Interdisciplinary Family Meetings with Structured Debriefings Are Effective to Educate Surgical Residents in Palliative Care Communication Skills (FR408-A)

Abstract

Background. Life-sustaining therapy is commonly withdrawn in intensive care units, yet little is known about the perceptions of families when a critically ill patient dies after life-sustaining treatment is withdrawn. Research Objectives. The purpose of this study was to understand the lived experience of families when a family member who had an unexpected life-threatening illness or injury died after life-sustaining therapy was withdrawn. Methods. A hermeneutic phenomenological study was conducted. Family members were interviewed 1-2 years after the patient’s death. All patients died in the critical care setting. Each interview was audiotaped. All interview transcripts were transcribed with units of meaning and clusters, and then categories were inductively determined. Within and across family analyses were conducted. Methodological rigor was established. Results. Twenty-two family members participated in the study. The categories that evolved from the data included: preparing for the dying process, the dying environment, perceptions of patient comfort, the death vigil, and essential aspects of care. Some families felt better prepared than others for the dying process. Families also had varying views of their family members’ level of comfort. Families described the death vigil as extremely difficult. Family members described several aspects of nursing care that were very meaningful to them during the dying process. Families described how important it was for the family to be together as a family during the dying process. Conclusions. Families need to be prepared, guided, and supported through the dying process. Healthcare providers need to provide quality end-of-life care to patients and families before and after the withdrawal of life-sustaining therapy. Implications for research, policy, or practice. Families need to be encouraged to take family leave and to ask support from their employers so that they can be present during the dying process of a loved one. Clinicians need to prepare families for what to expect before and during the active phase of dying. Additional research needs to be conducted to further understand what helps to prepare families for the dying process. Interdisciplinary Family Meetings with Structured Debriefings Are Effective to Educate Surgical Residents in Palliative Care Communication Skills (FR408-A) Sangeeta Lamba, MD, Rutgers New Jersey Medical School, Newark, NJ. Leslie Tyrie, MD, Rutgers New Jersey Medical School, Newark, NJ. Anne Mosenthal, MD FACS, Rutgers New Jersey Medical School, Newark, NJ. Janet Smith. (All authors listed above had no relevant financial relationships to disclose.)