title: Family management styles related to withdrawal of life-sustaining therapy from adults who are acutely ill or injured.
abstract: The purpose of this study is to define family management styles (FMSs) and determine distinctive characteristics of each FMS used by families participating in the process of withdrawal of life-sustaining therapy from a family member with an unexpected, life-threatening illness or injury. A total of 56 family members of 19 families participated in interviews and observations. Data were managed and analyzed maintaining a family focus, and each family was first examined for within family patterns of management, then compared to other families to identify differing patterns. A typology of five FMSs emerged: progressing, accommodating, maintaining, struggling, and floundering. Within this typology, dimensions emerged describing the families' varying definitions of the situations, management behaviors, and consequences. FMSs were constructed through typifying how these dimensions differed across families. Understanding FMSs can aid health care providers as families are assessed and interventions are planned.
authors.affiliation: University of Maryland School of Nursing, North Wales, PA 19454, USA. Wiegand@son.umaryland.edu
authors.forename: Debra Lynn-McHale
authors.initials: DL
authors.lastname: Wiegand
authors.forename: Janet A
authors.initials: JA
authors.lastname: Deatrick
authors.forename: Kathleen
authors.initials: K
authors.lastname: Knafl
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D001601:Bereavement; D016638:Critical Illness / Q000628:therapy; D003657:Decision Making; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D008016:Life Change Events; D008020:Life Support Care / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D015404:Nursing Methodology Research; D011446:Prospective Studies; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D028761:Withholding Treatment; D014947:Wounds and Injuries / Q000628:therapy