What Matters to Patients and Their Families During and After Critical Illness: A Qualitative Study.
Catherine L Auriemma, Michael O Harhay, Kimberley J Haines and 3 others
PMID 33385204WHAT IT FOUND
ICU survivors and families prioritized clear communication, comfort, and feeling the team tried everything.
They also described inability to communicate or severe disability as possible outcomes worse than death.
Key findings
01Patients and families prioritized communication, comfort, and the sense that the team was providing exhaustive care.
02Approximately 25% of participants said survival was the most important outcome, but most said survival alone was inadequate.
03Participants described outcomes considered as bad as or worse than death, including inability to communicate, severe physical disability, dependence on machines, and severe or constant pain.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 19 of 102 eligible patients and 30 of 102 eligible family caregivers completed interviews, so many eligible people were not represented. The study was done in one medical ICU with high mortality and long stays, so priorities may differ in other ICUs. All interviews were in English, so the findings may not reflect patients and families from other language or cultural backgrounds. Patient interviews were limited to survivors who regained decision-making capacity, so perspectives of patients who died or remained incapacitated are missing. Each participant was interviewed at only one time after discharge or death, so changes in priorities over time were not measured.
Declared interests
The supplied article is tagged as Research Support, N.I.H., Extramural and Research Support, Non-U.S. Gov't. No author conflict-of-interest declaration is included in the supplied text.
The easy way to misread this
Do not read these themes as evidence that a communication, comfort, or goal-setting intervention improves ICU outcomes. The study reported patient and family perspectives from interviews, not treatment effects.