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Related Experiment Videos

Communication about chronic critical illness.

Judith E Nelson1, Alice F Mercado, Sharon L Camhi

  • 1Mount Sinai School of Medicine, New York, NY 10029, USA. judith.nelson@mountsinai.org

Archives of Internal Medicine
|December 12, 2007
PubMed
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Patients with chronic critical illness and their families often lack crucial information for making treatment decisions. Improving communication is vital for shared decision-making and better care outcomes.

Area of Science:

  • Critical Care Medicine
  • Patient Communication
  • Health Outcomes Research

Background:

  • A growing population of patients with chronic critical illness (CCI) receive life-sustaining treatments like mechanical ventilation despite poor prognoses.
  • Inadequate communication between clinicians, patients, and families may contribute to continued aggressive treatment due to a lack of understanding.
  • This study investigated the informational needs of CCI patients and their families and the extent to which these needs are met.

Purpose of the Study:

  • To assess the informational needs of patients with chronic critical illness and their families.
  • To determine if these informational needs are adequately met by healthcare providers.
  • To identify gaps in communication regarding treatment decisions for chronic critical illness.

Main Methods:

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  • A prospective observational study was conducted in 5 adult intensive care units.
  • 100 patients with chronic critical illness or their surrogates completed an 18-item questionnaire on communication.
  • The survey assessed the importance of information and whether it was received for decision-making.

Main Results:

  • Over 78% of respondents found all surveyed information important for decision-making, with 16 of 18 items rated important by >98%.
  • Respondents reported not receiving information on a mean of 9.0 items, with 95% lacking information for about 25% of items.
  • Crucial information regarding expected functional status (80%) and 1-year survival prognosis (93%) was frequently not received.

Conclusions:

  • Patients and families with chronic critical illness often lack essential information for making informed treatment decisions.
  • There is a significant gap in communication regarding prognosis and functional status for patients with chronic critical illness.
  • Developing and implementing effective communication strategies is crucial for improving care in the chronic phase of critical illness.