Wiegand Debra
University of Maryland School of Nursing, Baltimore, MD 21201, USA.
J Palliat Med. 2008 Oct;11(8):1115-21. doi: 10.1089/jpm.2008.0015.
Withdrawal of life-sustaining therapy (LST) occurs commonly in critical care units, yet little is known about the family experience with this process. The purpose of this study was to understand the lived experience of families participating in the process of withdrawal of LST from a family member with an unexpected, life-threatening illness or injury. A hermeneutic phenomenological approach was used as nineteen families were interviewed and observed. Within and across family analyses were conducted. Methodological rigor was established and redundancy was achieved. The categories that evolved from the data included: this happens to other families, time to understand the severity of the illness or injury, time to see if health would be restored, riding a roller coaster, family readiness: willingness to consider withdrawal of LST as a possible option, one step at a time, family readiness: time to make a decision, the family will go on, and waiting for a miracle. The family experience participating in the process of withdrawal of LST happened for families "in their own time." The results of this study have important implications for clinical practice and future research.
在重症监护病房,撤除维持生命治疗(LST)的情况很常见,但对于家属在这一过程中的经历却知之甚少。本研究的目的是了解参与从患有意外危及生命疾病或损伤的家庭成员身上撤除LST过程的家庭的实际经历。采用诠释现象学方法,对19个家庭进行了访谈和观察。进行了家庭内部和家庭之间的分析。确立了方法的严谨性并实现了冗余。从数据中得出的类别包括:这种事发生在其他家庭身上、了解疾病或损伤严重程度的时间、观察健康是否会恢复的时间、坐过山车、家庭准备情况:愿意将撤除LST视为一种可能的选择、一步一个脚印、家庭准备情况:做出决定的时间、家庭会继续下去、等待奇迹。参与撤除LST过程的家庭经历是在“他们自己的时间”里发生在家庭身上的。本研究结果对临床实践和未来研究具有重要意义。