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Decision making and satisfaction with care in the pediatric intensive care unit: findings from a controlled clinical

Michelle M Mello1, Jeffrey P Burns, Robert D Truog

  • 1Department of Health Policy and Management, Harvard School of Public Health, Boston, MA 02115, USA. mmello@hsph.harvard.edu

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|December 31, 2003
PubMed

Insights

An intervention to identify and mitigate conflicts in pediatric intensive care units did not improve decision making or parental satisfaction. This study highlights the need for further research into effective communication strategies for families facing critical care decisions.

Area of Science:

  • Pediatric Intensive Care
  • Clinical Decision Making
  • Family-Centered Care

Background:

  • Families in pediatric intensive care units (PICUs) face complex decisions.
  • Effective communication and decision support are crucial for improving care satisfaction.

Purpose of the Study:

  • To facilitate critical decision making for families in a PICU.
  • To improve family satisfaction with care through enhanced communication.

Main Methods:

  • A prospective observational study followed by a nonrandomized controlled trial.
  • Interventions involved identifying conflicts and facilitating communication between families and clinical teams.
  • Surveys assessed information adequacy, understanding, communication, and decisional conflicts.

Main Results:

  • The intervention did not significantly increase decision making or parental satisfaction with care.
  • Incidence rates of comfort-care-only plans and foregoing resuscitation were lower in the intervention group.
  • Patient acuity and hospital stay data were extracted for analysis.

Conclusions:

  • Screening for and intervening to mitigate potential conflicts did not enhance decision making or satisfaction in this PICU setting.
  • Further strategies may be needed to support families during critical care decision-making processes.
Abstract

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