• Judith A Adams, Ruth A Anderson, Sharron L Docherty, James A Tulsky, Karen E Steinhauser, and Donald E Bailey.
• Durham VAMC, 508 Fulton Street, Durham, NC 27705, USA; Duke University School of Nursing, 307 Trent Drive, DUMC 3322, Durham, NC 27710, USA. Electronic address: judith.adams@duke.edu.
• Heart Lung. 2014 Sep 1;43(5):406-15.

ObjectivesTo explore how family members of ICU patients at high risk of dying respond to nursing communication strategies.BackgroundFamily members of ICU patients may face difficult decisions. Nurses are in a position to provide support. Evidence of specific strategies that nurses use to support decision-making and how family members respond to these strategies is lacking.MethodsThis is a prospective, qualitative descriptive study involving the family members of ICU patients identified as being at high risk of dying.ResultsFamily members described five nursing approaches: Demonstrating concern, building rapport, demonstrating professionalism, providing factual information, and supporting decision-making. This study provides evidence that when using these approaches, nurses helped family members to cope; to have hope, confidence, and trust; to prepare for and accept impending death; and to make decisions.ConclusionKnowledge lays a foundation for interventions targeting the areas important to family members and most likely to improve their ability to make decisions and their well-being.Copyright © 2014 Elsevier Inc. All rights reserved.

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