2.50
Hdl Handle:
http://hdl.handle.net/10755/154732
Type:
Presentation
Title:
Role Theory and Life-Sustaining Treatment Decisions
Abstract:
Role Theory and Life-Sustaining Treatment Decisions
Conference Sponsor:Sigma Theta Tau International
Conference Year:2002
Conference Date:July, 2002
Author:Hansen, Lissi
P.I. Institution Name:University of Washington
Objective: To present the use of the theoretical components of role strain and satisfaction in descriptions of experiences by family caregivers in making life-sustaining treatment (LST) decisions for elderly ill relatives in a variety of settings. Role strain and satisfaction are components of role theory and are used to understand family processes. Role theory within the symbolic interactionist view was used to frame the study from which this paper is based. Two of the study's specific aims were: (1) to refine the conceptualization of family caregiver role strain and satisfaction in making LST decisions within the context of ongoing family care and (2) to generate items for measures of family caregiver role strain and satisfaction in making LST decisions based on the refined conceptualization and words of caregivers. Design: Exploratory-descriptive. Sample, Setting, Years: The sample was comprised of seventeen community-based family caregivers who made LST decisions for 16 elderly ill relatives. Ten caregivers were women and 7 were men. Fifteen were Caucasian and 2 were African-American. Caregivers ranged in age from 26 to 85 years (M=59.2; SD=14.7). Deceased relatives ranged in age from 67 to 92 years (M=81.4; SD=9.0). Twelve were women and 4 were men. Fourteen were Caucasian, 1 was African-American, and 1 was American Indian. They had had various medical diagnoses. Eight of them had LSTs withheld, 7 had treatments withdrawn, and 1 had treatments both withheld and withdrawn. Nine died in hospital settings, 3 in assisted living facilities, 1 in a retirement home, 1 in a vacation house, 1 in an Alzheimer's unit, and 1 in a hospice facility. Concepts: Family caregiver role strain and satisfaction within the context of role theory. Methods: Family caregivers were recruited through various health care settings with which their elderly ill relatives had been affiliated. Using a semi-structured interview-guide, caregivers were interviewed 1 time only to obtain descriptions of their experiences in making LST decisions for ill relatives. The interviews were conducted 2 to 8 months after the death of the relatives. The interviews ranged in time from 36 to 128 minutes (M=68.8, SD=29.0). Content analysis as a combined deductive-inductive approach was used for data analysis. The analysis included both individual and group participation. Data were coded using QRS NUD*IST. Findings: Through the iterative analysis process, the concept of role strain was modified from the definition of "felt difficulty following LST decisions for elderly relatives" to being multidimensional. Since it could be experienced by family caregivers before, during, and after LST decision-making for elderly ill relatives, the definition was changed to "felt difficulty in making LST decisions for elderly relatives." The term "satisfaction" was not used by any of the interviewed family caregivers, and was changed to "ease." Ease was chosen to capture the neutral or more positive aspects of making LST decisions by caregivers as reflected in statements such as "The decision in itself was easy." The definition of ease was "feeling of being without discomfort in making LST decisions for elderly relatives." The findings also resulted in items for measures of family caregiver role strain and ease in making LST decisions for elderly ill relatives that are more universal (i.e. not setting specific). Some items encompass role expectations and responsibilities in relation to LST decision-making by family caregivers, the contextualized role enactment of making LST decisions, as well as caregiver responses to such decisions over time. Others are related to the primary decision-maker or to interactions between the decision-maker and other persons. Conclusions: The documentation of role strain within the context of role theory adds a new theoretical perspective to the LST decision-making literature. Such findings compliment the existing literature of role strain in family care. "Ease" is a new conceptual component in the LST and caregiving literature that needs further development and testing. Implications: Much of the literature on experiences of family caregivers for elders has focused on role strain or burden. This is the first study that uses role theory in the context of LST decision-making by family caregivers. The expansion of role theory provides a new direction for further theory development in this area. Also, a foundation has been laid for further testing of items included in measures of family caregiver role strain and ease in making LST decisions for elderly ill relatives.

