Half the families of intensive care unit patients experience inadequate communication with physicians

Objective: Effective communication of simple, clear information to families of intensive care unit (ICU) patients is a vital component of quality care . The purpose of this study was to identify factors associated with poor co mprehension by family members of the status of ICU patients. Design: Prospective study. Setting: University-affiliated medical intensive care unit. Patients and Methods: A total of 102 patients admitted to an ICU for >2 day s. Intervention: The representatives of 76 patients who were visited by at lea st one person during their ICU stay were interviewed. Results: Mean patient age was 54 +/- 17 yrs and mean Simplified Acute Physi ology Score II at admission was 40 +/- 20. The representative was the spous e in 47 cases (62%). Among representatives, 25 (33%) were of foreign descen t and 12 (16%) did not speak French. Mean duration of the first meeting wit h a physician was 10 +/- 6 mins. In 34 cases (54%), the representative fail ed to comprehend the diagnosis, prognosis, or treatment of the patient. Factors associated with poor comprehension by representatives included pati ent-related, family-related, and physician-related factors. Patient-related factors included age <50 yrs (p = .03), unemployment (p = .01), referral f rom a hematology or oncology ward (p = .006), admission for acute respirato ry failure (p = .005) or coma (p = .01), and a relatively favorable prognos is (p = .04). Family-related factors were foreign descent (p = .007), no kn owledge of French (p = .03), representative not the spouse (p = .03), and n o healthcare professional in the family (p = .01). Physician-related factor s were first meeting with representative <10 mins (p = .03) and failure to give the representative an information brochure (p = .02). Moreover, after the first meeting, caregivers accurately predicted poor comprehension by re presentatives (p = .03). Conclusions: Patient information is frequently not communicated effectively to family members by ICU physicians. Physicians should strive to identify patients and families who require special attention and to determine how th eir personal style of interrelating with family members may impair communic ation.