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End-of-Life Decision-Making Experiences and Influencing Factors Reported by Intensive Care Unit Medical and Nursing Staff Members in Southwestern China: A Qualitative Study

MengJie, Liu MD; HouXiu, Zhou MD; ChangBi, Lu BSc; FuYu, Han MD; SiLin, Zheng BSc; JingCi, Zhu BSc

Journal of Hospice & Palliative Nursing: December 2015 - Volume 17 - Issue 6 - p 544–550
doi: 10.1097/NJH.0000000000000196
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End-of-life decision making precedes many deaths in intensive care units (ICUs). In China, there are no guidelines for end-of-life decision making, and information on the frequency of such decisions is scarce. This article aimed to understand the end-of-life decision-making experiences and the influencing factors of 15 medical and nursing staff members from the general ICU department of a grade 3 hospital of Luzhou, Sichuan. We used the phenomenological method of qualitative research to explore the factors influencing end-of-life decision making through the experiences of participants. Data collection continued until information saturation was achieved. The factors affecting the end-of-life decision-making experience of ICU medical and nursing staff members included a negative physician-patient relationship associated with mistrust and potential conflict, a lack of awareness of palliative care, restrictive health policies, and economic factors. The main factors affecting the end-of-life decision making of ICU medical and nursing staff members were the economic conditions of the patient and current health care legislation. An effective coping mechanism should be established based on medical, economic, legal, and educational fields to normalize end-of-life decision making on the basis of a standard procedure and laws to effectively protect the interests of medical and nursing staff members as well as patients and their families.

Liu MengJie, MD, is nurse teacher, School of Nursing, Third Military Medical University, Chongqing, and Intensive Care Unit, The Affiliated Hospital of Luzhou Medical College, Sichuan, China.

Zhou HouXiu, MD, is nurse teacher, School of Nursing, Third Military Medical University, Chongqing, China.

Lu ChangBi, BSc, is ICU head nurse, Intensive Care Unit, The Affiliated Hospital of Luzhou Medical College, Sichuan, China

Han FuYu, MD, is nurse teacher, School of Nursing, Third Military Medical University, Chongqing, China.

Zheng SiLin, BSc, is director, Department of Nursing, The Affiliated Hospital of Luzhou Medical College, Sichuan, China.

Zhu JingCi, BSc, is nurse teacher, School of Nursing, Third Military Medical University, Chongqing, China.

Address correspondence to Zhu JingCi, BSc, No. 30 GaoTanYan Central St, ShaPingBa District, ChongQing, China 400038 (zhujingci2009@163.com).

L.M.J. and Z.H.X are co–first authors.

This study was supported by Luzhou Science and Technology Bureau of Sichuan Province (grant 2014-S-45[10/12]).

The authors have no conflicts of interest to disclose.

© 2015 by The Hospice and Palliative Nurses Association.