Under the radar: contributions of the SUPPORT nurses

SUPPORT (The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment) failed to produce changes in 5 quantitative outcome measures of care received by nearly 10,000 seriously ill patients in major teaching hospitals. This article reports a content analysis of documents produced during the SUPPORT study by the 17 nurses who delivered the intervention. "Effective communication" emerged as the central category, with "educational support" and "emotional support" as subcategories. "Readiness" of patients and families to accept prognoses, engage in decision making, and the like also arose from this analysis as an important concept. The investigation suggests that the SUPPORT intervention did have an important impact, albeit not one captured by the main effects analysis.