Patient involvement in health-related decisions during prolonged critical illness†
Article first published online: 24 JUL 2007
Copyright © 2007 Wiley Periodicals, Inc.
Research in Nursing & Health
Volume 30, Issue 4, pages 361–372, August 2007
How to Cite
Happ, M. B., Swigart, V. A., Tate, J. A., Hoffman, L. A. and Arnold, R. M. (2007), Patient involvement in health-related decisions during prolonged critical illness. Res. Nurs. Health, 30: 361–372. doi: 10.1002/nur.20197
Special thanks to Michael Donahoe, MD who served as a clinical expert on this project and to Dana DeVirgilio-Thomas for assistance with data management and manuscript preparation.
- Issue published online: 24 JUL 2007
- Article first published online: 24 JUL 2007
- Manuscript Accepted: 8 DEC 2006
- NINR (to Dr. Happ). Grant Number: RO1-NR07973
- intensive care;
- critical care;
- mechanical ventilation;
- treatment decision-making;
- patient decision making
We describe patterns of communication of patients involved in health-related decision making during prolonged mechanical ventilation (PMV). Data were collected using observation, interview, and record review. Twelve of 30 patients participated in decisions about initiating, withdrawing, and withholding life-sustaining treatment, surgery, artificial feeding, financial/legal issues, discharge care, and daily care procedures. Patient involvement was largely validation or confirmation of what clinicians and families had already decided. Patients' participation was enlisted by clinicians and family members even when the patients did not exhibit full decisional capacity. Patient involvement in health-related decisions during prolonged critical illness is a shared and negotiated process that requires continued empirical study and ethical analysis. © 2007 Wiley Periodicals, Inc. Res Nurs Health 30:361–372, 2007.