Family satisfaction with family conferences about end-of-life care in the intensive care unit: Increased proportion of family speech is associated with increased satisfaction

Jonathan R. McDonagh, Tricia B. Elliott, Ruth A. Engelberg, Patsy D. Treece, Sarah Shannon, Gordon D. Rubenfeld, Donald L. Patrick, J. Randall Curtis

Research output: Contribution to journalArticle

287 Citations (Scopus)

Abstract

Objective: Family members of critically ill patients report dissatisfaction with family-clinician communication about withdrawing life support, yet limited data exist to guide clinicians in this communication. The hypothesis of this analysis was that increased proportion of family speech during ICU family conferences would be associated with increased family satisfaction. Design: Cross-sectional study. Setting: We identified family conferences in intensive care units of four Seattle hospitals during which discussions about withdrawing life support were likely to occur. Participants: Participants were 214 family members from 51 different families. There were 36 different physicians leading the conferences, as some physicians led more than one conference. Interventions: Fifty-one conferences were audiotaped. Measurements: We measured the duration of time that families and clinicians spoke during the conference. All participants were given a survey assessing satisfaction with communication. Results: The mean conference time was 32.0 mins with an SD of 14.8 mins and a range from 7 to 74 mins. On average, family members spoke 29% and clinicians spoke 71% of the time. Increased proportion of family speech was significantly associated with increased family satisfaction with physician communication. Increased proportion of family speech was also associated with decreased family ratings of conflict with the physician. There was no association between the duration of the conference and family satisfaction. Conslusions: This study suggests that allowing family members more opportunity to speak during conferences may improve family satisfaction. Future studies should assess the effect of interventions to increase listening by critical care clinicians on the quality of communication and the family experience.

Original languageEnglish (US)
Pages (from-to)1484-1488
Number of pages5
JournalCritical Care Medicine
Volume32
Issue number7
DOIs
StatePublished - Jul 2004
Externally publishedYes

Fingerprint

Terminal Care
Intensive Care Units
Communication
Physicians
Family Conflict
Critical Care

Keywords

  • Communication
  • Critical care
  • Death
  • Dying
  • End-of-life care
  • Family satisfaction

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Family satisfaction with family conferences about end-of-life care in the intensive care unit : Increased proportion of family speech is associated with increased satisfaction. / McDonagh, Jonathan R.; Elliott, Tricia B.; Engelberg, Ruth A.; Treece, Patsy D.; Shannon, Sarah; Rubenfeld, Gordon D.; Patrick, Donald L.; Curtis, J. Randall.

In: Critical Care Medicine, Vol. 32, No. 7, 07.2004, p. 1484-1488.

Research output: Contribution to journalArticle

McDonagh, Jonathan R. ; Elliott, Tricia B. ; Engelberg, Ruth A. ; Treece, Patsy D. ; Shannon, Sarah ; Rubenfeld, Gordon D. ; Patrick, Donald L. ; Curtis, J. Randall. / Family satisfaction with family conferences about end-of-life care in the intensive care unit : Increased proportion of family speech is associated with increased satisfaction. In: Critical Care Medicine. 2004 ; Vol. 32, No. 7. pp. 1484-1488.
@article{d67f246e5307484497e354e891336047,
title = "Family satisfaction with family conferences about end-of-life care in the intensive care unit: Increased proportion of family speech is associated with increased satisfaction",
abstract = "Objective: Family members of critically ill patients report dissatisfaction with family-clinician communication about withdrawing life support, yet limited data exist to guide clinicians in this communication. The hypothesis of this analysis was that increased proportion of family speech during ICU family conferences would be associated with increased family satisfaction. Design: Cross-sectional study. Setting: We identified family conferences in intensive care units of four Seattle hospitals during which discussions about withdrawing life support were likely to occur. Participants: Participants were 214 family members from 51 different families. There were 36 different physicians leading the conferences, as some physicians led more than one conference. Interventions: Fifty-one conferences were audiotaped. Measurements: We measured the duration of time that families and clinicians spoke during the conference. All participants were given a survey assessing satisfaction with communication. Results: The mean conference time was 32.0 mins with an SD of 14.8 mins and a range from 7 to 74 mins. On average, family members spoke 29{\%} and clinicians spoke 71{\%} of the time. Increased proportion of family speech was significantly associated with increased family satisfaction with physician communication. Increased proportion of family speech was also associated with decreased family ratings of conflict with the physician. There was no association between the duration of the conference and family satisfaction. Conslusions: This study suggests that allowing family members more opportunity to speak during conferences may improve family satisfaction. Future studies should assess the effect of interventions to increase listening by critical care clinicians on the quality of communication and the family experience.",
keywords = "Communication, Critical care, Death, Dying, End-of-life care, Family satisfaction",
author = "McDonagh, {Jonathan R.} and Elliott, {Tricia B.} and Engelberg, {Ruth A.} and Treece, {Patsy D.} and Sarah Shannon and Rubenfeld, {Gordon D.} and Patrick, {Donald L.} and Curtis, {J. Randall}",
year = "2004",
month = "7",
doi = "10.1097/01.CCM.0000127262.16690.65",
language = "English (US)",
volume = "32",
pages = "1484--1488",
journal = "Critical Care Medicine",
issn = "0090-3493",
publisher = "Lippincott Williams and Wilkins",
number = "7",

