TY - JOUR
T1 - From Coping with Life to Coping with Death
T2 - Problematic Integration for the Seriously Ill Elderly
AU - Hines, Stephen C.
AU - Babrow, Austin S.
AU - Badzek, Laurie
AU - Moss, Alvin
N1 - Funding Information:
Research reported in this article was funded by grants from the National Kidney Foundation of Western Pennsylvania, the West Virginia University School of Nursing, and the Center for Health Ethics and Law, West Virginia University Health Sciences Center. Although we gratefully acknowledge this support, positions taken in the article do not necessarily reflect the views of the sponsoring organizations. We also thank the nurses and patients who shared their insights with us so generously.
PY - 2001
Y1 - 2001
N2 - Decisions made by and for elderly patients nearing death frequently perpetuate unwanted suffering and dependence. This article extends the argument that Babrow's (1992, 1995) problematic integration theory can provide insights into why communication fails to produce desired outcomes for such patients. Open-ended responses obtained in face-to-face interviews with 142 elderly dialysis patients and mailed surveys of 393 dialysis unit nurses were examined to better understand how patients and nurses reconciled incompatible probabilistic and evaluative judgments. Results indicate that patients seek information that will enable them to cope with debilitating dialysis treatments rather than information nurses believe is necessary for them to make informed choices about whether to undergo such treatments. The tension between the information patients want to successfully cope with life and the information they need to decide intelligently about treatments that forestall death constitutes a key reason why communication about end-of-life issues is frequently flawed. Our analysis of these communication flaws leads to specific recommendations for how this tension can be eased, which in turn may better prepare patients to make the transition from coping with life to coping with death.
AB - Decisions made by and for elderly patients nearing death frequently perpetuate unwanted suffering and dependence. This article extends the argument that Babrow's (1992, 1995) problematic integration theory can provide insights into why communication fails to produce desired outcomes for such patients. Open-ended responses obtained in face-to-face interviews with 142 elderly dialysis patients and mailed surveys of 393 dialysis unit nurses were examined to better understand how patients and nurses reconciled incompatible probabilistic and evaluative judgments. Results indicate that patients seek information that will enable them to cope with debilitating dialysis treatments rather than information nurses believe is necessary for them to make informed choices about whether to undergo such treatments. The tension between the information patients want to successfully cope with life and the information they need to decide intelligently about treatments that forestall death constitutes a key reason why communication about end-of-life issues is frequently flawed. Our analysis of these communication flaws leads to specific recommendations for how this tension can be eased, which in turn may better prepare patients to make the transition from coping with life to coping with death.
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U2 - 10.1207/S15327027HC1303_6
DO - 10.1207/S15327027HC1303_6
M3 - Article
C2 - 11550854
AN - SCOPUS:0035225156
SN - 1041-0236
VL - 13
SP - 327
EP - 342
JO - Health Communication
JF - Health Communication
IS - 3
ER -