associated physical changes during the dying process. Significant associations (p<0.05) were identified between the variables gender, nursing experience and critical care experiences and some of the information items most and least frequently provided.

Conclusions: The provision of information during end-of-life care reflects a family-centred care approach by critical care nurses with information pertaining to emotional care and support of the family paramount. The findings of this study provide a useful framework for the development of interventions to improve practice and support nurses in communicating with families at this time.

Keywords: Communication; Critical care; End of life care; Family centred care; Intensive care; Nurse; Survey; Withdrawal of treatment.

MeSH terms

  • Adult
  • Attitude to Death
  • Australia
  • Communication
  • Critical Care Nursing / methods*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Intensive Care Units
  • Male
  • New Zealand
  • Nursing Staff, Hospital / psychology*
  • Professional-Family Relations*
  • Surveys and Questionnaires
  • Terminal Care / psychology*
  • Withholding Treatment*