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Titolo:
Conflict associated with decisions to limit life-sustaining treatment in intensive care units
Autore:
Breen, CM; Abernethy, AP; Abbott, KH; Tulsky, JA;
Indirizzi:
Vet Adm Med Ctr, Program Med Encounter & Palliat Care, Durham, NC 27705 USA Vet Adm Med Ctr Durham NC USA 27705 & Palliat Care, Durham, NC 27705 USA Duke Univ, Dept Pathol, Durham, NC 27706 USA Duke Univ Durham NC USA 27706 uke Univ, Dept Pathol, Durham, NC 27706 USA Duke Univ, Dept Med, Ctr Study Aging & Human Dev, Durham, NC 27706 USA Duke Univ Durham NC USA 27706 udy Aging & Human Dev, Durham, NC 27706 USA Duke Univ, Inst Care End Life, Durham, NC 27706 USA Duke Univ Durham NC USA 27706 v, Inst Care End Life, Durham, NC 27706 USA
Titolo Testata:
JOURNAL OF GENERAL INTERNAL MEDICINE
fascicolo: 5, volume: 16, anno: 2001,
pagine: 283 - 289
SICI:
0884-8734(200105)16:5<283:CAWDTL>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
CRITICALLY ILL; SUPPORT; WITHDRAWAL; FAMILIES; PHYSICIANS; ETHICS;
Keywords:
conflict (psychology); terminal care; decision making; life support care; resuscitation orders;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
35
Recensione:
Indirizzi per estratti:
Indirizzo: Tulsky, JA Vet Adm Med Ctr, Program Med Encounter & Palliat Care, Durham, NC 27705 USA Vet Adm Med Ctr Durham NC USA 27705 Care, Durham, NC 27705 USA
Citazione:
C.M. Breen et al., "Conflict associated with decisions to limit life-sustaining treatment in intensive care units", J GEN INT M, 16(5), 2001, pp. 283-289

Abstract

OBJECTIVE: To determine the incidence and nature of interpersonal conflicts that arise when patients in the intensive care unit are considered for limitation of life-sustaining treatment. DESIGN: Qualitative analysis of prospectively gathered interviews. SETTING: Six intensive care units at a university medical center. PARTICIPANTS: Semistructured interviews addressed disagreement during life-sustaining treatment decision making. Two raters coded transcripts of the audiotaped interviews. MAIN RESULTS: At least 1 health care provider in 78% of the cases described a situation coded as conflict. Conflict occurred between the staff and family members in 48% of the cases, among staff members in 48%, and among family members in 24%. In 63% of the cases, conflict arose over the decision about life-sustaining treatment itself. In 45% of the cases, conflict occurred over other tasks such as communication and pain control. Social issues caused conflict in 19% of the cases. CONCLUSIONS: Conflict is more prevalent in the setting of intensive care decision making than has previously been demonstrated. While conflict over the treatment decision itself is most common, conflict over other issues, including social issues, is also significant. By identifying conflict and by recognizing that the treatment decision may not be the only conflict present, or even the main one, clinicians may address conflict more constructively.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 23/09/20 alle ore 09:01:27