Healthcare workers' experiences of participating in life-sustaining treatment decision-making in a Chinese intensive care unit：A qualitative study

Background: With the aging of the population and advancements in medical technology, making decisions about life-sustaining treatment (LST) poses emotional dilemmas for physicians and nurses. Methods: A phenomenological qualitative research method was used. Ten nurses and ten doctors were selected from the intensive care unit of a tertiary hospital in China using convenience sampling for face-to-face semi-structured interviews, after which the interviews were recorded verbatim, and themes were identified and coded using Colaizzi analysis. Findings: The decision-making experience of healthcare professionals withdrawing ICU patients from LST can be categorized into three themes and six subthemes, including healthcare professionals' perceptions of LST (professional and humanitarian perspectives), factors influencing healthcare professionals' decisions to withdraw LST (personal factors of healthcare professionals, decision-making conflicts, lack of preparedness, and ethical dilemmas), and healthcare professionals' behavioral preferences for performing LST (nurses' behavioral preferences, physicians' behavioral preferences). Conclusion: Decision-making about whether a patient needs to withdraw LST can result in decision-making dilemmas due to differences in healthcare personnel's personal attributes and decision-making conflicts; secondly, healthcare personnel have complex multiple emotional experiences during the engagement process, and nurses do not have a high level of voice in the decision-making team due to the complex clinical environment and professional constraints; and lastly, trust between healthcare personnel and patients needs to be strengthened. In the future, it is hoped that clinical staff in the healthcare team can emphasize interdisciplinary cooperation and enhance the trust between healthcare professionals and patients from the patient's perspective.