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An integrative review of how families are prepared for, and supported during withdrawal of life-sustaining treatment in intensive care

Coombs, Maureen A., Parker, Roses, Ranse, Kristen, Endacott, Ruth and Bloomer, Melissa J. 2017, An integrative review of how families are prepared for, and supported during withdrawal of life-sustaining treatment in intensive care, Journal of advanced nursing, vol. 73, no. 1, pp. 39-55, doi: 10.1111/jan.13097.

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Title An integrative review of how families are prepared for, and supported during withdrawal of life-sustaining treatment in intensive care
Author(s) Coombs, Maureen A.
Parker, Roses
Ranse, Kristen
Endacott, Ruth
Bloomer, Melissa J.ORCID iD for Bloomer, Melissa J. orcid.org/0000-0003-1170-3951
Journal name Journal of advanced nursing
Volume number 73
Issue number 1
Start page 39
End page 55
Total pages 17
Publisher Wiley-Blackwell
Place of publication Chichester, Eng.
Publication date 2017-01
ISSN 0309-2402
1365-2648
Keyword(s) end of life
families
integrative review
intensive care
nursing role
treatment withdrawal
Summary AIM: To conduct an integrative review on how nurses prepare families for and support families during withdrawal of life-sustaining treatments in intensive care.

BACKGROUND: End-of-life care is widely acknowledged as integral to the practice of intensive care. However, little is known about what happens after the decision to withdraw life-sustaining treatments has been made and how families are prepared for death and the dying process.

DESIGN: Integrative literature review.

DATA SOURCES: MEDLINE, CINAHL Plus, PsychINFO, PUBMED, Scopus, EMBASE and Web of Knowledge were searched for papers published between 2000 - May 2015.

REVIEW METHODS: A five stage review process, informed by Whittemore and Knafl's methodology was conducted. All papers were reviewed and quality assessment performed. Data were extracted, organised and analysed. Convergent qualitative thematic synthesis was used.

RESULTS: From an identified 479 papers, 24 papers were included in this review with a range of research approaches: qualitative (n=15); quantitative (n=4); mixed methods (n=2); case study (n=2); and discourse analysis (n=1). Thematic analysis revealed the nurses: equipped families for end of life through information provision and communication; managed the withdrawal of life-sustaining treatments to meet family need; and continued care to build memories.

CONCLUSION: Greater understanding is needed of the language that can be used with families to describe death and dying in intensive care. Clearer conceptualisation of the relationship between the medically focussed withdrawal of life-sustaining treatments and patient/family centred end-of-life care is required making the nursing contribution at this time more visible.
Language eng
DOI 10.1111/jan.13097
Field of Research 111099 Nursing not elsewhere classified
1110 Nursing
Socio Economic Objective 920210 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, John Wiley & Sons
Free to Read? No
Free to Read Start Date 2018-02-01
Persistent URL http://hdl.handle.net/10536/DRO/DU:30085640

Document type: Journal Article
Collection: School of Nursing and Midwifery
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