title: Defining the Medical Intensive Care Unit in the Words of Patients and Their Family Members: A Freelisting Analysis.
abstract: BACKGROUND
  No validated conceptual framework exists for understanding the outcomes of patient- and family-centered care in critical care.
  
  
  OBJECTIVE
  To explore the meaning of intensive care unit among patients and their families by using freelisting.
  
  
  METHODS
  The phrase intensive care unit was used to prompt freelisting among intensive care unit patients and patients' family members. Freelisting is an anthropological technique in which individuals define a domain by listing all words that come to mind in response to a topic. Salience scores, derived from the frequency with which a word was mentioned, the order in which it was mentioned, and the length of each list, were calculated and analyzed.
  
  
  RESULTS
  Among the 45 participants, many words were salient to both patients and patients' family members. Words salient solely for patients included consciousness, getting better, noisy, and personal care. Words salient solely for family members included sadness, busy, professional, and hope. The words suffering, busy, and team were salient solely for family members of patients who lived, whereas sadness, professionals, and hope were salient solely for family members of patients who died. The words caring and death were salient for both groups.
  
  
  CONCLUSIONS
  Intensive care unit patients and their families define intensive care unit by using words to describe sickness, caring, medical staff, emotional states, and physical qualities of the unit. The results validate the importance of these topics among patients and their families in the intensive care unit and illustrate the usefulness of freelisting in critical care research.
authors.affiliation: Catherine L. Auriemma is a resident physician in internal medicine, University of California San Francisco and a research trainee with the Fostering Improvement in End-of-Life Decision Science (FIELDS) Program, University of Pennsylvania, Philadelphia. Sarah M. Lyon is an instructor of medicine in the Division of Pulmonary, Allergy, and Critical Care Medicine at the University of Pennsylvania Perelman School of Medicine. Lauren E. Strelec and Saida Kent are research assistants with the FIELDS Program, University of Pennsylvania. Frances K. Barg is an associate professor in the Department of Family Medicine and Community Health and the Department of Anthropology, University of Pennsylvania School of Arts and Sciences. Scott D. Halpern is director of the FIELDS Program and an associate professor in the Departments of Medicine, Epidemiology, and Medical Ethics and Health Policy, as well as senior fellow in the Leonard Davis Institute of Health Economics, all at the University of Pennsylvania Perelman School of Medicine.
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Auriemma
authors.affiliation: Catherine L. Auriemma is a resident physician in internal medicine, University of California San Francisco and a research trainee with the Fostering Improvement in End-of-Life Decision Science (FIELDS) Program, University of Pennsylvania, Philadelphia. Sarah M. Lyon is an instructor of medicine in the Division of Pulmonary, Allergy, and Critical Care Medicine at the University of Pennsylvania Perelman School of Medicine. Lauren E. Strelec and Saida Kent are research assistants with the FIELDS Program, University of Pennsylvania. Frances K. Barg is an associate professor in the Department of Family Medicine and Community Health and the Department of Anthropology, University of Pennsylvania School of Arts and Sciences. Scott D. Halpern is director of the FIELDS Program and an associate professor in the Departments of Medicine, Epidemiology, and Medical Ethics and Health Policy, as well as senior fellow in the Leonard Davis Institute of Health Economics, all at the University of Pennsylvania Perelman School of Medicine.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Lyon
authors.affiliation: Catherine L. Auriemma is a resident physician in internal medicine, University of California San Francisco and a research trainee with the Fostering Improvement in End-of-Life Decision Science (FIELDS) Program, University of Pennsylvania, Philadelphia. Sarah M. Lyon is an instructor of medicine in the Division of Pulmonary, Allergy, and Critical Care Medicine at the University of Pennsylvania Perelman School of Medicine. Lauren E. Strelec and Saida Kent are research assistants with the FIELDS Program, University of Pennsylvania. Frances K. Barg is an associate professor in the Department of Family Medicine and Community Health and the Department of Anthropology, University of Pennsylvania School of Arts and Sciences. Scott D. Halpern is director of the FIELDS Program and an associate professor in the Departments of Medicine, Epidemiology, and Medical Ethics and Health Policy, as well as senior fellow in the Leonard Davis Institute of Health Economics, all at the University of Pennsylvania Perelman School of Medicine.
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Strelec
authors.affiliation: Catherine L. Auriemma is a resident physician in internal medicine, University of California San Francisco and a research trainee with the Fostering Improvement in End-of-Life Decision Science (FIELDS) Program, University of Pennsylvania, Philadelphia. Sarah M. Lyon is an instructor of medicine in the Division of Pulmonary, Allergy, and Critical Care Medicine at the University of Pennsylvania Perelman School of Medicine. Lauren E. Strelec and Saida Kent are research assistants with the FIELDS Program, University of Pennsylvania. Frances K. Barg is an associate professor in the Department of Family Medicine and Community Health and the Department of Anthropology, University of Pennsylvania School of Arts and Sciences. Scott D. Halpern is director of the FIELDS Program and an associate professor in the Departments of Medicine, Epidemiology, and Medical Ethics and Health Policy, as well as senior fellow in the Leonard Davis Institute of Health Economics, all at the University of Pennsylvania Perelman School of Medicine.
authors.forename: Saida
authors.initials: S
authors.lastname: Kent
authors.affiliation: Catherine L. Auriemma is a resident physician in internal medicine, University of California San Francisco and a research trainee with the Fostering Improvement in End-of-Life Decision Science (FIELDS) Program, University of Pennsylvania, Philadelphia. Sarah M. Lyon is an instructor of medicine in the Division of Pulmonary, Allergy, and Critical Care Medicine at the University of Pennsylvania Perelman School of Medicine. Lauren E. Strelec and Saida Kent are research assistants with the FIELDS Program, University of Pennsylvania. Frances K. Barg is an associate professor in the Department of Family Medicine and Community Health and the Department of Anthropology, University of Pennsylvania School of Arts and Sciences. Scott D. Halpern is director of the FIELDS Program and an associate professor in the Departments of Medicine, Epidemiology, and Medical Ethics and Health Policy, as well as senior fellow in the Leonard Davis Institute of Health Economics, all at the University of Pennsylvania Perelman School of Medicine.
authors.forename: Frances K
authors.initials: FK
authors.lastname: Barg
authors.affiliation: Catherine L. Auriemma is a resident physician in internal medicine, University of California San Francisco and a research trainee with the Fostering Improvement in End-of-Life Decision Science (FIELDS) Program, University of Pennsylvania, Philadelphia. Sarah M. Lyon is an instructor of medicine in the Division of Pulmonary, Allergy, and Critical Care Medicine at the University of Pennsylvania Perelman School of Medicine. Lauren E. Strelec and Saida Kent are research assistants with the FIELDS Program, University of Pennsylvania. Frances K. Barg is an associate professor in the Department of Family Medicine and Community Health and the Department of Anthropology, University of Pennsylvania School of Arts and Sciences. Scott D. Halpern is director of the FIELDS Program and an associate professor in the Departments of Medicine, Epidemiology, and Medical Ethics and Health Policy, as well as senior fellow in the Leonard Davis Institute of Health Economics, all at the University of Pennsylvania Perelman School of Medicine. shalpern@exchange.upenn.edu.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Halpern
mesh_terms: D002983:Clinical Competence / Q000706:statistics & numerical data; D003422:Critical Care / Q000523:psychology*; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D015143:Philadelphia; D011368:Professional-Family Relations; D011369:Professional-Patient Relations