An integrative review of how families are prepared for, and supported during withdrawal of life-sustaining treatment in intensive care

Maureen Coombs, Kristen RANSE, Roses Parker, Melissa Bloomer

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Aim: The aim of this study was to conduct an integrative review on how nurses prepare families for and support families during withdrawal of life-sustaining treatments in intensive care. Background: End-of-life care is widely acknowledged as integral to the practice of intensive care. However, little is known about what happens after the decision to withdraw life-sustaining treatments has been made and how families are prepared for death and the dying process. Design: Integrative literature review. Data sources: MEDLINE, CINAHL Plus, PsychINFO, PUBMED, Scopus, EMBASE and Web of Knowledge were searched for papers published between 2000–May 2015. Review methods: A five stage review process, informed by Whittemore and Knafl's methodology was conducted. All papers were reviewed and quality assessment performed. Data were extracted, organized and analysed. Convergent qualitative thematic synthesis was used. Results: From an identified 479 papers, 24 papers were included in this review with a range of research approaches: qualitative (n = 15); quantitative (n = 4); mixed methods (n = 2); case study (n = 2) and discourse analysis (n = 1). Thematic analysis revealed the nurses: equipped families for end of life through information provision and communication; managed the withdrawal of life-sustaining treatments to meet family need; and continued care to build memories. Conclusion: Greater understanding is needed of the language that can be used with families to describe death and dying in intensive care. Clearer conceptualization of the relationship between the medically focussed withdrawal of life-sustaining treatments and patient/family-centred end-of-life care is required making the nursing contribution at this time more visible.
Original languageEnglish
Pages (from-to)39-55
Number of pages17
JournalJournal of Advanced Nursing
Volume73
Issue number1
DOIs
Publication statusPublished - 2017

Fingerprint

Critical Care
Terminal Care
Therapeutics
Nurses
Qualitative Research
Information Storage and Retrieval
MEDLINE
Nursing
Language
Communication

Cite this

Coombs, Maureen ; RANSE, Kristen ; Parker, Roses ; Bloomer, Melissa. / An integrative review of how families are prepared for, and supported during withdrawal of life-sustaining treatment in intensive care. In: Journal of Advanced Nursing. 2017 ; Vol. 73, No. 1. pp. 39-55.
@article{3d00c97b77c048868dfb12bf039c7463,
title = "An integrative review of how families are prepared for, and supported during withdrawal of life-sustaining treatment in intensive care",
abstract = "Aim: The aim of this study was to conduct an integrative review on how nurses prepare families for and support families during withdrawal of life-sustaining treatments in intensive care. Background: End-of-life care is widely acknowledged as integral to the practice of intensive care. However, little is known about what happens after the decision to withdraw life-sustaining treatments has been made and how families are prepared for death and the dying process. Design: Integrative literature review. Data sources: MEDLINE, CINAHL Plus, PsychINFO, PUBMED, Scopus, EMBASE and Web of Knowledge were searched for papers published between 2000–May 2015. Review methods: A five stage review process, informed by Whittemore and Knafl's methodology was conducted. All papers were reviewed and quality assessment performed. Data were extracted, organized and analysed. Convergent qualitative thematic synthesis was used. Results: From an identified 479 papers, 24 papers were included in this review with a range of research approaches: qualitative (n = 15); quantitative (n = 4); mixed methods (n = 2); case study (n = 2) and discourse analysis (n = 1). Thematic analysis revealed the nurses: equipped families for end of life through information provision and communication; managed the withdrawal of life-sustaining treatments to meet family need; and continued care to build memories. Conclusion: Greater understanding is needed of the language that can be used with families to describe death and dying in intensive care. Clearer conceptualization of the relationship between the medically focussed withdrawal of life-sustaining treatments and patient/family-centred end-of-life care is required making the nursing contribution at this time more visible.",
keywords = "end of life, families, integrative review, intensive care, nursing role, treatment withdrawal",
author = "Maureen Coombs and Kristen RANSE and Roses Parker and Melissa Bloomer",
year = "2017",
doi = "10.1111/jan.13097",
language = "English",
volume = "73",
pages = "39--55",
journal = "Journal of Advanced Nursing",
issn = "0309-2402",
publisher = "Wiley-Blackwell",
number = "1",

}

An integrative review of how families are prepared for, and supported during withdrawal of life-sustaining treatment in intensive care. / Coombs, Maureen; RANSE, Kristen; Parker, Roses; Bloomer, Melissa.

