Evidence map›Paper›PMID 27034436›Full record

ArticleThe American journal of hospice & palliative care2017

Decision-Making of Patients With Implantable Cardioverter-Defibrillators at End of Life: Family Members' Experiences.

Mei Ching Lee, Daniel P Sulmasy, Joseph Gallo, Joan Kub, Mark T Hughes, Stuart Russell, Anela Kellogg, Sharon G Owens, Peter Terry, Marie T Nolan

Abstract read
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In one paragraph

Article in The American journal of hospice & palliative care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Mei Ching Lee1 Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD, USA.
Daniel P Sulmasy2 School of Medicine and Divinity School, University of Chicago, Chicago, IL, USA.
Joseph Gallo3 Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Joan Kub4 School of Nursing, Johns Hopkins University, Baltimore, MD, USA.
Mark T Hughes5 School of Medicine, Johns Hopkins Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA.
Stuart Russell6 School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Anela Kellogg4 School of Nursing, Johns Hopkins University, Baltimore, MD, USA.
Sharon G Owens7 Cardiac Surgery, Johns Hopkins Hospital, Baltimore, MD, USA.
Peter Terry6 School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Marie T Nolan8 School of Nursing, Johns Hopkins Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA.

Funding

Trial of Ascertaining Individual Preferences for Loved Ones' Role in End-of-lifeR01NR010733 · NINR · JOHNS HOPKINS UNIVERSITY · PI NOLAN, MARIE T. · 2009 to 2013
$3.5M
NINR NIH HHS R01 NR010733
6 · The paper itself

Abstract

introductionMany patients with advanced heart failure (HF) experience the life-extending benefits of implantable cardioverter-defibrillators (ICD), but at the end stage of HF, patients may experience shocks with increasing frequency and change the plan for end-of-life (EOL) care including the deactivation of the ICD. This report describes family members' experiences of patients with ICD making decisions at EOL. Understanding the decision-making of patients with ICD at EOL can promote informed decision-making and improve the quality of EOL care.

methodsThis pilot study used a mixed methods approach to test the effects of a nurse-guided discussion in decision-making about ICD deactivation (turning off the defibrillation function) at the EOL. Interviews were conducted, audiotaped, and transcribed in 2012 to 2013 with 6 family members of patients with advanced HF and ICDs. Three researchers coded the data and identified themes in 2014.

resultsThree main themes described family members' experiences related to patients having HF with ICDs making health-care decision at EOL: decision-making preferences, patients' perception on ICD deactivation, and communication methods. DISCUSSION: Health-care providers need to have knowledge of patients' decision-making preferences. Preferences for decision-making include the allowing of appropriate people to involve and encourages direct conversation with family members even when advance directives is completed. Information of ICD function and the option of deactivation need to be clearly delivered to patients and family members. Education and guidelines will facilitate the communication of the preferences of EOL care.

Indexed as

Decision MakingDefibrillators, ImplantableWithholding TreatmentAdultAgedAged, 80 and overAttitude to HealthFamilyFemaleHeart FailureHumansMaleMiddle AgedPatient PreferencePilot ProjectsSurveys and Questionnairesdecision-makingend-of-lifefamilyheart failureimplantable cardioverter-defibrillators deactivationquality of life

Identifiers

PMID27034436
PMCPMC8976445

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.