{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:08:07Z","timestamp":1787018887971,"version":"build-2736575974"},"reference-count":31,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100001018","name":"California Health Care Foundation","doi-asserted-by":"publisher","award":["G-20615"],"award-info":[{"award-number":["G-20615"]}],"id":[{"id":"10.13039\/100001018","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Intensive Care Med"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Developing effective strategies to improve shared decision-making (SDM) about potentially non-beneficial intensive care unit (ICU) treatments for patients with advanced medical illness requires understanding patients\u2019 and family members\u2019 perspectives. This study explores family members\u2019 experiences in discussing potentially non-beneficial treatments with ICU clinicians to identify factors that influenced their decision-making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Semi-structured interviews of pre-dominantly non-White family members making decisions about potentially non-beneficial ICU treatments were conducted in the medical ICU of an academic public hospital in Los Angeles County. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eighteen surrogate decision-makers were interviewed for this study. Perceived barriers to decision-making included intimidation, dehumanizing family meetings, time-pressure to make decisions, and uncertainty of benefit from ICU treatments. Factors that affected the perceived susceptibility from harm or likelihood of benefit from invasive treatments included health status prior to hospitalization, physicians\u2019 discussion of prognoses, and direct observation of clinical status during ICU hospitalization. Greater self-efficacy in making decisions was promoted by stronger family support, gaining experience with the clinical situation, and empathic characteristics of the clinical team.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Interviews with family members at a single ICU revealed that strategies to improve decision-making may include emphasizing empathic communication styles that focus on patients\u2019 values and preferences for care, reducing time-pressure and uncertainty by seeing the effects of ICU treatments, and creating time for families to adjust and seek social support. Adopting this approach may allow ICU clinicians and family members to become more aligned in their efforts to provide compassionate care for patients while minimizing non-beneficial treatments. These findings need to be validated in larger patient populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08850666251371579","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T12:54:02Z","timestamp":1756731242000},"page":"427-435","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Decision-Making About Potentially Non-Beneficial Intensive Care Unit Treatments: Interviews of Family Members from an Academic Public Hospital"],"prefix":"10.1177","volume":"41","author":[{"given":"Jennifer","family":"Parrish","sequence":"first","affiliation":[{"name":"Department of Medicine, Good Samaritan Hospital, San Jose, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8506-7591","authenticated-orcid":false,"given":"Thanh H.","family":"Neville","sequence":"additional","affiliation":[{"name":"David Geffen School of Medicine at UCLA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7426-6387","authenticated-orcid":false,"given":"Derjung M.","family":"Tarn","sequence":"additional","affiliation":[{"name":"David Geffen School of Medicine at UCLA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8771-3908","authenticated-orcid":false,"given":"Dong W.","family":"Chang","sequence":"additional","affiliation":[{"name":"Keck School of Medicine at the University of Southern California"},{"name":"The Lundquist Institute at Harbor-UCLA Medical Center, David Geffen School of Medicine at UCLA, Torrance, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,9,1]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000114816.62331.08"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2011.0650"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(19)30088-8"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(19)30087-6"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000001396"},{"key":"e_1_3_2_7_2","volume-title":"Partnering with Patients to Drive Shared Decisions, Better Value, and Care Improvement: Workshop Proceedings","author":"Medicine Io","year":"2014","unstructured":"Medicine Io. 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