Family perceptions of ICU nurses' interpersonal communication at EOL

Adams, Judith A.

Saturday, 16 November 2013

Judith A. Adams, MSn, RN,
School of Nursing, Duke University, Durham, NC

Learning Objective 1: 1. To identify opportunities for nurses to become more engaged in the process of transition from curative to palliative care

Learning Objective 2: 2. To understand the association between the strength of the nurse-FM relationship and the use of strategies to support decision-making.

Background: Family members of patients who die in the ICU face tremendous burden. Nurses are in a unique position to provide support to family members during this time. The literature provides ample studies of how ICU nurses perceive they are involved with family members during EOL decision-making. However, the literature does not address family members’ perceptions of the specific interpersonal communication strategies that nurses use and whether these are helpful. The proposed study will build on prior work by exploring in greater depth the specific interpersonal communication strategies that family members perceive nurses use and how family members respond to these strategies.

Purpose. In this study, I am exploring how family members respond to nursing interpersonal communication strategies with family members of patients in the ICU deemed to be at high risk of dying and needing complex decision-making, including family members perceptions of the strategies, how these strategies change over the trajectory of decision-making, and how these strategies affect their ability to make decisions consistent with the goals of the patient.

Methods: In this prospective, longitudinal, qualitative descriptive study, I will identify ICU patients who are likely to need complex decision-making and use narrative style interviewing techniques to explore the family members’ perceptions of the interpersonal communication strategies nurses use and the effectiveness of these strategies. Participants will be recruited from two16 bed adult ICUs at Duke Hospital, a tertiary care university hospital system.

Summary: Findings from this study will provide knowledge for developing interventions targeting the areas identified as important by family members, most likely to improve their well being, and feasible in ICU environment. With this knowledge, nurses will be able to interact with families based on empirical data to support family members as they make decisions that are consistent with the patient’s goals.

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