PURPOSE: Critical care practice embraces shared-decision making (SDM) in collaboration with families for patients with compromised capacity in the ICU. We report a study of family members perceptions of this collaboration.
METHODS: Four questions were created to measure the family’s perception of SDM in item format paralleling the Family Satisfaction in the ICU (FS-ICU). We surveyed family members of 50 patients admitted to the ICU for at least 48 hours from November 2010 to February 2011.
RESULTS: Forty-seven family members completed the FS-ICU and SDM questions (age 52 +/- 14 years, female 73%, employed 52%, some religious affiliation 62%). Analysis of the four SDM questions showed:: How well did the doctors try to understand the ways that you wanted to be involved in medical decisions with the care team (66% excellent, 18% very good, 4% good, 4% fair, 7% poor); How well did the doctors then work with you in the ways that you wanted to be involved in decisions (62% excellent, 23% very good, 4% good, 4% fair, 7% poor); How well did the doctors try to understand your family values / preferences around care (62% excellent, 23% very good, 5% good, 2% fair, 9% poor); and Did you feel that your family values and styles of communicating were respectfully used to guide the care decisions (66% excellent, 19% very good, 6% good, 2% fair, 7% poor). FS-ICU scores (graded 0-100, 100 being highest satisfaction) were 87+/-18.6. Analyses did not find any association with family member age, education, religion, occupational status, or overall family satisfaction scores.
CONCLUSIONS: Family members reported predominantly positive responses to four questions assessing aspects of shared decision-making.
CLINICAL IMPLICATIONS: Compared to previous data from White et al, survey respondents indicated positive ratings of family participation in decision-making in the ICU. We did not find any significant relationships with demographic or satisfaction scores across assessed aspects of SDM. Ability to discern discrete aspects of SDM may be limited in family self-report assessment.
DISCLOSURE: The following authors have nothing to disclose: Vikas Grover, Paula Nagy, Susan Rosenkranz, Tia Swaney, Lissi Hansen, Michael Leo, Richard Mularski
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