title: Prevalence and factors of intensive care unit conflicts: the conflicus study.
abstract: BACKGROUND
  Many sources of conflict exist in intensive care units (ICUs). Few studies recorded the prevalence, characteristics, and risk factors for conflicts in ICUs.
  
  
  OBJECTIVE
  To record the prevalence, characteristics, and risk factors for conflicts in ICUs.
  
  
  METHODS
  One-day cross-sectional survey of ICU clinicians. Data on perceived conflicts in the week before the survey day were obtained from 7,498 ICU staff members (323 ICUs in 24 countries).
  
  
  RESULTS
  Conflicts were perceived by 5,268 (71.6%) respondents. Nurse-physician conflicts were the most common (32.6%), followed by conflicts among nurses (27.3%) and staff-relative conflicts (26.6%). The most common conflict-causing behaviors were personal animosity, mistrust, and communication gaps. During end-of-life care, the main sources of perceived conflict were lack of psychological support, absence of staff meetings, and problems with the decision-making process. Conflicts perceived as severe were reported by 3,974 (53%) respondents. Job strain was significantly associated with perceiving conflicts and with greater severity of perceived conflicts. Multivariate analysis identified 15 factors associated with perceived conflicts, of which 6 were potential targets for future intervention: staff working more than 40 h/wk, more than 15 ICU beds, caring for dying patients or providing pre- and postmortem care within the last week, symptom control not ensured jointly by physicians and nurses, and no routine unit-level meetings.
  
  
  CONCLUSIONS
  Over 70% of ICU workers reported perceived conflicts, which were often considered severe and were significantly associated with job strain. Workload, inadequate communication, and end-of-life care emerged as important potential targets for improvement.
authors: AP-HP, Hôpital Saint-Louis, Medical ICU, University Paris-7 Paris-Diderot, UFR de Médecine, 1 avenue Claude Vellefaux, 75010 Paris, France. elie.azoulay@sls.ap-hop-paris.fr
authors: Elie
authors: E
authors: Azoulay
authors: Jean-François
authors: JF
authors: Timsit
authors: Charles L
authors: CL
authors: Sprung
authors: Marcio
authors: M
authors: Soares
authors: Katerina
authors: K
authors: Rusinová
authors: Ariane
authors: A
authors: Lafabrie
authors: Ricardo
authors: R
authors: Abizanda
authors: Mia
authors: M
authors: Svantesson
authors: Francesca
authors: F
authors: Rubulotta
authors: Bara
authors: B
authors: Ricou
authors: Dominique
authors: D
authors: Benoit
authors: Daren
authors: D
authors: Heyland
authors: Gavin
authors: G
authors: Joynt
authors: Adrien
authors: A
authors: Français
authors: Paulo
authors: P
authors: Azeivedo-Maia
authors: Radoslaw
authors: R
authors: Owczuk
authors: Julie
authors: J
authors: Benbenishty
authors: Michael
authors: M
authors: de Vita
authors: Andreas
authors: A
authors: Valentin
authors: Akos
authors: A
authors: Ksomos
authors: Simon
authors: S
authors: Cohen
authors: Lidija
authors: L
authors: Kompan
authors: Kwok
authors: K
authors: Ho
authors: Fekri
authors: F
authors: Abroug
authors: Anne
authors: A
authors: Kaarlola
authors: Herwig
authors: H
authors: Gerlach
authors: Theodoros
authors: T
authors: Kyprianou
authors: Andrej
authors: A
authors: Michalsen
authors: Sylvie
authors: S
authors: Chevret
authors: Benoît
authors: B
authors: Schlemmer
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000453:epidemiology / Q000523:psychology; D003142:Communication; D003220:Conflict, Psychological; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D006282:Health Personnel / Q000523:psychology / Q000706:statistics & numerical data; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007398:Interpersonal Relations; D008297:Male; D010465:Perception; D015995:Prevalence; D012307:Risk Factors; D012944:Social Support; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000523:psychology / Q000706:statistics & numerical data; D016526:Workload / Q000523:psychology