Impact of a Family Information Leaflet on Effectiveness of Information Provided to Family Members of Intensive Care Unit Patients

Abstract

Comprehension and satisfaction are relevant criteria for evaluating the effectiveness of information provided to family members of intensive care unit (ICU) patients. We performed a prospective randomized trial in 34 French ICUs to compare comprehension of diagnosis, prognosis, treatment, and satisfaction with information provided by ICU caregivers, in ICU patient family representatives who did (n = 87) or did not (n = 88) receive a family information leaflet (FIL) in addition to standard information. An FIL designed specifically for this study was delivered at the first visit of the family representative: it provided general information on the ICU and hospital, the name of the ICU physician caring for the patient, a diagram of a typical ICU room with the names of all the devices, and a glossary of 12 terms commonly used in ICUs. Characteristics of the ICUs, patients, and family representatives were similar in the two groups. The FIL reduced the proportion of family members with poor comprehension from 40.9% to 11.5% (p < 0.0001). In the representatives with good comprehension, the FIL was associated with significantly better satisfaction (21 [18 to 24, quartiles] versus 27 [24 to 29, quartiles], p = 0.01). These results indicate that ICU caregivers should consider using an FIL to improve the effectiveness of the information they impart to families.

What are the ethical issues in relation to the role of the family in intensive care?

“…In a landmark study by Ferrand et al concerning end-of-life in the ICU, only 40% of family members were found to participate in the end-of-life decision-making process (5). Furthermore, the factors that give rise to dissatisfaction with ICU care among the patients' families are well established, and logically, are mostly the mirror image of the causes of satisfaction, and include the communication between the physician the families in the patient's room, conflict between the families and the caregiving team, family financial difficulties, and restricted visiting hours (32,33). It has also been shown that the involvement of families in the decision-making process can create an increased state of post-traumatic stress 3 months after the death, especially when the families received conflicting information or when they felt the decision was not the right one (34).…”

Assessing Family Satisfaction With Care of Critically Ill Patients: A Pilot Study

“…The CCFNI was used in several studies with large samples that included family members from different cultures. 3,7,8 This instrument had been developed and validated by Johnson and colleagues. 6 In the studies with this instrument, researchers identified the following predictors of family satisfaction: patient to nurse ratio of 3 or less; information provided by physicians; information provided to the family; knowledge of the role of each caregiver; involvement of their usual doctor; desired/allowed time ratio.…”

I Don’t Want to Be the One Saying ‘We Should Just Let Him Die’: Intrapersonal Tensions Experienced by Surrogate Decision Makers in the ICU

“…[8][9][10][11][12][13][14] Interventions to improve surrogate decision making similarly focus on strategies to provide better prognostic information, values clarification, and surrogateclinician communication. [15][16][17][18][19][20][21] There has been little exploration of how family members grapple with intrapersonal Electronic supplementary material The online version of this article (doi:10.1007/s11606-012-2129-y) contains supplementary material, which is available to authorized users.…”