Identifying elements of ICU care that families report as important but unsatisfactory: Decision-making, control, and ICU atmosphere

Tristan R. Osborn, J. Randall Curtis, Elizabeth L. Nielsen, Anthony L. Back, Sarah Shannon, Ruth A. Engelberg

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Background: One in five deaths in the United States occurs in the ICU, and many of these deaths are experienced as less than optimal by families of dying people. The current study investigated the relationship between family satisfaction with ICU care and overall ratings of the quality of dying as a means of identifying targets for improving end-of-life experiences for patients and families. Methods: This multisite cross-sectional study surveyed families of patients who died in the ICU in one of 15 hospitals in western Washington State. Measures included the Family Satisfaction in the ICU (FS-ICU) and the Single-Item Quality of Dying (QOD-1) questionnaires. Associations between FS-ICU items and the QOD-1 were examined using multivariate linear regression controlling for patient and family demographics and hospital site. Results: Questionnaires were returned for 1,290 of 2,850 decedents (45%). Higher QOD-1 scores were significantly associated (all P<.05) with (1) perceived nursing skill and competence(β = 0.15), (2) support for family as decision-makers(β = 0.10), (3) family control over the patient's care (β = 0.18), and (4) ICU atmosphere(β = 0.12). FS-ICU items that received low ratings and correlated with higher QOD-1 scores (ie, important items with room for improvement) were (1) support of family as decision-maker, (2) family control over patient's care, and (3) ICU atmosphere. Conclusions: Increased support for families as decision-makers and for their desired level of control over patient care along with improvements in the ICU atmosphere were identified as aspects of the ICU experience that may be important targets for quality improvement. Trial registry: ClinicalTrials.gov; No.: NCT00685893; URL: www.clinicaltrials.gov.

Original languageEnglish (US)
Pages (from-to)1185-1192
Number of pages8
JournalChest
Volume142
Issue number5
DOIs
StatePublished - Nov 2012
Externally publishedYes

Fingerprint

Atmosphere
Decision Making
Patient Care
Quality Improvement
Mental Competency
Registries
Linear Models
Nursing
Cross-Sectional Studies
Demography

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Osborn, T. R., Curtis, J. R., Nielsen, E. L., Back, A. L., Shannon, S., & Engelberg, R. A. (2012). Identifying elements of ICU care that families report as important but unsatisfactory: Decision-making, control, and ICU atmosphere. Chest, 142(5), 1185-1192. https://doi.org/10.1378/chest.11-3277

Identifying elements of ICU care that families report as important but unsatisfactory : Decision-making, control, and ICU atmosphere. / Osborn, Tristan R.; Curtis, J. Randall; Nielsen, Elizabeth L.; Back, Anthony L.; Shannon, Sarah; Engelberg, Ruth A.

In: Chest, Vol. 142, No. 5, 11.2012, p. 1185-1192.

Research output: Contribution to journalArticle

Osborn, TR, Curtis, JR, Nielsen, EL, Back, AL, Shannon, S & Engelberg, RA 2012, 'Identifying elements of ICU care that families report as important but unsatisfactory: Decision-making, control, and ICU atmosphere', Chest, vol. 142, no. 5, pp. 1185-1192. https://doi.org/10.1378/chest.11-3277
Osborn, Tristan R. ; Curtis, J. Randall ; Nielsen, Elizabeth L. ; Back, Anthony L. ; Shannon, Sarah ; Engelberg, Ruth A. / Identifying elements of ICU care that families report as important but unsatisfactory : Decision-making, control, and ICU atmosphere. In: Chest. 2012 ; Vol. 142, No. 5. pp. 1185-1192.
@article{ef6f24ced79649b9961e5d19671a65da,
title = "Identifying elements of ICU care that families report as important but unsatisfactory: Decision-making, control, and ICU atmosphere",
abstract = "Background: One in five deaths in the United States occurs in the ICU, and many of these deaths are experienced as less than optimal by families of dying people. The current study investigated the relationship between family satisfaction with ICU care and overall ratings of the quality of dying as a means of identifying targets for improving end-of-life experiences for patients and families. Methods: This multisite cross-sectional study surveyed families of patients who died in the ICU in one of 15 hospitals in western Washington State. Measures included the Family Satisfaction in the ICU (FS-ICU) and the Single-Item Quality of Dying (QOD-1) questionnaires. Associations between FS-ICU items and the QOD-1 were examined using multivariate linear regression controlling for patient and family demographics and hospital site. Results: Questionnaires were returned for 1,290 of 2,850 decedents (45{\%}). Higher QOD-1 scores were significantly associated (all P<.05) with (1) perceived nursing skill and competence(β = 0.15), (2) support for family as decision-makers(β = 0.10), (3) family control over the patient's care (β = 0.18), and (4) ICU atmosphere(β = 0.12). FS-ICU items that received low ratings and correlated with higher QOD-1 scores (ie, important items with room for improvement) were (1) support of family as decision-maker, (2) family control over patient's care, and (3) ICU atmosphere. Conclusions: Increased support for families as decision-makers and for their desired level of control over patient care along with improvements in the ICU atmosphere were identified as aspects of the ICU experience that may be important targets for quality improvement. Trial registry: ClinicalTrials.gov; No.: NCT00685893; URL: www.clinicaltrials.gov.",
author = "Osborn, {Tristan R.} and Curtis, {J. Randall} and Nielsen, {Elizabeth L.} and Back, {Anthony L.} and Sarah Shannon and Engelberg, {Ruth A.}",
year = "2012",
month = "11",
doi = "10.1378/chest.11-3277",
language = "English (US)",
volume = "142",
pages = "1185--1192",
journal = "Chest",
issn = "0012-3692",
publisher = "American College of Chest Physicians",
number = "5",

