Communication and Problematic Integration in End-of-Life Decisions: Dialysis Decisions among the Elderly

Stephen C. Hines, Austin S. Babrow, Laurie Badzek, Alvin H. Moss

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

End-of-life (EOL) decisions made by and for elderly patients often perpetuate unwanted suffering at great expense. Recent efforts to improve the decision-making process have been ineffective. In this article, we argue that Babrow's (1992, 1995) problematic integration (PI) theory can enhance understandings of flaws in EOL decisions. Face-to-face interviews of 142 elderly hemodialysis patients were conducted to test predictions derived from the theory. Results supported the prediction that doctors would often fail to disclose the need for dialysis until a decision had to be made. And, as expected, patients were satisfied with the decision-making process despite relatively little discussion of their options. When EOL discussions occurred, they focused on topics that were least likely to evoke PI. Moreover, as expected, patients and doctors relied on stereotypical roles to minimize ambiguity in EOL decisions. Results suggest that PI theory can contribute to improved EOL decisions by demonstrating that poor decision making is the collaborative consequence of efforts by both doctors and patients to cope with PI.

Original languageEnglish (US)
Pages (from-to)199-217
Number of pages19
JournalHealth Communication
Volume9
Issue number3
DOIs
StatePublished - Jan 1 1997

Fingerprint

Dialysis
chronic illness
Communication
communication
Decision making
Decision Making
decision-making process
Psychological Stress
Renal Dialysis
Defects
Interviews
decision making
interview

All Science Journal Classification (ASJC) codes

  • Health(social science)
  • Communication

Cite this

Hines, Stephen C. ; Babrow, Austin S. ; Badzek, Laurie ; Moss, Alvin H. / Communication and Problematic Integration in End-of-Life Decisions : Dialysis Decisions among the Elderly. In: Health Communication. 1997 ; Vol. 9, No. 3. pp. 199-217.
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Communication and Problematic Integration in End-of-Life Decisions : Dialysis Decisions among the Elderly. / Hines, Stephen C.; Babrow, Austin S.; Badzek, Laurie; Moss, Alvin H.

In: Health Communication, Vol. 9, No. 3, 01.01.1997, p. 199-217.

Research output: Contribution to journalArticle

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