Date of Award
August 2024
Degree Type
Dissertation
Degree Name
Doctor of Philosophy
Department
Nursing
First Advisor
Julie Ellis
Committee Members
Natalie McAndrew, Maureen Greene, Anika Wilson
Keywords
African Americans, End of Life, Intensive Care Unit, Surrogate Decision Makers
Abstract
Background: Healthcare disparities are a significant problem in the U.S., particularly among African Americans and is evident in the increased usage of more aggressive end-of-lifecare in the intensive care unit and a lesser propensity for hospice or palliative care. These disparities have the potential to cause additional suffering for patients and place a burden upon families who act as surrogate decision makers.Aim and objectives: To gain an understanding of the end-of-life decision making experiences of African American surrogate decision makers regarding interactions with nurses. To analyze how communication between nurses and AA end-of-life decision makers impacts treatment preferences and to describe how interactions with ICU nurses affect the quality of end-of-life. Methods: A qualitative study using narrative inquiry through one-on-one interviews 30 African Americans was conducted. Analysis and Results: Inductive and deductive data analysis using a critical race lens was conducted using a process called ‘Framework’ Four themes were identified with subthemes including racism and its impact on the perception of hospital reputation among AA, structural/institutional racism, unconscious bias, medical mistrust, health and health system literacy, and of recognition of the non-nuclear family. Recommendations: Further study is needed about African American patients and families during end-of-life decision making in the ICU to guide nurses into using a more culturally sensitive approach.
Recommended Citation
Warczak, Leslie, "END-OF-LIFE DECISION MAKING FOR SURROGATE DECISION MAKERS IN THE INTENSIVE CARE UNIT AND IMPLICATIONS FOR NURSING PRACTICE" (2024). Theses and Dissertations. 3635.
https://dc.uwm.edu/etd/3635