Research Topics
| Ruth EngelbergSummaryAffiliation: University of Washington Country: USA Publications
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Publications
Measuring the quality of dying and death: methodological considerations and recent findingsRuth A Engelberg
Department of Medicine, School of Medicine, University of Washington, Seattle, Washington, USA
Curr Opin Crit Care 12:381-7. 2006..In this article, we present methodological considerations and recent findings that pertain to the measurement of the quality of dying and death...- Psychometric characteristics of a quality of communication questionnaire assessing communication about end-of-life careRuth Engelberg
Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, 98104, USA
J Palliat Med 9:1086-98. 2006..While further validation studies are needed, this assessment of the QOC represents an important step toward providing a measure of the quality of end-of-life communication... 
Measuring the quality of end-of-life careRuth A Engelberg
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Harborview Medical Center, Seattle, Washington 98104 2499, USA
J Pain Symptom Manage 39:951-71. 2010..Although there is a documented need to improve end-of-life care, there are few validated and brief questionnaires that are available as outcome measures for use in improving that care...- Commentary: observational studies and their importance in improving end-of-life care in the intensive care unitRuth A Engelberg
Harborview Medical Center, Division of Pulmonary and Critical Care, Department of Medicine, School of Medicine, Washington Seatle, WA 98104-2499, USA
J Crit Care 18:141-4. 2003 
Responding to families' questions about the meaning of physical movements in critically ill patientsRuth A Engelberg
Department of Medicine, School of Medicine, University of Washington, Seattle, WA 98104, USA
J Crit Care 23:565-71. 2008..This study used qualitative methods to describe physicians' responses to families' questions about the meaning of patients' movements in critically ill patients...- Barriers and facilitators to end-of-life care communication for patients with COPDElizabeth Knauft
Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine, University of Washington, Seattle, USA
Chest 127:2188-96. 2005..Barriers and facilitators associated with communication are targets for interventions to improve end-of-life care, but such interventions will likely need to address the specific barriers relevant to individual patient-physician pairs... - Factors associated with nurse assessment of the quality of dying and death in the intensive care unitNaomi M Hodde
Harborview Medical Center, Division of Pulmonary and Critical Care, Department of Medicine, University of Washington, Seattle, WA, USA
Crit Care Med 32:1648-53. 2004..If nurse-assessed quality of dying is to be a useful tool for measuring and improving quality of end-of-life care, it is important to understand the factors associated with nurse ratings... - Communication about palliative care for patients with chronic obstructive pulmonary diseaseJ Randall Curtis
Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, USA
J Palliat Care 21:157-64. 2005..Further research is needed to develop and test interventions that can enhance patient-physician communication about palliative and EOL care for patients with COPD, and we describe our perspective on a research agenda in each area... - Treatment preferences for resuscitation and critical care among homeless personsWendi M Norris
Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine, University of Washington, Seattle, USA
Chest 127:2180-7. 2005..Hospitals serving homeless individuals should consider developing policies to address this issue... - Family satisfaction with family conferences about end-of-life care in the intensive care unit: increased proportion of family speech is associated with increased satisfactionJonathan R McDonagh
Department of Medicine, School of Medicine, University of Washington, Seattle, WA, USA
Crit Care Med 32:1484-8. 2004..Future studies should assess the effect of interventions to increase listening by critical care clinicians on the quality of communication and the family experience... - Evaluation of a standardized order form for the withdrawal of life support in the intensive care unitPatsy D Treece
Division of Pulmonary and Critical Care, Department of Medicine, Harborview Medical Center, University of Washington, Seattle, WA, USA
Crit Care Med 32:1141-8. 2004..Although the order form was helpful to clinicians and changed medication delivery, demonstrating clear improvements in quality of dying may require larger sample sizes, more sensitive measures, or more effective interventions... - Integrating palliative and critical care: description of an interventionPatsy D Treece
Harborview Medical Center, Division of Pulmonary and Critical Care, Department of Medicine, University of Washington, Seattle, Washington, USA
Crit Care Med 34:S380-7. 2006..Future reports will need to examine the ability of the interventions to improve outcomes of palliative care in the ICU... - Refinement, scoring, and validation of the Family Satisfaction in the Intensive Care Unit (FS-ICU) surveyRichard J Wall
Harborview Medical Center, Division of Pulmonary and Critical Care, Department of Medicine, University of Washington, Seattle, WA, USA
Crit Care Med 35:271-9. 2007..To refine the Family Satisfaction in the Intensive Care Unit (FS-ICU) survey and develop a validated method for scoring the instrument... - Nurses' identification of important yet under-utilized end-of-life care skills for patients with life-limiting or terminal illnessesLynn F Reinke
