The factors related to the decision-making made by family members in emergency medical situations : from family nursing perspective

Abstract

The purpose of this study was to explore the confidence levels of family members' decisions for medical care of gravely ill patients and the factors related to those confidence levels. Based on past research and the theory of decision-making 11 factors related to the confidence levels were identified. A qualitative study was conducted on five participants who made decisions for their family members who had cerebral vascular disorder (Glasgow Coma Scale 7-14). Using participant observation and semi-structured interview methods, we collected data regarding the states of the decision-making made by family members and analyzed the levels of confidence in their decision-makings and the 11 factors qualitatively. The results revealed that participants showed high level of confidence in four decision-making situations and low level of confidence in five situations. It was suggested that high levels of confidence in the decision-makings were related to the following six factors : 1) conditions of the patient, 2) family member's psychological stability at the time of making the decision, 3) time allowed to make the decision, 4) seeing the patient before making the decision, 5) family member's trust in the medical and nursing staff, and 6) no coercing in the physician's explanation regarding decision-making. The results indicated some strategies for nursing care and support procedures to assist family members making decisions with confidence under difficult emergency medical situations.