TY - JOUR
T1 - Humanity behind the intention of primary caregiver to choose withdrawing life-sustaining treatment for terminating patients
AU - Chen, Ya Chin
AU - Loh, El Wui
AU - Huang, Tsai Wei
N1 - Funding Information:
We are grateful to the patients and their caregivers who allowed us to record and analyze these profoundly difficult conversations. This manuscript was edited by Wallace Academic Editing.
Publisher Copyright:
© 2020 Elsevier B.V.
PY - 2020/12/1
Y1 - 2020/12/1
N2 - Objective: Mechanical ventilation, a measure of life-sustaining treatment (LST), may not be helpful and can be devastating for patients with terminal illness. We explored the effects of demographic characteristics, attitude, subjective norms, and perceived behavioral control on the behavioral intentions of primary caregivers to withdraw LST of long-term ventilator-dependent patients. Methods: Primary caregivers of ventilator-dependent patients in the respiratory care units of six hospitals participated in the study. A cross-sectional design including the domains of attitude, subjective norms, perceived behavioral control, and behavioral intention was adopted. Results: Valid data for 99 participants were analyzed using logistic regression. Religious belief, a spousal relationship with the patient, item 5 in subjective norms, and item 5 in perceived behavioral control positively influenced the intention to withdraw patient LST. Conclusions: Religious beliefs, a spousal relationship, perceived behavioral control (confidence in relieving patient suffering), and the opportunity of current favorable subjective norms are major determinants of the intention to withdraw patients’ LST. Practice Implications: Shared decision-making with the kin and primary caregivers of long-term ventilator-dependent patients at the end of life is crucial.
AB - Objective: Mechanical ventilation, a measure of life-sustaining treatment (LST), may not be helpful and can be devastating for patients with terminal illness. We explored the effects of demographic characteristics, attitude, subjective norms, and perceived behavioral control on the behavioral intentions of primary caregivers to withdraw LST of long-term ventilator-dependent patients. Methods: Primary caregivers of ventilator-dependent patients in the respiratory care units of six hospitals participated in the study. A cross-sectional design including the domains of attitude, subjective norms, perceived behavioral control, and behavioral intention was adopted. Results: Valid data for 99 participants were analyzed using logistic regression. Religious belief, a spousal relationship with the patient, item 5 in subjective norms, and item 5 in perceived behavioral control positively influenced the intention to withdraw patient LST. Conclusions: Religious beliefs, a spousal relationship, perceived behavioral control (confidence in relieving patient suffering), and the opportunity of current favorable subjective norms are major determinants of the intention to withdraw patients’ LST. Practice Implications: Shared decision-making with the kin and primary caregivers of long-term ventilator-dependent patients at the end of life is crucial.
KW - End of life
KW - Life-sustaining treatment
KW - Planned behavior
KW - Shared decision-making
KW - Ventilator-dependent patients
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U2 - 10.1016/j.pec.2020.06.011
DO - 10.1016/j.pec.2020.06.011
M3 - Article
C2 - 32561315
AN - SCOPUS:85086506204
SN - 0738-3991
VL - 103
SP - 2477
EP - 2482
JO - Patient Education and Counseling
JF - Patient Education and Counseling
IS - 12
ER -