title: Nursing strategies to support family members of ICU patients at high risk of dying.
abstract: OBJECTIVE
  To explore how family members of ICU patients at high risk of dying respond to nursing communication strategies.
  
  
  BACKGROUND
  Family members of ICU patients may face difficult decisions. Nurses are in a position to provide support. Evidence of specific strategies that nurses use to support decision-making and how family members respond to these strategies is lacking.
  
  
  METHODS
  This is a prospective, qualitative descriptive study involving the family members of ICU patients identified as being at high risk of dying.
  
  
  RESULTS
  Family members described five nursing approaches: Demonstrating concern, building rapport, demonstrating professionalism, providing factual information, and supporting decision-making. This study provides evidence that when using these approaches, nurses helped family members to cope; to have hope, confidence, and trust; to prepare for and accept impending death; and to make decisions.
  
  
  CONCLUSIONS
  Knowledge lays a foundation for interventions targeting the areas important to family members and most likely to improve their ability to make decisions and their well-being.
authors.affiliation: Durham VAMC, 508 Fulton Street, Durham, NC 27705, USA; Duke University School of Nursing, 307 Trent Drive, DUMC 3322, Durham, NC 27710, USA. Electronic address: judith.adams@duke.edu.
authors.forename: Judith A
authors.initials: JA
authors.lastname: Adams
authors.affiliation: Duke University School of Nursing, 307 Trent Drive, DUMC 3322, Durham, NC 27710, USA.
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Anderson
authors.affiliation: Duke University School of Nursing, 307 Trent Drive, DUMC 3322, Durham, NC 27710, USA.
authors.forename: Sharron L
authors.initials: SL
authors.lastname: Docherty
authors.affiliation: Duke Medicine and Nursing, Duke Palliative Care, DUMC 2706, Durham, NC 27710, USA.
authors.forename: James A
authors.initials: JA
authors.lastname: Tulsky
authors.affiliation: Duke Medicine, Durham VAMC, 508 Fulton Street, Durham, NC 27705, USA.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Steinhauser
authors.affiliation: Duke University School of Nursing, 307 Trent Drive, DUMC 3322, Durham, NC 27710, USA.
authors.forename: Donald E
authors.initials: DE
authors.lastname: Bailey
mesh_terms: D000328:Adult; D000368:Aged; D001293:Attitude to Death; D003142:Communication; D003657:Decision Making; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role; D011368:Professional-Family Relations; D011446:Prospective Studies; D035502:Trust; D055815:Young Adult
keywords: Critical care; End-of-life; Family members; Nursing communication; Palliative care