Abstract
BackgroundFamily members experience decision-making conflicts regarding changes in patient care. If the medical team does not attempt to understand the family members' awareness of palliative care, family members may experience medical decision-making stress and dilemmas. This study examined the decision-making conflicts of the family members of patients dependent on prolonged mechanical ventilator regarding palliative care in Taiwan.MethodsA cross-sectional design was used in this study. Family members of such patients in the subacute respiratory care ward and the respiratory intensive care unit of a medical center in Taiwan were recruited. A structured questionnaire was used to collect data.ResultsAmong the family members of the 127 patients included, 57.5% hesitated to make palliative medical decisions and 61.4% experienced palliative medical decision conflicts. The absence of other chronic diseases, family members' inability to accept the movement of patients to palliative care, and family members' hesitation in palliative care medical decision-making resulted in decision-making conflicts. In this study, 127 prolonged mechanical ventilation-dependent patients (PMVDP) and their family members were examined. The results revealed that family members experienced palliative care medical decision-making difficulties (61.40% = <2.5). Predictors of palliative care decision-making conflict for PMVDP and their family members included the following: absence of other comorbid chronic diseases, the inability of family to accept palliative care on behalf of patients, and hesitation in palliative care medical decision-making by family members.ConclusionThe study results are able to help Taiwanese medical staff in evaluating such conflicts and palliative care medical decisions of PMVDP.