Department of Veterans Affairs, VA Puget Sound Health Care System, Health Services Research and Development, Seattle, Washington 98195, USA
J Palliat Med 13:753-9. 2010..This study was designed to identify nurses' perspectives on nursing skills that are important yet under-utilized in end-of-life care... - Discussing religion and spirituality is an advanced communication skill: an exploratory structural equation model of physician trainee self-ratingsDee W Ford
Medical University of South Carolina, Division of Pulmonary and Critical Care, Department of Medicine, Charleston, South Carolina 29425, USA
J Palliat Med 15:63-70. 2012..The goal of this study was to develop an improved understanding of physicians' perspectives on their communication competence about religious and spiritual issues... - Improving social work in intensive care unit palliative care: results of a quality improvement interventionAndrew J McCormick
Division of Pulmonary and Critical Care Medicine, Harborview Medical Center University of Washington, Seattle, Washington 98104 2499, USA
J Palliat Med 13:297-304. 2010..Social workers are involved in providing this care for patients and families. Our goal was to examine the social worker component of an intervention to improve interdisciplinary palliative care in the ICU... - An approach to understanding the interaction of hope and desire for explicit prognostic information among individuals with severe chronic obstructive pulmonary disease or advanced cancerJ Randall Curtis
Department of Pulmonary and Critical Care Medicine, University of Washington, Seattle, Washington 98104, USA
J Palliat Med 11:610-20. 2008.... - Managed care, access to specialists, and outcomes among primary care patients with painDavid E Grembowski
Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle 98195-7660, USA
Health Serv Res 38:1-19. 2003.... - Potential for response bias in family surveys about end-of-life care in the ICUErin K Kross
Division of Pulmonary and Critical Care Medicine, Harborview Medical Center, Seattle, WA 98104, USA
Chest 136:1496-502. 2009.... - Supporting hope and prognostic information: nurses' perspectives on their role when patients have life-limiting prognosesLynn F Reinke
Department of Veterans Affairs, VA Puget Sound Health Care System, Health Services Research and Development, Seattle, Washington, USA
J Pain Symptom Manage 39:982-92. 2010..Few studies have examined nurses' perspectives on their roles in meeting these patient and family needs... - Measuring success of interventions to improve the quality of end-of-life care in the intensive care unitJ Randall Curtis
Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine, University of Washington, Seattle, Washington, USA
Crit Care Med 34:S341-7. 2006..In this article, we examine some of the data supporting potential process and outcome measures that could be used to evaluate the success of interventions designed to improve end-of-life care in the ICU... - Clinician statements and family satisfaction with family conferences in the intensive care unitRenee D Stapleton
Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine, University of Washington, Seattle, WA, USA
Crit Care Med 34:1679-85. 2006.... - Agreement among family members in their assessment of the Quality of Dying and DeathRichard Mularski
Department of Medicine, VA Greater Los Angeles Healthcare System, The University of California, 90073, USA
J Pain Symptom Manage 28:306-15. 2004.... - Correspondence between patients' preferences and surrogates' understandings for dying and deathRuth A Engelberg
Department of Medicine, University of Washington, Seattle, Washington 98104, USA
J Pain Symptom Manage 30:498-509. 2005..These discussions may enable surrogates and clinicians to more accurately follow patient preferences... - A measure of the quality of dying and death. Initial validation using after-death interviews with family membersJ Randall Curtis
Department of Medicine, University of Washington, Seattle, WA 98104, USA
J Pain Symptom Manage 24:17-31. 2002..Future work will assess the potential role of the QODD in improving the quality of the dying experience... - Managed care, access to mental health specialists, and outcomes among primary care patients with depressive symptomsDavid E Grembowski
Center for Cost and Outcomes Research, Department of Health Services, University of Washington, Seattle, Wash 98195 7660, USA
J Gen Intern Med 17:258-69. 2002..To determine whether managed care is associated with reduced access to mental health specialists and worse outcomes among primary care patients with depressive symptoms... - Medicine residents' self-perceived competence in end-of-life careMartha E Billings
Division of Pulmonary and Critical Care, University of Washington, Seattle, Washington 98104, USA
Acad Med 84:1533-9. 2009..Understanding how residents' experiences and attitudes affect their perceived competence in providing end-of-life care is important for targeting educational interventions... - The Quality of Dying and Death Questionnaire (QODD): empirical domains and theoretical perspectivesLois Downey
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Harborview Medical Center, University of Washington, Seattle, Washington 98104, USA
J Pain Symptom Manage 39:9-22. 2010..We conclude that research based on the current version of the QODD might benefit from the use of composite measures representing the four identified domains, but that future expansion and modification of the questionnaire are in order... - Predictors of symptoms of posttraumatic stress and depression in family members after patient death in the ICUCynthia J Gries
University of Washington, Division of Pulmonary and Critical Care, Seattle, WA 98104, USA
