Family experiences participating in the process of withdrawal of life sustaining therapy.

Format:

Book

Thesis/Dissertation

Author/Creator:

Wiegand, Debra Lynn-McHale.

Contributor:

University of Pennsylvania.

Language:

English

Subjects (All):

Nursing.

0569.

Local Subjects:

0569.

Physical Description:

218 pages

Contained In:

Dissertation Abstracts International 64-06B.

System Details:

Mode of access: World Wide Web.

text file

Summary:

Little is known about withdrawing life sustaining therapy from patients with acute illnesses. The purpose of this study was to describe this experience for families participating in the process of withdrawal of life sustaining therapy from a family member with an unexpected, life threatening illness or injury. Using a family symbolic interactionism theoretical framework and a hermeneutic phenomenological perspective, this study sought to answer the question: What do families experience during the process of withdrawal of life sustaining therapy from a family member with an unexpected, life threatening illness or injury?

Van Manen's (1984) phenomenological method of qualitative research was used. This method allowed the researcher and the family members to mutually commit to describing the phenomenon being studied. Interviews were conducted with family members and observation techniques were employed. Multiple interviews and observations occurred over a period of days to weeks as families participated in the process of withdrawal of life sustaining therapy. Four critical care units of a metropolitan medical center were used for data collection. Theoretical purposive sampling was used to obtain families with a variety of experiences. Nineteen families and 56 family members were included in the study. Families were enrolled into the study until data saturation was reached. All interview transcripts and field notes were transcribed. Units of meaning, clusters, then categories were inductively determined from each line of recorded data. Within and across case analyses were conducted. Methodological rigor was established.

The study found that the family experience involves a variety of dimensions including personal issues within the family, family issues specifically related to having an ill or injured family member with a life threatening illness or injury, family issues with health care providers, family issues with the health care system, and bioethical issues. Five qualitatively distinct styles of family management were evident in this sample of families and were the overarching ways in which families participated in the process of withdrawal of life sustaining therapy: progressing, accommodating, maintaining, struggling, and floundering. The results of this study have important implications for future research and clinical practice regarding withdrawal of life sustaining therapy.

Notes:

Source: Dissertation Abstracts International, Volume: 64-06, Section: B, page: 2599.

Supervisor: Janet A. Deatrick.

Thesis (Ph.D.)--University of Pennsylvania, 2003.

Local Notes:

School code: 0175.

ISBN:

9780496435845

Access Restriction:

Restricted for use by site license.