Amanda Moale1, Melissa L Teply2, Tiange Liu3, Arun L Singh4, Pragyashree Sharma Basyal5, Alison E Turnbull6. 1. Department of Internal Medicine, Johns Hopkins Hospital, Baltimore, Maryland, USA. Electronic address: amoale1@jhmi.edu. 2. Division of Geriatrics, Gerontology, and Palliative Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA. 3. Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA. 4. Division of Pediatric Palliative Care, Department of Pediatrics, Prisma Health Children's Hospital-Upstate, Greenville, South Carolina, USA. 5. Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, Maryland, USA; Division of Geriatric Medicine and Gerontology, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA. 6. Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA; Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, Maryland, USA; Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Abstract
CONTEXT: Conflict is frequently reported by both clinicians and surrogate decision makers for adult patients in intensive care units. Because religious clinicians view religion as an important dimension of end-of-life care, we hypothesized that religious critical care attendings (intensivists) would be more comfortable and perceive less conflict when discussing a patient's critical illness with a religious surrogate. OBJECTIVES: The objective of this study was to assess if religious intensivists are more or less likely to perceive conflict during a simulated family meeting than secular colleagues. METHODS: Intensivists were recruited to participate in a standardized, simulated family meeting with an actor portraying a family member of a critically ill patient. Intensivists provided demographic information including their current religion and the importance of religion in their lives. After the simulation, intensivists rated the amount of conflict they perceived during the simulation. The association between intensivist's self-reported religiosity and perceived conflict was estimated using both univariate analysis and multivariable logistic regression. RESULTS: Among 112 participating intensivists, 43 (38%) perceived conflict during the simulation. Among intensivists who perceived conflict, 49% were religious, and among those who did not perceive conflict, 35% were religious. After adjusting for physician race, gender, years in practice, intensive care unit weeks worked per year and actor, physician religiosity was associated with greater odds of perceiving conflict during the simulated family meeting (adjusted prevalence ratio = 2.77, [95% CI 1.12-7.16], P = 0.03). CONCLUSION: Religious intensivists were more likely to perceive conflict during a simulated family meeting. Crown
CONTEXT: Conflict is frequently reported by both clinicians and surrogate decision makers for adult patients in intensive care units. Because religious clinicians view religion as an important dimension of end-of-life care, we hypothesized that religious critical care attendings (intensivists) would be more comfortable and perceive less conflict when discussing a patient's critical illness with a religious surrogate. OBJECTIVES: The objective of this study was to assess if religious intensivists are more or less likely to perceive conflict during a simulated family meeting than secular colleagues. METHODS: Intensivists were recruited to participate in a standardized, simulated family meeting with an actor portraying a family member of a critically illpatient. Intensivists provided demographic information including their current religion and the importance of religion in their lives. After the simulation, intensivists rated the amount of conflict they perceived during the simulation. The association between intensivist's self-reported religiosity and perceived conflict was estimated using both univariate analysis and multivariable logistic regression. RESULTS: Among 112 participating intensivists, 43 (38%) perceived conflict during the simulation. Among intensivists who perceived conflict, 49% were religious, and among those who did not perceive conflict, 35% were religious. After adjusting for physician race, gender, years in practice, intensive care unit weeks worked per year and actor, physician religiosity was associated with greater odds of perceiving conflict during the simulated family meeting (adjusted prevalence ratio = 2.77, [95% CI 1.12-7.16], P = 0.03). CONCLUSION: Religious intensivists were more likely to perceive conflict during a simulated family meeting. Crown
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