Chest 137:280-7. 2010..Patients' deaths in the ICU have been associated with a high burden of psychologic symptoms in families. This study identifies characteristics associated with psychologic symptoms in family members... - Three lessons from a randomized trial of massage and meditation at end of life: patient benefit, outcome measure selection, and design of trials with terminally ill patientsLois Downey
Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, Washington 98195, USA
Am J Hosp Palliat Care 26:246-53. 2009.... - Narcotic and benzodiazepine use after withdrawal of life support: association with time to death?Jeannie D Chan
Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, USA
Chest 126:286-93. 2004..To determine whether the dose of narcotics and benzodiazepines is associated with length of time from mechanical ventilation withdrawal to death in the setting of withdrawal of life-sustaining treatment in the ICU... - Predictors of time to death after terminal withdrawal of mechanical ventilation in the ICUColin R Cooke
Division of Pulmonary and Critical Care Medicine, University of Michigan, 6 Ann Arbor, MI 48109 5604, USA
Chest 138:289-97. 2010..Little information exists about the expected time to death after terminal withdrawal of mechanical ventilation. We sought to determine the independent predictors of time to death after withdrawal of mechanical ventilation... - Family satisfaction in the ICU: differences between families of survivors and nonsurvivorsRichard J Wall
Department of Medicine, University of Washington, Seattle, WA 98104, USA
Chest 132:1425-33. 2007..In the current study, we sought to confirm these findings and identify specific aspects of care that were rated more highly by the family members of patients dying in the ICU compared to family members of ICU survivors... - Measuring and improving the quality of dying and deathDonald L Patrick
University of Washington and Harborview Medical Center, Seattle 98195 7660, USA
Ann Intern Med 139:410-5. 2003..Overcoming these challenges is of great importance in the search for the social, organizational, and individual determinants of high-quality dying in the U.S. cultural and health care context... - Studying communication about end-of-life care during the ICU family conference: development of a frameworkJ Randall Curtis
Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine, University of Washington, Seattle, WA, USA
J Crit Care 17:147-60. 2002..The purpose of this study was to develop an understanding of the way this communication is currently conducted... - ICU care associated with symptoms of depression and posttraumatic stress disorder among family members of patients who die in the ICUErin K Kross
Department of Medicine, Division of Pulmonary and Critical Care, Harborview Medical Cente, University of Washington, Seattle, WA, USA
Chest 139:795-801. 2011..The patient-level risk factors for these family symptoms are not well understood but may help to target future interventions... - Effect of a quality-improvement intervention on end-of-life care in the intensive care unit: a randomized trialJ Randall Curtis
Harborview Medical Center, Division of Pulmonary and Critical Care, Department of Medicine, University of Washington, Seattle Washington, USA
Am J Respir Crit Care Med 183:348-55. 2011..Because of high mortality, end-of-life care is an important component of intensive care... - The influence of race/ethnicity and socioeconomic status on end-of-life care in the ICUSarah Muni
Division of Pulmonary and Critical Care Medicine, Harborview Medical Center, University of Washington, 325 Ninth Ave, Seattle, WA 98104, USA
Chest 139:1025-33. 2011..There is conflicting evidence about the influence of race/ethnicity on the use of intensive care at the end of life, and little is known about the influence of socioeconomic status... - Abandonment at the end of life from patient, caregiver, nurse, and physician perspectives: loss of continuity and lack of closureAnthony L Back
Fred Hutchinson Cancer Research Center, School of Medicine, Department of Medicine, University of Washington, Seattle, WA, USA
Arch Intern Med 169:474-9. 2009..Surveys and anecdotes suggest that patients and family members sometimes feel abandoned by their physicians at the transition to end-of-life care. To our knowledge, no prior studies describe abandonment prospectively... - Missed opportunities during family conferences about end-of-life care in the intensive care unitJ Randall Curtis
Division of Pulmonary and Critical Care Medicine, Harborview Medical Center, Box 359762, 325 Ninth Avenue, Seattle, WA 98104 2499, USA
Am J Respir Crit Care Med 171:844-9. 2005..Improved communication with family members of critically ill patients can decrease the prolongation of dying in the intensive care unit (ICU), but few data exist to guide the conduct of this communication... - The language of prognostication in intensive care unitsDouglas B White
Program in Medical Ethics, Department of Medicine, University of California, San Francisco, CA, USA
Med Decis Making 30:76-83. 2010..Rationale. Although misunderstandings about prognosis are common in intensive care units (ICUs), little is known about how physicians actually communicate prognostic information... - Measuring intensive care nurses' perspectives on family-centered end-of-life care: evaluation of 3 questionnairesLois Downey
Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine, University of Washington, Seattle WA 98195, USA
Am J Crit Care 15:568-79. 2006..Attempts to improve end-of-life care increasingly focus on family-centered care, but few validated assessment tools exist... - Expressions of nonabandonment during the intensive care unit family conferenceHeather F West
