Access Type

Open Access Dissertation

Date of Award

January 2021

Degree Type

Dissertation

Degree Name

Ph.D.

Department

Nursing

First Advisor

Margaret L. Campbell

Abstract

Background: Witnessing ventilator withdrawal and the subsequent death of a loved one in the ICU is a traumatic experience for family members, whose needs thus differ from those of other families in the ICU. Although various studies have noted the importance of preparing family members for ventilator withdrawal, based on retrospective interviews, little is known about which needs should be met, prospectively, to equip family members to witness and cope with ventilator withdrawal or about how sociodemographic characteristics affect those needs. Purpose: To prospectively determine the needs of family members who will witness a loved one undergo the process of ventilator withdrawal in the ICU, determining the effects of sociodemographic status (age, gender, race, religion, education, and previous history of witnessing death and/or ventilator withdrawal) on those needs. Theoretical framework: Self-regulation theory and its concrete–objective features were used to develop a survey with which to identify family members’ needs in response to a hypothetical scenario. Method: Using a prospective, descriptive study, data were collected using self-administered survey uploaded at Qualtrics from a sample of the university’s students, staff, and faculty. Frequency and percentage analysis were used to compute demographic data and report the important needs of family members. Multiple regression and stepwise regression were used to evaluate the potential effects of sociodemographic status on family needs. Results: sample of 109 participants were completed the survey. In analyzing participants’ needs, 11 needs statements were considered to be very important for family members. Those needs related to have regular communication with the health care team. The needs for information about expected physiological changes and the medications provided for the patient after the withdrawal process were very important. The needs for privacy, for information regarding survival time after ventilator withdrawal, and for time to say goodbyes to the dying loved one were also very important. Regression analysis indicated that White/Caucasian family members having fewer needs than other minorities. Conclusions: Determining family members’ needs prospectively will lay the foundation for developing a structured program that can guide critical care nurses in communicating with family members and addressing their needs at the end of a patient’s life.

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