title: Do they hear what we speak? Assessing the effectiveness of communication to families of critically ill neurosurgical patients.
abstract: OBJECTIVE
  Clinician-family communication must be effective for medical decision making in any Intensive Care Unit (ICU) setting. We performed a prospective study to assess the effectiveness of communication to families of critically ill neurosurgical patients based on the two criteria of comprehension and satisfaction.
  
  
  METHODS
  The study was conducted on 75 patients in a 15 bedded neurosurgical ICU. An independent investigator assessed the comprehension and satisfaction of families between the 3(rd) and the 5(th) day of admission in ICU. Comprehension was tested using three components, that is, comprehension of diagnosis, prognosis and treatment. The satisfaction was measured using a modified version of the Critical Care Family Needs Inventory (CCFNI) (score of 56-extreme dissatisfaction and 14-extreme satisfaction).
  
  
  RESULTS
  Poor comprehension was noted in 52 representatives (71.2%). The mean satisfaction score as measured by the CCFNI score was 28. Factors associated with poor comprehension included increasing age of patient representative (P = 0.024), higher simplified acute physiology score (P = 0.26), nonoperated patients (P = 0.0087) and clinician estimation of poor prognosis (P = 0.01). Operated patients had significantly better satisfaction score (P = 0.04).
  
  
  CONCLUSIONS
  Families of patients were reasonably satisfied, but had poor comprehension levels of the patient's illness. The severity of the patient's illness, poor prognosis as estimated by the physician and nonoperated patients were independent predictors of poor comprehension. Extra effort to communicate with patient representatives at risk of poor comprehension and provision of a family information leaflet could possibly remedy this situation.
authors: Department of Neurosurgery, Christian Medical College and Hospital, Ludhiana, Punjab, India.
authors: Jacob Eapen
authors: JE
authors: Mathew
authors: Department of Neurosurgery, Christian Medical College and Hospital, Ludhiana, Punjab, India.
authors: Jayraj
authors: J
authors: Azariah
authors: Department of Anaesthesia, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
authors: Smitha Elizabeth
authors: SE
authors: George
authors: Department of Neurosurgery, Christian Medical College and Hospital, Ludhiana, Punjab, India.
authors: Sarvpreet Singh
authors: SS
authors: Grewal
keywords: Clinician; Intensive Care Unit; communication; comprehension; critical care; family representatives; satisfaction