booklet, comfort cart, end of life, family support, intensive care unit, intervention study, withdrawal of life-sustaining treatment



  1. Scharf, Barbara PhD, RN
  2. Zhu, Shijun PhD
  3. Tomlin, Sarah MSN, CCRN
  4. Cheon, Jooyoung PhD, RN
  5. Mooney-Doyle, Kim PhD, RN
  6. Baggs, Judith Gedney PhD, RN
  7. Weigand, Debra PhD, CCRN


This investigation addressed family member perceptions of preparation for withdrawal of life-sustaining treatment in the intensive care unit. These families are at a high risk for psychosocial and physical sequelae. The quantitative results of this mixed methods study are reported. A control group received usual care and an educational booklet component of the intervention. The experimental group received the above plus exposure to comfort cart items and additional psychological support. Twenty-eight family members enrolled over a 13-month period. Sixty-one percent (10 intervention, 7 control) completed the follow-up. Fourteen family members (82%) recalled the booklet. Some family members reported moderate to severe depression (12.5%), anxiety (12.5%), and stress (12.6%). Satisfaction with care (83.7%-85.2%) and family member well-being (44.1) were within the norm. Short Form-36 physical component score was higher than the norm, and the mental component score was lower than the norm. This study demonstrated feasibility and acceptability of the interventions and follow-up questionnaires when families make the difficult decision to withdraw treatment. Strategies are suggested to strengthen statistical power.