Family Members' Knowledge and Attitude Toward Life-Sustaining Treatment Decisions for Patients in the Intensive Care Unit

Abstract

The decision to withhold or withdraw life-sustaining treatment (LST) lies sometimes in the hands of intensive care unit patients' families. Since 2018, family members of dying patients in South Korea have had the legal right to make decisions for the patients. This study aimed to examine knowledge and attitude toward LST among the family members of patients under intensive care since the foundation of the new legislation. Their perceptions of the roles of nurses were also explored. In this cross-sectional study, 89 participants completed survey questionnaires on demographic characteristics, relationship to patient, reason for admission, length of stay, awareness of the new legislation, knowledge and attitude toward LST, and perception of the role of nurses. The results indicated that knowledge was significantly associated with attitude and was, in fact, the only predictor of attitude toward LST ( P = .021). Explaining the disease and prognosis in detail and relieving patients of their physical pain were the roles of nurses most valued by family members. The findings suggest that it is crucial for nurses to support family members and provide information about critical changes and medical options for collaborative decision making according to the patients' wishes during the dying process.

Competencies of the nurses in the limitation of therapeutic effort in the intensive care unit: An integrative review

“… Knowledge about the patient. 5 D Kim, Sunjung, Tak, Sunghee H. 2021 [ 34 ], South Korea Quantitative transversal study 89 participants ICU of a tertiary general hospital in Seoul, South Korea This study aimed to assess knowledge about LST and examine factors influencing attitude toward LST among family members of ICU patients. Their perceptions of the role of ICU nurses were also explored.…”

Characteristics and outcomes of patients with do-not-resuscitate and physician orders for life-sustaining treatment in a medical intensive care unit: a retrospective cohort study

“…Therefore, it is important for healthcare providers to discuss POLST with both patients and families prior to ICU admission to clarify the meaning and scope of treatment. These conversations are necessary to help make sure that a patient’s end-of-life care is consistent with their wishes and values, paving the way for what can be considered a “good death” [ 34 ].…”

Intensive Care Unit Nurses' Attitudes Toward Truth-Telling, Life-Sustaining Treatment, and Decision-Making Intention for End-of-Life Patients

“…Intensive care unit nurses are directly involved in the whole process of end-of-life care for patients, so they can better understand the value of life-sustaining treatment to the lives of dying patients 17,25 . In addition, it is vital that ICU nurses support ICU patients and their families by providing detailed information during the process of life-sustaining treatment decision making 27 . Here, some nurses agreed that life-sustaining treatment could prolong patients' lives but did not fully agree that it had a positive influence of delaying patients' end-of-life and death.…”

“…17,25 In addition, it is vital that ICU nurses support ICU patients and their families by providing detailed information during the process of life-sustaining treatment decision making. 27 Here, some nurses agreed that life-sustaining treatment could prolong patients' lives but did not fully agree that it had a positive influence of delaying patients' end-of-life and death. In China, life-sustaining treatment at the end of life is given at the strong request of the family, which helps to prolong the patient's life while relieving the family's sadness and promoting the family's gradual acceptance of the fact that the patient is dying, although it is more of a prolongation of suffering for the patients themselves.…”