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Journal of Family Nursing
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Family Management Styles Related to Withdrawal of Life-Sustaining Therapy From Adults Who Are Acutely Ill or Injured

Debra Lynn-McHale Wiegand, RN, MBE, PhD, CCRN, FAAN

University of Maryland School of Nursing, Wiegand{at}son.umaryland.edu

Janet A. Deatrick, RN, PhD, FAAN

University of Pennsylvania School of Nursing

Kathleen Knafl, PhD, FAAN

Oregon Health and Science University School of Nursing

The purpose of this study is to define family management styles (FMSs) and determine distinctive characteristics of each FMS used by families participating in the process of withdrawal of life-sustaining therapy from a family member with an unexpected, life-threatening illness or injury. A total of 56 family members of 19 families participated in interviews and observations. Data were managed and analyzed maintaining a family focus, and each family was first examined for within family patterns of management, then compared to other families to identify differing patterns. A typology of five FMSs emerged: progressing, accommodating, maintaining, struggling, and floundering. Within this typology, dimensions emerged describing the families' varying definitions of the situations, management behaviors, and consequences. FMSs were constructed through typifying how these dimensions differed across families. Understanding FMSs can aid health care providers as families are assessed and interventions are planned.

Key Words: family management style • withdrawal of life-sustaining therapy • end of life • critical care

Journal of Family Nursing, Vol. 14, No. 1, 16-32 (2008)
DOI: 10.1177/1074840707313338
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