BACKGROUND: The emotional toll of critical illness on patients and their families can be profound and is emerging as an important target for value improvement. One source of emotional harm to patients and families may be care perceived as inadequately respectful. The prevalence and risk factors for types of emotional harms is under-studied. METHODS: This prospective cohort study was conducted in nine ICUs at a tertiary care academic medical center in the United States. Prevalence of inadequate respect for (a) the patient and (b) the family, as well as prevalence of perceived lack of control over the care of their loved ones, was assessed by the Family Satisfaction with Care in the Intensive Care Unit instrument. The relationship between these outcomes with demographic and clinical covariates was assessed. Stratification by patient survivorship was performed in sensitivity analysis. RESULTS: Of more than 1,500 respondents, 16.9% and 21.8% reported that the patient or the family member, respectively, received inadequate respect. No clinical characteristics of the patients were associated with inadequate respect for either the patient or the family member. By comparison, more than half of respondents reported a lack of control over their loved one's care; this finding was associated with multiple clinical factors. Prevalence and associated factors differed by patient survivorship status. CONCLUSION: Care that is inadequately respectful to patients and families in the setting of critical illness is prevalent but does not appear to be associated with clinical characteristics. The incidence of such emotional harms is nuanced, difficult to predict, and deserves further investigation.
BACKGROUND: The emotional toll of critical illness on patients and their families can be profound and is emerging as an important target for value improvement. One source of emotional harm to patients and families may be care perceived as inadequately respectful. The prevalence and risk factors for types of emotional harms is under-studied. METHODS: This prospective cohort study was conducted in nine ICUs at a tertiary care academic medical center in the United States. Prevalence of inadequate respect for (a) the patient and (b) the family, as well as prevalence of perceived lack of control over the care of their loved ones, was assessed by the Family Satisfaction with Care in the Intensive Care Unit instrument. The relationship between these outcomes with demographic and clinical covariates was assessed. Stratification by patient survivorship was performed in sensitivity analysis. RESULTS: Of more than 1,500 respondents, 16.9% and 21.8% reported that the patient or the family member, respectively, received inadequate respect. No clinical characteristics of the patients were associated with inadequate respect for either the patient or the family member. By comparison, more than half of respondents reported a lack of control over their loved one's care; this finding was associated with multiple clinical factors. Prevalence and associated factors differed by patient survivorship status. CONCLUSION: Care that is inadequately respectful to patients and families in the setting of critical illness is prevalent but does not appear to be associated with clinical characteristics. The incidence of such emotional harms is nuanced, difficult to predict, and deserves further investigation.
Authors: Dimitry S Davydow; Jeneen M Gifford; Sanjay V Desai; Dale M Needham; O Joseph Bienvenu Journal: Gen Hosp Psychiatry Date: 2008-07-30 Impact factor: 3.238
Authors: Kay H Stricker; Steffen Niemann; Sophie Bugnon; Jeannie Wurz; Ottilia Rohrer; Hans U Rothen Journal: J Crit Care Date: 2007-03-30 Impact factor: 3.425
Authors: Curtis N Sessler; Mark S Gosnell; Mary Jo Grap; Gretchen M Brophy; Pam V O'Neal; Kimberly A Keane; Eljim P Tesoro; R K Elswick Journal: Am J Respir Crit Care Med Date: 2002-11-15 Impact factor: 21.405
Authors: Daren K Heyland; Graeme M Rocker; Peter M Dodek; Demetrios J Kutsogiannis; Elsie Konopad; Deborah J Cook; Sharon Peters; Joan E Tranmer; Christopher J O'Callaghan Journal: Crit Care Med Date: 2002-07 Impact factor: 7.598
Authors: Harvey Max Chochinov; Thomas Hassard; Susan McClement; Thomas Hack; Linda J Kristjanson; Mike Harlos; Shane Sinclair; Alison Murray Journal: J Pain Symptom Manage Date: 2008-06-24 Impact factor: 3.612
Authors: Kimberly A Fisher; Thomas H Gallagher; Kelly M Smith; Yanhua Zhou; Sybil Crawford; Azraa Amroze; Kathleen M Mazor Journal: BMJ Qual Saf Date: 2019-11-13 Impact factor: 7.035
Authors: Melissa J Basile; Eileen Rubin; Michael E Wilson; Jennifer Polo; Sonia N Jacome; Samuel M Brown; Gabriel Heras La Calle; Victor M Montori; Negin Hajizadeh Journal: Crit Care Explor Date: 2021-06-15