}

TY - JOUR

T1 - Identifying elements of ICU care that families report as important but unsatisfactory

T2 - Decision-making, control, and ICU atmosphere

AU - Osborn, Tristan R.

AU - Curtis, J. Randall

AU - Nielsen, Elizabeth L.

AU - Back, Anthony L.

AU - Shannon, Sarah

AU - Engelberg, Ruth A.

PY - 2012/11

Y1 - 2012/11

N2 - Background: One in five deaths in the United States occurs in the ICU, and many of these deaths are experienced as less than optimal by families of dying people. The current study investigated the relationship between family satisfaction with ICU care and overall ratings of the quality of dying as a means of identifying targets for improving end-of-life experiences for patients and families. Methods: This multisite cross-sectional study surveyed families of patients who died in the ICU in one of 15 hospitals in western Washington State. Measures included the Family Satisfaction in the ICU (FS-ICU) and the Single-Item Quality of Dying (QOD-1) questionnaires. Associations between FS-ICU items and the QOD-1 were examined using multivariate linear regression controlling for patient and family demographics and hospital site. Results: Questionnaires were returned for 1,290 of 2,850 decedents (45%). Higher QOD-1 scores were significantly associated (all P<.05) with (1) perceived nursing skill and competence(β = 0.15), (2) support for family as decision-makers(β = 0.10), (3) family control over the patient's care (β = 0.18), and (4) ICU atmosphere(β = 0.12). FS-ICU items that received low ratings and correlated with higher QOD-1 scores (ie, important items with room for improvement) were (1) support of family as decision-maker, (2) family control over patient's care, and (3) ICU atmosphere. Conclusions: Increased support for families as decision-makers and for their desired level of control over patient care along with improvements in the ICU atmosphere were identified as aspects of the ICU experience that may be important targets for quality improvement. Trial registry: ClinicalTrials.gov; No.: NCT00685893; URL: www.clinicaltrials.gov.

AB - Background: One in five deaths in the United States occurs in the ICU, and many of these deaths are experienced as less than optimal by families of dying people. The current study investigated the relationship between family satisfaction with ICU care and overall ratings of the quality of dying as a means of identifying targets for improving end-of-life experiences for patients and families. Methods: This multisite cross-sectional study surveyed families of patients who died in the ICU in one of 15 hospitals in western Washington State. Measures included the Family Satisfaction in the ICU (FS-ICU) and the Single-Item Quality of Dying (QOD-1) questionnaires. Associations between FS-ICU items and the QOD-1 were examined using multivariate linear regression controlling for patient and family demographics and hospital site. Results: Questionnaires were returned for 1,290 of 2,850 decedents (45%). Higher QOD-1 scores were significantly associated (all P<.05) with (1) perceived nursing skill and competence(β = 0.15), (2) support for family as decision-makers(β = 0.10), (3) family control over the patient's care (β = 0.18), and (4) ICU atmosphere(β = 0.12). FS-ICU items that received low ratings and correlated with higher QOD-1 scores (ie, important items with room for improvement) were (1) support of family as decision-maker, (2) family control over patient's care, and (3) ICU atmosphere. Conclusions: Increased support for families as decision-makers and for their desired level of control over patient care along with improvements in the ICU atmosphere were identified as aspects of the ICU experience that may be important targets for quality improvement. Trial registry: ClinicalTrials.gov; No.: NCT00685893; URL: www.clinicaltrials.gov.

UR - http://www.scopus.com/inward/record.url?scp=84868624343&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84868624343&partnerID=8YFLogxK

U2 - 10.1378/chest.11-3277

DO - 10.1378/chest.11-3277

M3 - Article

C2 - 22661455

AN - SCOPUS:84868624343

VL - 142

SP - 1185

EP - 1192

JO - Chest

JF - Chest

SN - 0012-3692

IS - 5

ER -