Feasibility of an Intervention Study to Support Families When Their Loved One Has Life-sustaining Therapy Withdrawn.
Barbara Scharf, Shijun Zhu, Sarah Tomlin and 4 others
PMID 33284144WHAT IT FOUND
Families recalled a plain-language booklet and comfort items after withdrawal, but too few completed follow-up to test whether usual care, booklet, nurse support, and comfort items reduced stress.
Key findings
01Only 17 of 29 family members completed follow-up, and attrition was 41%, so group differences could not be tested.
0214 of 17 family members recalled the booklet, and some found it helpful while others said they could not absorb information.
03Not every family chose each comfort cart item. Some remembered water (6 of 10), tissues (6 of 9), a lock of hair (4 of 5), or hand molds (6 of 8).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Recruitment was difficult: 54 families were asked, and 22 patients with 29 family members consented. Attrition was 41%, leaving too few people at follow-up to test group differences. The intervention group received usual ICU care, a booklet, comfort cart items, and nurse psychological support together, so the contribution of any one component cannot be separated. Control families also received the booklet, so any difference between groups would not isolate the comfort cart or nurse support. The study was done in one ICU and required English-speaking families. Timing of consent was challenging when withdrawal decisions happened in the evening or unexpectedly.
Declared interests
The article is listed as supported by NIH extramural research. No conflict-of-interest declaration is provided.
The easy way to misread this
Do not conclude that the comfort cart or nurse support reduced family stress. The study did not statistically compare groups, and families in the intervention arm also received usual ICU care and the booklet.