Skip to main content Accessibility help
×
Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-17T16:39:12.805Z Has data issue: false hasContentIssue false

Chapter 4 - Communication Skills for Critical Care Family Meetings

Published online by Cambridge University Press:  27 May 2021

Matthew N. Jaffa
Affiliation:
Hartford Hospital, Connecticut
David Y. Hwang
Affiliation:
Yale University, Connecticut
Get access

Summary

Excellent communication is a foundation of shared decision making. As discussed throughout this book, shared decision-making is a collaborative process of (1) exchanging medical and personal information about patients’ values, goals and preferences, (2) deliberation about how to apply these values to the clinical situation and (3) development of a treatment plan that reflects these values. This process is a very complex communication task. Unskilled clinicians may leave decisions largely to the discretion of surrogates without providing adequate support, and surrogates may struggle to make patient-centered decisions rather than decisions based on their own values, resulting in higher levels of post-traumatic stress disorder and depression.1 Conversely, in a recent study of recorded family meetings regarding ICU decision-making, fewer than one-half included deliberation about how to apply a patient’s values and preferences to the clinical situation.2

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Gries, C., Engelberg, R., Kross, E., et al. Predictors of symptoms of posttraumatic stress and depression in family members after patient death in the ICU. Chest 2010; 137: 280–7.CrossRefGoogle ScholarPubMed
Scheunemann, L., Ernecoff, N.. Buddadhumaruk, P., et al. Clinician-family communication about patient’s values and preferences in intensive care units. JAMA Internal Medicine 2019; 179: 676–84.CrossRefGoogle ScholarPubMed
Azoulet, E., Chevret, S., Leleu, G., et al. Half the families of intensive care unit patients experience inadequate communication with physicians. Critical Care Medicine 2000; 28: 3044–9.Google Scholar
Kramer, M., Schmalenberg, C.. Securing “good” nurse/physician relationships. Nursing Management 2003; 34: 34–8.CrossRefGoogle ScholarPubMed
Johnson, D., Wilson, M., Cavanaugh, B., et al. Measuring the ability to meet family needs in an intensive care unit. Critical Care Medicine 1998; 26: 266–71.CrossRefGoogle Scholar
Kon, A., Davidson, J., Morrison, W., et al. Shared decision making in intensive care units: an American College of Critical Care Medicine and American Thoracic Society Policy Statement. Critical Care Medicine 2016; 44: 188201.CrossRefGoogle ScholarPubMed
White, D. Engleberg, R., Wenrich, M, et al. Prognostication during physician-family discussions about limiting life support in intensive care units. Critical Care Medicine 2007; 35: 442–8.CrossRefGoogle ScholarPubMed
Back, A., Arnold, R.. Isn’t there anything more you can do? When empathic statements work and when they don’t. Journal of Palliative Medicine 2013; 16: 1429–32.CrossRefGoogle Scholar
Pollack, K., Arnold, R., Jeffrey, A, et al. Oncologist communication about emotion during visits with patients with advanced cancer. Journal of Clinical Oncology 2007; 36: 5748–52.Google Scholar
McFarlin, J., Tuslky, J., Back, A., et al. A talking map for family meetings in the intensive care unit. Journal of Clinical Outcomes Management 2017; 24: 1522.Google Scholar
Scheunemann, L., Arnold, R., White, D.. The facilitated values history. American Journal of Critical Care Medicine 2012; 186: 480–6.CrossRefGoogle ScholarPubMed
Childers, J., Back, A., Tulsky, J, et al. REMAP: a framework for goals of care conversations. Journal of Oncology Practice 2017; 13: e844–50.CrossRefGoogle ScholarPubMed
Elwyn, G., Frosch, D., Thomson, R, et al. Shared decision making: a model for clinical practice. Journal of General Internal Medicine 2012; 27: 1361–7.CrossRefGoogle Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×