Obstacles to Shared Expectations in a Burn Intensive Care Unit

Area of Science:

• Critical Care Medicine
• Health Communication
• Sociology of Health

Background:

• Critical care patients rely on healthcare teams and families for care aligned with their values.
• Effective communication is crucial for achieving patient-centered care goals.

Purpose of the Study:

• To identify and understand communication obstacles impacting critical care teams and family members.
• To explore differences in perceived obstacles between these two groups.

Main Methods:

• Conducted in-depth semistructured interviews with 10 burn intensive care unit (BICU) care team members and 20 family members.
• Utilized a two-cycle coding, inductive analytical approach to identify themes.

Main Results:

• Three obstacle metathemes emerged: family engagement, information exchange, and process transparency/standardization.
• Distinct themes within each metatheme were identified for care team members and family members.
• Findings align with actor-network theory's concept of resistances.

Conclusions:

• Actor-network theory offers a framework for understanding communication obstacles in critical care.
• Future interventions can be developed based on this theory to enhance shared agency.
• Improving communication networks can lead to better alignment of care goals with patient values.