title: Life-sustaining treatment decisions in the ICU for patients with ESLD: a prospective investigation.
abstract: We conducted a prospective study in the ICU of life-sustaining treatment and comfort care decisions over time in patients with end-stage liver disease (ESLD) from the perspectives of patients, family members, and healthcare professionals. Six patients with ESLD, 19 family members, and 122 professionals participated. The overarching theme describing the decision-making process was "on the train." Four sub-themes positioned patients and family members as passengers with limited control, unable to fully understand the decision-making process. Findings suggest that including patients and family members in non-immediate life-saving decisions and verifying early on their understanding may help to improve the decision-making process.
authors.affiliation: Oregon Health & Science University, Portland, OR 97239-2941, USA.
authors.forename: Lissi
authors.initials: L
authors.lastname: Hansen
authors.forename: Nancy
authors.initials: N
authors.lastname: Press
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Rosenkranz
authors.forename: Judith Gedney
authors.initials: JG
authors.lastname: Baggs
authors.forename: Judith
authors.initials: J
authors.lastname: Kendall
authors.forename: Amanda
authors.initials: A
authors.lastname: Kerber
authors.forename: Angel
authors.initials: A
authors.lastname: Williamson
authors.forename: Mark S
authors.initials: MS
authors.lastname: Chesnutt
mesh_terms: D000328:Adult; D058625:End Stage Liver Disease / Q000523:psychology / Q000628:therapy*; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007407:Interviews as Topic; D008297:Male; D010166:Palliative Care / Q000379:methods / Q000523:psychology; D011446:Prospective Studies; D013727:Terminal Care / Q000379:methods* / Q000523:psychology