Journal
PATIENT EDUCATION AND COUNSELING
Volume 105, Issue 6, Pages 1532-1538Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.pec.2021.10.004
Keywords
Shared decision-making; Family meeting; Critically ill patient; Family; Randomized trial
Funding
- China Medical Board [CMB 14-200]
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This study investigated the benefits of a Family-Clinician Shared Decision-Making (FCSDM) intervention for patients, families, and ICU clinicians. The results showed that the FCSDM intervention improved families' satisfaction and depression, shortened patients' duration of ICU stay, and enhanced ICU clinicians' collaboration.
Objective: To investigate if a Family-Clinician Shared Decision-Making (FCSDM) intervention benefits patients, families and intensive care units (ICUs) clinicians. Methods: Six ICUs in China were allocated to intervention or usual care. 548 patients with critical illness, 548 family members and 387 ICU clinicians were included into the study. Structured FCSDM family meetings were held in the intervention group. Scales of SSDM, HADS, QoL2 and CSACD were used to assess families' satisfaction and distress, patients' quality of life, and clinicians' collaboration respectively. Results: Comparing the intervention group with the control group at post-intervention, there were significant differences in the families' satisfaction (P = 0.0001), depression level (P = 0.005), and patients' quality of life (P = 0.0007). The clinicians' mean CSCAD score was more positive in the intervention group than controls (P < 0.05). There was no significant between-group differences on ICU daily medical cost, but the intervention group demonstrated shorter number of days' stay in ICU (P = 0.0004). Conclusion: The FCSDM intervention improved families' satisfaction and depression, shortened patients' duration of ICU stay, and enhanced ICU clinicians' collaboration. Practice implications: Further improvement and promotion of the FCSDM model are needed to provide more evidence to this field in China. (c) 2021 The Authors. Published by Elsevier B.V. CC_BY_NC_ND_4.0
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