title: Half the families of intensive care unit patients experience inadequate communication with physicians.
abstract: 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 comprehension by family members of the status of ICU patients.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  University-affiliated medical intensive care unit.
  
  
  METHODS
  A total of 102 patients admitted to an ICU for >2 days.
  
  
  METHODS
  The representatives of 76 patients who were visited by at least one person during their ICU stay were interviewed.
  
  
  RESULTS
  Mean patient age was 54+/-17 yrs and mean Simplified Acute Physiology Score II at admission was 40+/-20. The representative was the spouse in 47 cases (62%). Among representatives, 25 (33%) were of foreign descent and 12 (16%) did not speak French. Mean duration of the first meeting with a physician was 10+/-6 mins. In 34 cases (54%), the representative failed to comprehend the diagnosis, prognosis, or treatment of the patient. Factors associated with poor comprehension by representatives included patient-related, family-related, and physician-related factors. Patient-related factors included age <50 yrs (p = .03), unemployment (p = .01), referral from a hematology or oncology ward (p = .006), admission for acute respiratory failure (p = .005) or coma (p = .01), and a relatively favorable prognosis (p = .04). Family-related factors were foreign descent (p = .007), no knowledge of French (p = .03), representative not the spouse (p = .03), and no healthcare professional in the family (p = .01). Physician-related factors 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 representatives (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 their personal style of interrelating with family members may impair communication.
authors.affiliation: Service de Réanimation Médicale, Hôpital Saint-Louis et Université Paris 7, France.
authors.forename: E
authors.initials: E
authors.lastname: Azoulay
authors.forename: S
authors.initials: S
authors.lastname: Chevret
authors.forename: G
authors.initials: G
authors.lastname: Leleu
authors.forename: F
authors.initials: F
authors.lastname: Pochard
authors.forename: M
authors.initials: M
authors.lastname: Barboteu
authors.forename: C
authors.initials: C
authors.lastname: Adrie
authors.forename: P
authors.initials: P
authors.lastname: Canoui
authors.forename: J R
authors.initials: JR
authors.lastname: Le Gall
authors.forename: B
authors.initials: B
authors.lastname: Schlemmer
mesh_terms: D003142:Communication; D003258:Consumer Behavior; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011368:Professional-Family Relations; D011446:Prospective Studies