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Patient involvement in health‐related decisions during prolonged critical illness
Author(s) -
Happ Mary Beth,
Swigart Valerie A.,
Tate Judith A.,
Hoffman Leslie A.,
Arnold Robert M.
Publication year - 2007
Publication title -
research in nursing and health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.836
H-Index - 85
eISSN - 1098-240X
pISSN - 0160-6891
DOI - 10.1002/nur.20197
Subject(s) - medicine , critical illness , patient participation , health care , family medicine , nursing , psychology , intensive care medicine , critically ill , economics , economic growth
We describe patterns of communication of patients involved in health‐related decision making during prolonged mechanical ventilation (PMV). Data were collected using observation, interview, and record review. Twelve of 30 patients participated in decisions about initiating, withdrawing, and withholding life‐sustaining treatment, surgery, artificial feeding, financial/legal issues, discharge care, and daily care procedures. Patient involvement was largely validation or confirmation of what clinicians and families had already decided. Patients' participation was enlisted by clinicians and family members even when the patients did not exhibit full decisional capacity. Patient involvement in health‐related decisions during prolonged critical illness is a shared and negotiated process that requires continued empirical study and ethical analysis. © 2007 Wiley Periodicals, Inc. Res Nurs Health 30:361–372, 2007.