{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T12:16:55Z","timestamp":1790079415508,"version":"4.0.1"},"reference-count":47,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":264,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing Research and Practice"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>End\u2010of\u2010life (EOL) decision\u2010making in intensive care units (ICUs) is ethically demanding. Nurses are often excluded from this process despite their continuous bedside presence. Surgical units, particularly cardiothoracic ICUs, are described as more inclined to pursue aggressive treatment, yet little is known about how nurses in these specialised settings experience EOL decision\u2010making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The study aimed to illuminate how nurses in the cardiothoracic ICU experience EOL decision\u2010making and the withdrawal of intensive care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A qualitative descriptive design was used. Twelve nurses from six cardiothoracic ICUs in Sweden were recruited through purposive sampling. Data were collected through digital semistructured interviews. An inductive content analysis following Elo and Kyng\u00e4s guided the analytic process.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four categories captured the nurses\u2019 experiences. Decision\u2010making as a winding road described the diverse and challenging nature of the decision\u2010making process. Endeavouring to be a part of the team reflected the importance of teamwork and the nurses\u2019 inconsistent inclusion in EOL discussions. Facing ethical quandaries: Navigating doing good and doing no harm highlighted the ethical tensions inherent in intensive care. Caring beyond the patient: The crucial role of supporting relatives underscored the difficulties faced by relatives and the nurses\u2019 commitment to caring for them.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Cardiothoracic ICU nurses navigate significant ethical challenges during EOL decision\u2010making and emphasise the need for greater inclusion to strengthen advocacy. While several findings align with research from general ICUs, this study provides a context\u2010specific account of how EOL decision\u2010making is navigated in cardiothoracic intensive care. Persistent challenges related to nurses\u2019 involvement and interprofessional communication highlight the need for strategies to support nurse inclusion in EOL decision\u2010making, as nurses\u2019 contributions may strengthen patient advocacy and care for relatives during EOL transitions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/nrp\/4969285","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T11:56:17Z","timestamp":1790078177000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Journey Towards Withdrawal: Nurses\u2019 Experiences of End\u2010of\u2010Life Decisions in Cardiothoracic Intensive Care"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1380-3320","authenticated-orcid":false,"given":"Christina","family":"Bj\u00f6rklund Pal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3594-3944","authenticated-orcid":false,"given":"Katarina","family":"Sj\u00f6gren Forss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"e_1_2_9_1_2","doi-asserted-by":"publisher","DOI":"10.3390\/medicina60091461"},{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-024-07579-1"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2702.2006.01427.x"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/0969733012452683"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1191\/0969733004ne723oa"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/1054773814533791"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11673-021-10128-w"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11673-012-9416-5"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccn.2022.103249"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccn.2007.11.002"},{"key":"e_1_2_9_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccn.2019.102768"},{"key":"e_1_2_9_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/nicc.12026"},{"key":"e_1_2_9_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/nicc.12157"},{"key":"e_1_2_9_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.aucc.2019.08.004"},{"key":"e_1_2_9_15_2","doi-asserted-by":"publisher","DOI":"10.4037\/ajcc2017774"},{"key":"e_1_2_9_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002710"},{"key":"e_1_2_9_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccn.2009.06.007"},{"key":"e_1_2_9_18_2","doi-asserted-by":"publisher","DOI":"10.1080\/23294515.2021.1907477"},{"key":"e_1_2_9_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2006.09.008"},{"key":"e_1_2_9_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccn.2009.05.001"},{"key":"e_1_2_9_21_2","volume-title":"Nursing Research: Generating and Assessing Evidence for Nursing Practice","author":"Polit D. 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