Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jan-Feb;24(1):56-60.
doi: 10.4103/ijnmr.IJNMR_146_17.

Developing a Tool for Evaluation of Causes of Futile Care in Intensive Care Units

Leili Yekefallah  1 , Tahereh Ashktorab  2 , Houman Manoochehri  2 , Hamid Alavi Majd  3
Affiliations

Developing a Tool for Evaluation of Causes of Futile Care in Intensive Care Units

Leili Yekefallah et al. Iran J Nurs Midwifery Res. 2019 Jan-Feb.

Abstract

Background: In Iran, futile care has become a challenge for intensive care nurses. The aim of the study was to develop a tool for assessing the reasons of futile care at intensive care units (ICUs).

Materials and methods: A sequential mixed method in three stages was applied. In the first stage, a phenomenological study was performed with van Manen's method by interviewing 25 nurses at ICUs of 11 hospitals in Qazvin. To extract the items of the tool in the second stage, the concept of futile care in ICUs and its reasons were defined. Ultimately, the psychometric properties of the questionnaire were evaluated with face validity, content validity (quantitative and qualitative), construct validity (exploratory factor analysis), internal consistency (Cronbach's alpha), and test-retest reliability.

Results: The initial tool had 119 questions. After validation, 39 items remained in the final questionnaire. Five extracted factors were as follows: professional competence (14 items), organizational policy (9 items), socio-cultural factors (7 items), personal beliefs and values (4 items), and legal issues (5 items). Cronbach's alpha for the whole questionnaire was 0.91 (range: 0.71-0.96). The test-retest reliability was 0.87 (p < 0.001).

Conclusions: Nursing managers and clinical nurses can use this tool to identify the causes of futile care and reduce it in their clinical settings. Policy makers can use this tool for improving the management of ICUs.

Keywords: Intensive care unit; medical futility; nurses; psychometric.

PubMed Disclaimer

Conflict of interest statement

Nothing to declare.

Figures

Figure 1
Figure 1
Scree Plot of explanatory factors
See this image and copyright information in PMC

References

    1. Gabbay E, Calvo-Broce J, Meyer KB, Trikalinos TA, Cohen J, Kent DM, et al. The empirical basis for determinations of medical futility. J Gen Intern Med. 2010;25:1083–9. - PMC - PubMed
    1. Palda VA, Bowman KW, McLean RF, Chapman MG. “Futile” care: Do we provide it? Why? A semistructured, Canada-wide survey of intensive care unit doctors and nurses. J Crit Care. 2005;20:207–13. - PubMed
    1. Heland M. Fruitful or futile: Intensive care nurses' experiences and perceptions of medical futility. Aust Crit Care. 2006;19:25–31. - PubMed
    1. Chwang E. Futility clarified. J Law Med Ethics. 2009;37:487–95, 396. - PubMed
    1. Niederman MS, Berger JT. The delivery of futile care is harmful to other patients. Crit Care Med. 2010;38:S518–22. - PubMed