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      Theories of Health Care Decision Making at the End of Life: A Meta-Ethnography

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          Abstract

          The aim of this meta-ethnography is to appraise the types and uses of theories relative to end-of-life decision-making and to develop a conceptual framework to describe end-of-life decision making among patients with advanced cancers, heart failure, and amyotrophic lateral sclerosis (ALS) and their caregivers or providers. We used PubMed, Embase, and CINAHL databases to extract English-language articles published between January 2002 and April 2015. Forty-three articles were included. The most common theories included decision-making models (n=14) followed by family-centered (n=11) and behavioral change models (n=7). A conceptual framework was developed using themes including: context of decision-making, communication and negotiation of decision-making, characteristics of decision makers, goals of decision-making, options and alternatives, and outcomes. Future research should enhance and apply these theories to guide research to develop patient-centered decision-making programs that facilitate informed and shared decision-making at the end of life among patients with advanced illness and their caregivers.

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          Author and article information

          Journal
          7905435
          8072
          West J Nurs Res
          West J Nurs Res
          Western journal of nursing research
          0193-9459
          1552-8456
          12 April 2019
          17 August 2017
          December 2018
          01 December 2019
          : 40
          : 12
          : 1861-1884
          Affiliations
          [1 ]University of Connecticut, Storrs, USA
          [2 ]Johns Hopkins University, Baltimore, MD, USA
          [3 ]University of Utah, Salt Lake City, USA
          [4 ]Towson University, MD, USA
          Author notes
          Corresponding Author: Kyounghae Kim, University of Connecticut School of Nursing, 231 Glenbrook Road Unit 4026, Storrs, CT 06269, USA., kyounghae.kim@ 123456uconn.edu
          Article
          PMC6474239 PMC6474239 6474239 nihpa1019801
          10.1177/0193945917723010
          6474239
          28816094
          ffe3cc03-76bd-46a3-95e3-fa3ec911fb05
          History
          Categories
          Article

          meta-ethnography,end-of-life,patients with advanced illness,decision making,framework

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