}

TY - JOUR

T1 - Family satisfaction with family conferences about end-of-life care in the intensive care unit

T2 - Increased proportion of family speech is associated with increased satisfaction

AU - McDonagh, Jonathan R.

AU - Elliott, Tricia B.

AU - Engelberg, Ruth A.

AU - Treece, Patsy D.

AU - Shannon, Sarah

AU - Rubenfeld, Gordon D.

AU - Patrick, Donald L.

AU - Curtis, J. Randall

PY - 2004/7

Y1 - 2004/7

N2 - Objective: Family members of critically ill patients report dissatisfaction with family-clinician communication about withdrawing life support, yet limited data exist to guide clinicians in this communication. The hypothesis of this analysis was that increased proportion of family speech during ICU family conferences would be associated with increased family satisfaction. Design: Cross-sectional study. Setting: We identified family conferences in intensive care units of four Seattle hospitals during which discussions about withdrawing life support were likely to occur. Participants: Participants were 214 family members from 51 different families. There were 36 different physicians leading the conferences, as some physicians led more than one conference. Interventions: Fifty-one conferences were audiotaped. Measurements: We measured the duration of time that families and clinicians spoke during the conference. All participants were given a survey assessing satisfaction with communication. Results: The mean conference time was 32.0 mins with an SD of 14.8 mins and a range from 7 to 74 mins. On average, family members spoke 29% and clinicians spoke 71% of the time. Increased proportion of family speech was significantly associated with increased family satisfaction with physician communication. Increased proportion of family speech was also associated with decreased family ratings of conflict with the physician. There was no association between the duration of the conference and family satisfaction. Conslusions: This study suggests that allowing family members more opportunity to speak during conferences may improve family satisfaction. Future studies should assess the effect of interventions to increase listening by critical care clinicians on the quality of communication and the family experience.

AB - Objective: Family members of critically ill patients report dissatisfaction with family-clinician communication about withdrawing life support, yet limited data exist to guide clinicians in this communication. The hypothesis of this analysis was that increased proportion of family speech during ICU family conferences would be associated with increased family satisfaction. Design: Cross-sectional study. Setting: We identified family conferences in intensive care units of four Seattle hospitals during which discussions about withdrawing life support were likely to occur. Participants: Participants were 214 family members from 51 different families. There were 36 different physicians leading the conferences, as some physicians led more than one conference. Interventions: Fifty-one conferences were audiotaped. Measurements: We measured the duration of time that families and clinicians spoke during the conference. All participants were given a survey assessing satisfaction with communication. Results: The mean conference time was 32.0 mins with an SD of 14.8 mins and a range from 7 to 74 mins. On average, family members spoke 29% and clinicians spoke 71% of the time. Increased proportion of family speech was significantly associated with increased family satisfaction with physician communication. Increased proportion of family speech was also associated with decreased family ratings of conflict with the physician. There was no association between the duration of the conference and family satisfaction. Conslusions: This study suggests that allowing family members more opportunity to speak during conferences may improve family satisfaction. Future studies should assess the effect of interventions to increase listening by critical care clinicians on the quality of communication and the family experience.

KW - Communication

KW - Critical care

KW - Death

KW - Dying

KW - End-of-life care

KW - Family satisfaction

UR - http://www.scopus.com/inward/record.url?scp=2942561745&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=2942561745&partnerID=8YFLogxK

U2 - 10.1097/01.CCM.0000127262.16690.65

DO - 10.1097/01.CCM.0000127262.16690.65

M3 - Article

C2 - 15241092

AN - SCOPUS:2942561745

VL - 32

SP - 1484

EP - 1488

JO - Critical Care Medicine

JF - Critical Care Medicine

SN - 0090-3493

IS - 7

ER -