Xinchun Liu1, Gerald Humphris2, Aijing Luo3, Mingshi Yang4, Jin Yan5, Shaohua Huang6, Siyu Xiao7, Ailian Lv6, Guobao Wu8, Peigen Gui9, Qingyan Wang10, Yudong Zhang8, Yaxin Yan11, Nie Jing12, Jie Xu11. 1. Department of Clinical Psychology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China. Electronic address: angelaliu23@sina.com. 2. Health Psychology, School of Medicine, University of St. Andrews, Scotland, UK. 3. Key Laboratory of Medical Information Research (Central South University, College of Hunan Province), Hunan, China. 4. Intensive Care Unit, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China. 5. Department of Nursing, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China. 6. Intensive Care Unit, The First Changsha Hospital, Changde, Hunan, China. 7. Department of Obstetrics and Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, New York, USA. 8. Intensive Care Unit, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China. 9. Intensive Care Unit, The Second Affiliated Hospital Nanhua University, Hengyang, Hunan, China. 10. Department of Clinical Psychology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China. 11. Xiangya School of Public Health, Central South University, Changsha, Hunan, China. 12. Intensive Care Unit, Hunan Provincial Tumor Hospital, Changsha, Hunan, China.
Abstract
OBJECTIVE: To investigate if a Family-Clinician Shared Decision-Making (FCSDM) intervention benefits patients, families and intensive care units (ICUs) clinicians. METHODS: Six ICUs in China were allocated to intervention or usual care. 548 patients with critical illness, 548 family members and 387 ICU clinicians were included into the study. Structured FCSDM family meetings were held in the intervention group. Scales of SSDM, HADS, QoL2 and CSACD were used to assess families' satisfaction and distress, patients' quality of life, and clinicians' collaboration respectively. RESULTS: Comparing the intervention group with the control group at post-intervention, there were significant differences in the families' satisfaction (P = 0.0001), depression level (P = 0.005), and patients' quality of life (P = 0.0007). The clinicians' mean CSCAD score was more positive in the intervention group than controls (P < 0.05). There was no significant between-group differences on ICU daily medical cost, but the intervention group demonstrated shorter number of days' stay in ICU (P = 0.0004). CONCLUSION: The FCSDM intervention improved families' satisfaction and depression, shortened patients' duration of ICU stay, and enhanced ICU clinicians' collaboration. PRACTICE IMPLICATIONS: Further improvement and promotion of the FCSDM model are needed to provide more evidence to this field in China.
OBJECTIVE: To investigate if a Family-Clinician Shared Decision-Making (FCSDM) intervention benefits patients, families and intensive care units (ICUs) clinicians. METHODS: Six ICUs in China were allocated to intervention or usual care. 548 patients with critical illness, 548 family members and 387 ICU clinicians were included into the study. Structured FCSDM family meetings were held in the intervention group. Scales of SSDM, HADS, QoL2 and CSACD were used to assess families' satisfaction and distress, patients' quality of life, and clinicians' collaboration respectively. RESULTS: Comparing the intervention group with the control group at post-intervention, there were significant differences in the families' satisfaction (P = 0.0001), depression level (P = 0.005), and patients' quality of life (P = 0.0007). The clinicians' mean CSCAD score was more positive in the intervention group than controls (P < 0.05). There was no significant between-group differences on ICU daily medical cost, but the intervention group demonstrated shorter number of days' stay in ICU (P = 0.0004). CONCLUSION: The FCSDM intervention improved families' satisfaction and depression, shortened patients' duration of ICU stay, and enhanced ICU clinicians' collaboration. PRACTICE IMPLICATIONS: Further improvement and promotion of the FCSDM model are needed to provide more evidence to this field in China.