In: Journal of Advanced Nursing, Vol. 73, No. 1, 2017, p. 39-55.

Research output: Contribution to journalArticle

TY - JOUR

T1 - An integrative review of how families are prepared for, and supported during withdrawal of life-sustaining treatment in intensive care

AU - Coombs, Maureen

AU - RANSE, Kristen

AU - Parker, Roses

AU - Bloomer, Melissa

PY - 2017

Y1 - 2017

N2 - Aim: The aim of this study was to conduct an integrative review on how nurses prepare families for and support families during withdrawal of life-sustaining treatments in intensive care. Background: End-of-life care is widely acknowledged as integral to the practice of intensive care. However, little is known about what happens after the decision to withdraw life-sustaining treatments has been made and how families are prepared for death and the dying process. Design: Integrative literature review. Data sources: MEDLINE, CINAHL Plus, PsychINFO, PUBMED, Scopus, EMBASE and Web of Knowledge were searched for papers published between 2000–May 2015. Review methods: A five stage review process, informed by Whittemore and Knafl's methodology was conducted. All papers were reviewed and quality assessment performed. Data were extracted, organized and analysed. Convergent qualitative thematic synthesis was used. Results: From an identified 479 papers, 24 papers were included in this review with a range of research approaches: qualitative (n = 15); quantitative (n = 4); mixed methods (n = 2); case study (n = 2) and discourse analysis (n = 1). Thematic analysis revealed the nurses: equipped families for end of life through information provision and communication; managed the withdrawal of life-sustaining treatments to meet family need; and continued care to build memories. Conclusion: Greater understanding is needed of the language that can be used with families to describe death and dying in intensive care. Clearer conceptualization of the relationship between the medically focussed withdrawal of life-sustaining treatments and patient/family-centred end-of-life care is required making the nursing contribution at this time more visible.

AB - Aim: The aim of this study was to conduct an integrative review on how nurses prepare families for and support families during withdrawal of life-sustaining treatments in intensive care. Background: End-of-life care is widely acknowledged as integral to the practice of intensive care. However, little is known about what happens after the decision to withdraw life-sustaining treatments has been made and how families are prepared for death and the dying process. Design: Integrative literature review. Data sources: MEDLINE, CINAHL Plus, PsychINFO, PUBMED, Scopus, EMBASE and Web of Knowledge were searched for papers published between 2000–May 2015. Review methods: A five stage review process, informed by Whittemore and Knafl's methodology was conducted. All papers were reviewed and quality assessment performed. Data were extracted, organized and analysed. Convergent qualitative thematic synthesis was used. Results: From an identified 479 papers, 24 papers were included in this review with a range of research approaches: qualitative (n = 15); quantitative (n = 4); mixed methods (n = 2); case study (n = 2) and discourse analysis (n = 1). Thematic analysis revealed the nurses: equipped families for end of life through information provision and communication; managed the withdrawal of life-sustaining treatments to meet family need; and continued care to build memories. Conclusion: Greater understanding is needed of the language that can be used with families to describe death and dying in intensive care. Clearer conceptualization of the relationship between the medically focussed withdrawal of life-sustaining treatments and patient/family-centred end-of-life care is required making the nursing contribution at this time more visible.

KW - end of life

KW - families

KW - integrative review

KW - intensive care

KW - nursing role

KW - treatment withdrawal

UR - http://www.scopus.com/inward/record.url?scp=84987916915&partnerID=8YFLogxK

U2 - 10.1111/jan.13097

DO - 10.1111/jan.13097

M3 - Article

VL - 73

SP - 39

EP - 55

JO - Journal of Advanced Nursing

JF - Journal of Advanced Nursing

SN - 0309-2402

IS - 1

ER -