Repository Posting Date:
26-Oct-2011
Date of Publication:
Jul-2002
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleRole Theory and Life-Sustaining Treatment Decisionsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/154732-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Role Theory and Life-Sustaining Treatment Decisions</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2002</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">July, 2002</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Hansen, Lissi</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Washington</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">lh0@u.washington.edu</td></tr><tr><td colspan="2" class="item-abstract">Objective: To present the use of the theoretical components of role strain and satisfaction in descriptions of experiences by family caregivers in making life-sustaining treatment (LST) decisions for elderly ill relatives in a variety of settings. Role strain and satisfaction are components of role theory and are used to understand family processes. Role theory within the symbolic interactionist view was used to frame the study from which this paper is based. Two of the study's specific aims were: (1) to refine the conceptualization of family caregiver role strain and satisfaction in making LST decisions within the context of ongoing family care and (2) to generate items for measures of family caregiver role strain and satisfaction in making LST decisions based on the refined conceptualization and words of caregivers. Design: Exploratory-descriptive. Sample, Setting, Years: The sample was comprised of seventeen community-based family caregivers who made LST decisions for 16 elderly ill relatives. Ten caregivers were women and 7 were men. Fifteen were Caucasian and 2 were African-American. Caregivers ranged in age from 26 to 85 years (M=59.2; SD=14.7). Deceased relatives ranged in age from 67 to 92 years (M=81.4; SD=9.0). Twelve were women and 4 were men. Fourteen were Caucasian, 1 was African-American, and 1 was American Indian. They had had various medical diagnoses. Eight of them had LSTs withheld, 7 had treatments withdrawn, and 1 had treatments both withheld and withdrawn. Nine died in hospital settings, 3 in assisted living facilities, 1 in a retirement home, 1 in a vacation house, 1 in an Alzheimer's unit, and 1 in a hospice facility. Concepts: Family caregiver role strain and satisfaction within the context of role theory. Methods: Family caregivers were recruited through various health care settings with which their elderly ill relatives had been affiliated. Using a semi-structured interview-guide, caregivers were interviewed 1 time only to obtain descriptions of their experiences in making LST decisions for ill relatives. The interviews were conducted 2 to 8 months after the death of the relatives. The interviews ranged in time from 36 to 128 minutes (M=68.8, SD=29.0). Content analysis as a combined deductive-inductive approach was used for data analysis. The analysis included both individual and group participation. Data were coded using QRS NUD*IST. Findings: Through the iterative analysis process, the concept of role strain was modified from the definition of &quot;felt difficulty following LST decisions for elderly relatives&quot; to being multidimensional. Since it could be experienced by family caregivers before, during, and after LST decision-making for elderly ill relatives, the definition was changed to &quot;felt difficulty in making LST decisions for elderly relatives.&quot; The term &quot;satisfaction&quot; was not used by any of the interviewed family caregivers, and was changed to &quot;ease.&quot; Ease was chosen to capture the neutral or more positive aspects of making LST decisions by caregivers as reflected in statements such as &quot;The decision in itself was easy.&quot; The definition of ease was &quot;feeling of being without discomfort in making LST decisions for elderly relatives.&quot; The findings also resulted in items for measures of family caregiver role strain and ease in making LST decisions for elderly ill relatives that are more universal (i.e. not setting specific). Some items encompass role expectations and responsibilities in relation to LST decision-making by family caregivers, the contextualized role enactment of making LST decisions, as well as caregiver responses to such decisions over time. Others are related to the primary decision-maker or to interactions between the decision-maker and other persons. Conclusions: The documentation of role strain within the context of role theory adds a new theoretical perspective to the LST decision-making literature. Such findings compliment the existing literature of role strain in family care. &quot;Ease&quot; is a new conceptual component in the LST and caregiving literature that needs further development and testing. Implications: Much of the literature on experiences of family caregivers for elders has focused on role strain or burden. This is the first study that uses role theory in the context of LST decision-making by family caregivers. The expansion of role theory provides a new direction for further theory development in this area. Also, a foundation has been laid for further testing of items included in measures of family caregiver role strain and ease in making LST decisions for elderly ill relatives.<br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T13:14:00Z-
dc.date.issued2002-07en_GB
dc.date.accessioned2011-10-26T13:14:00Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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