title: ICU family communication and health care professionals: A qualitative analysis of perspectives.
abstract: OBJECTIVE
  Although ineffective communication is known to influence patient and family satisfaction with care in intensive care unit [ICU] settings, there has been little systematic analysis of the features of the perceived problem from a communication theory perspective. This study was undertaken to understand perceptions of miscommunication and the circumstances in which they present.
  Semi-structured interviews were conducted with 22 health care professionals [HCPs] in five adult ICUs at an academic medical centre in the United States.
  
  
  RESULTS
  From qualitative analysis of the transcribed interviews, four themes emerged, each containing multiple subthemes. Person factors are problems that originate within individuals, related to education, cultural background and emotion. Structural factors are associated with boundaries and coordination of institutional roles. Information management problems result from social and psychological processes by which HCPs and family members seek, distribute and understand information. Relationship management problems arise from difficulties in interpersonal interactions.
  
  
  CONCLUSIONS
  Ineffective communication is not a single problem, but rather several distinct problems that exist at different levels of abstraction and vary in over-time stability. These findings provide a framework for designing interventions to improve the well-being of patients and family members.
authors.affiliation: The Pennsylvania State University, College of Medicine, Departments of Surgery, Medicine, and Public Health Sciences, 500 University Drive, Hershey, PA 17033-0850, USA. Electronic address: jschubart@hmc.psu.edu.
authors.forename: Jane R
authors.initials: JR
authors.lastname: Schubart
authors.affiliation: The Pennsylvania State University, College of Medicine, Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, 500 University Drive, Hershey, PA 17033-0850, USA.
authors.forename: Margaret
authors.initials: M
authors.lastname: Wojnar
authors.affiliation: The Pennsylvania State University, Department of Communication Arts and Sciences, University Park, State College, PA 16801, USA.
authors.forename: James Price
authors.initials: JP
authors.lastname: Dillard
authors.affiliation: The Pennsylvania State University, Department of Communication Arts and Sciences, University Park, State College, PA 16801, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Meczkowski
authors.affiliation: The Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033-0850, USA.
authors.forename: Mary Louise
authors.initials: ML
authors.lastname: Kanaskie
authors.affiliation: The Pennsylvania State University, College of Medicine, Department of Pediatrics, Division of Hematology Oncology, 500 University Drive, Hershey, PA 17033-0850, USA.
authors.forename: George F
authors.initials: GF
authors.lastname: Blackall
authors.affiliation: The Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033-0850, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Sperry
authors.affiliation: The Pennsylvania State University, College of Medicine, Department of Public Health Sciences, 500 University Drive, Hershey, PA 17033-0850, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lloyd
mesh_terms: D001291:Attitude of Health Personnel; D003142:Communication; D064648:Critical Care Nursing; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D009722:Nurse Practitioners; D009726:Nurses; D010820:Physicians; D011368:Professional-Family Relations; D036301:Qualitative Research
keywords: Communication; Health professional; Intensive care unit; Qualitative