Department of Medicine, School of Medicine, University of Washington, Seattle, WA, USA
J Palliat Med 8:797-807. 2005..Future studies could use this model to develop a communication intervention for the ICU family conference... - Prognostication during physician-family discussions about limiting life support in intensive care unitsDouglas B White
Division of Pulmonary and Critical Care Medicine, Program in Medical Ethics, Department of Medicine, University of California, San Francisco, USA
Crit Care Med 35:442-8. 2007.... - Spiritual care of families in the intensive care unitRichard J Wall
Harborview Medical Center, Division of Pulmonary and Critical Care, Department of Medicine, University of Washington, Seattle, WA, USA
Crit Care Med 35:1084-90. 2007.... - Family member satisfaction with end-of-life decision making in the ICUCynthia J Gries
Division of Pulmonary and Critical Care, Department of Medicine, University of Washington, Seattle, WA 98195, USA
Chest 133:704-12. 2008..The identification of chart-based quality indicators of palliative care that predict family satisfaction with decision making may help to guide interventions to improve decision making and family outcomes... - Quality-of-life trajectories at the end of life: assessments over time by patients with and without cancerLois Downey
Division of Pulmonary and Critical Care, Department of Medicine, Harborview Medical Center, School of Medicine, University of Washington, Seattle, Washington 98104, USA
J Am Geriatr Soc 58:472-9. 2010..To compare quality-of-life (QOL) ratings of terminally ill patients with and without cancer over time... - Association of depression and life-sustaining treatment preferences in patients with COPDRenee D Stapleton
Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine, University of Washington, Seattle, WA, USA
Chest 127:328-34. 2005..No prior studies have examined the effects of depression and quality of life on treatment preferences in this population... - Using the medical record to evaluate the quality of end-of-life care in the intensive care unitBradford J Glavan
Division of Pulmonary and Critical Care Medicine, School of Medicine, University of Washington, Seattle, WA, USA
Crit Care Med 36:1138-46. 2008..We investigated whether proposed "quality markers" within the medical record are associated with family assessment of the quality of dying and death in the intensive care unit (ICU)... - Transitions regarding palliative and end-of-life care in severe chronic obstructive pulmonary disease or advanced cancer: themes identified by patients, families, and cliniciansLynn F Reinke
Department of Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington, Seattle, Washington, USA
J Palliat Med 11:601-9. 2008..Patients may experience transitions in different ways than clinicians. No prior studies have examined this issue from patients', families', and clinicians' perspectives... - Shared priorities for the end-of-life periodLois Downey
Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, Washington, USA
J Pain Symptom Manage 37:175-88. 2009..This change would reduce respondent burden in future investigations, simplify analyses aimed at identifying domains underlying the dying-and-death experience, and exclude the top-priority item of fewer than 4% of respondents... - Integrating palliative and critical care: evaluation of a quality-improvement interventionJ Randall Curtis
Division of Pulmonary and Critical Care, Box 359762, Harborview Medical Center, University of Washington, Seattle, WA 98104, USA
Am J Respir Crit Care Med 178:269-75. 2008..Palliative care in the intensive care unit (ICU) is an important focus for quality improvement... - Determinants of medical students' perceived preparation to perform end-of-life care, quality of end-of-life care education, and attitudes toward end-of-life careMartha E Billings
Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, Washington 98104, USA
J Palliat Med 13:319-26. 2010..In this study, we evaluated associations between survey items assessing these learning modalities and students' perceptions of their preparation, quality of education, and attitudes toward end-of-life care... - Social workers in palliative care: assessing activities and barriers in the intensive care unitAndrew J McCormick
Harborview Medical Center, Seattle, Washington 98104, USA
J Palliat Med 10:929-37. 2007.... - Quality of dying and death in two medical ICUs: perceptions of family and cliniciansCari R Levy
Division of Healthcare Policy and Research, University of Colorado Health Sciences Center, Aurora, CO 80011, USA
Chest 127:1775-83. 2005..The aim was to obtain a surrogate assessment of the quality of the dying process and examine differences in the perceptions of different types of raters... - Duration of withdrawal of life support in the intensive care unit and association with family satisfactionEric Gerstel
Departments of Internal Medicine and Critical Care, Geneva University Hospitals of Geneva and University of Geneva, Geneva, Switzerland
Am J Respir Crit Care Med 178:798-804. 2008..Most deaths in the intensive care unit (ICU) involve withholding or withdrawing multiple life-sustaining therapies, but little is known about how to proceed practically and how this process affects family satisfaction... - Alterations during medical interpretation of ICU family conferences that interfere with or enhance communicationKiemanh Pham
Department of Emergency Medicine, Kern Medical Center, Bakersfield, CA, USA
Chest 134:109-16. 2008..Despite the importance of medical interpretation, little is known about the alterations that occur and their effect on communication...