The Effect of Intensivist Communication on Prognosis Interpretation by Family Members of Patients at High Risk for Intensive Care Unit Admission: A Randomized Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 302
- 试验地点
- 1
- 主要终点
- Participant perception of the intensivist's prognostic estimate.
研究概览
简要总结
This study evaluates the effect of physician communication styles on the interpretation of prognosis by family members of chronically-ill patients. Participants were randomized to view one of four videos how depicting different physicians disclose prognosis when physicians expect an ICU patient to die.
详细描述
Intensivist-surrogate discordance about prognosis is common in the intensive care unit. Minimizing discordance and empowering families to make informed decisions about participants' loved one's care is important, but it is unclear how best to communicate prognostic information to vulnerable surrogates when a patient is expected to die. Participants are randomized to view one of 4 intensivist communication styles in response to the question "What do you think is most likely to happen?": 1) a direct response (control), 2) an indirect response comparing the patient's condition to other patients, 3) an indirect response describing physiology, or 4) redirection to a discussion of patient values and goals.
The participant will then be asked a series of questions to measure participants' interpretation of what the intensivist says.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •spouse/partner, sibling, or adult child of a patient with Chronic Obstructive Pulmonary Disease (COPD) on home oxygen
- •over age 18
排除标准
- •ever working in healthcare as a nurse, advanced practice provider, or physician
研究组 & 干预措施
Indirect - physiology
An indirect response describing the severe physiologic abnormalities present in the patient and potential future problems.
干预措施: Indirect - physiology (Behavioral)
Direct Communication (control)
A direct response where the intensivist acknowledges that he is not certain but believes the patient will not survive hospitalization.
干预措施: Direct communication (Behavioral)
Indirect - other patients
An indirect response describing the prognosis of other people similar to the patient in question.
干预措施: Indirect - other patients (Behavioral)
Redirection
Redirection to a conversation about the values of the patient and possible future decisions.
干预措施: Redirection (Behavioral)
结局指标
主要结局
Participant perception of the intensivist's prognostic estimate.
时间窗: approximately 5 minutes
Participant response to the question "If you had to guess, what do you think the doctor thinks is the chance that your loved one will survive this hospitalization?" answered on a 0-100% percentage scale. 0% signifies no chance of survival and 100% signifies definitely will survive.
次要结局
- Participant prognostic estimate.(approximately 5 minutes)
- Participant difference in belief about prognosis.(approximately 5 minutes)