title: Preparing families of intensive care patients for withdrawal of life support: a pilot study.
abstract: BACKGROUND
  Most deaths in intensive care occur after withdrawal of life support. Although preparation of patients' families is recommended, the specific information required has not been theoretically developed or tested.
  
  
  OBJECTIVE
  To assess the feasibility of testing 4 tailored messages to prepare families of patients having a planned withdrawal of life support, to assess barriers to conducting such a study, and to obtain preliminary data on measurable effects that could be used to compare such preparation with usual care. Self-regulation theory was used to structure the messages.
  
  
  METHODS
  Families were randomly assigned to usual care (n=10) or to an intervention group (n=10) that received 1 of 4 tailored messages to prepare them for withdrawal of life support. They were contacted 2 to 4 weeks later to complete the Profile of Mood States and to give their evaluation of the experience, inclusive of the information received.
  
  
  RESULTS
  Compared with the usual-care group, the intervention group was significantly more satisfied with the information they received and understood better what was to happen. The intervention group had lower negative mood scores and higher positive mood scores than did the usual-care group, although the difference was not significant. Unsolicited comments by the usual-care participants were requests for the specific information that had been received by the intervention group.
  
  
  CONCLUSIONS
  The information provided was considered helpful. A larger sample might yield more significant differences. Further work is needed on other aspects of preparation such as healthcare support, spiritual issues, and preparation for funeral arrangements.
authors.affiliation: School of Nursing, University of Wisconsin, Madison, WI 53792, USA. ktkirchhoff@wisc.edu
authors.forename: Karin T
authors.initials: KT
authors.lastname: Kirchhoff
authors.forename: Jenna
authors.initials: J
authors.lastname: Palzkill
authors.forename: Jennifer
authors.initials: J
authors.lastname: Kowalkowski
authors.forename: Anne
authors.initials: A
authors.lastname: Mork
authors.forename: Elfa
authors.initials: E
authors.lastname: Gretarsdottir
mesh_terms: D000368:Aged; D003258:Consumer Behavior; D022143:Family Nursing; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008020:Life Support Care; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011368:Professional-Family Relations; D014922:Wisconsin; D028761:Withholding Treatment