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Learning Objective 1: Through exposion to legal guardian (LG) point of view over the decision making process the learner will be able to understand better LGs' difficulties
Learning Objective 2: The learner will be able to improve current strategies of surrogate decision making
Introduction: ICU patients frequently undergo non life-saving invasive procedures. When patient informed consent cannot be obtained, legal guardianship (LG) often from a close relative may be required by law. The objective of this descriptive study was to investigate the attitudes of LG of ventilated ICU patients regarding the process of decision making for invasive non life-saving procedures.
Three questionnaires were administered: a demographic data questionnaire, the Family Satisfaction with ICU 34 Questionnaire, (Heyland & Tranmer, 2001) and the Attitudes towards the LG Decision Making Process questionnaire, developed by the authors. The study was conducted in general medical and surgical ICUs in two large Israeli medical centers. Questionnaires were delivered by the researcher after LGs' appointment and informed consents verification.
Results: The sample consisted of 64 LGs who were appointed with full family support. Participants were 49.2 (±11.22) years of age, 33 (51.6%) were males, most were married (n=56, 87.5%), had high school (n=24, 37.5%) or college (n=19, 29.7%) education. Majority of the procedures performed were tracheotomies (n=63, 98.4%). Most LGs preferred decisions to be taken by the medical staff after consulting with them (n= 42, 65.6%) and stated that decisions could be made without the need of a LG (n=37, 57.8%). “Consistency” and “Understanding” of information got lower satisfaction percent than other parameters (only 67.2% and 68.7% respectfully). The majority of the LGs were not aware (48.6%, N=30) or were not sure (37.5% N=24) of the patients’ preferences regarding invasive procedures.
Conclusions: The legal guardianship process entails difficulties especially in the fields of communication with the medical staff, support mechanisms for family members and difficulties in decision making for unconscious relatives. There is a need for communication improvement between the medical staff, and LGs especially in providing more consistent and understandable information.
See more of: World Academy of Nursing Science: Oral Paper & Posters