Fassier Thomas, Darmon Michel, Laplace Christian, Chevret Sylvie, Schlemmer Benoit, Pochard Frédéric, Azoulay Elie
Intensive Care Unit of the Saint-Louis Teaching Hospital and University of Paris 7, Assistance Publique-Hôpitaux de Paris, Paris, France.
Crit Care Med. 2007 Jan;35(1):177-83. doi: 10.1097/01.CCM.0000249834.26847.BE.
Providing family members with clear, honest, and timely information is a major task for intensive care unit physicians. Time spent informing families has been associated with effectiveness of information but has not been measured in specifically designed studies.
To measure time spent informing families of intensive care unit patients.
One-day cross-sectional study in 90 intensive care units in France.
Clocked time spent by physicians informing the families of each of 951 patients hospitalized in the intensive care unit during a 24-hr period.
Median family information time was 16 (interquartile range, 8-30) mins per patient, with 20% of the time spent explaining the diagnosis, 20% on explaining treatments, and 60% on explaining the prognosis. One third of the time was spent listening to family members. Multivariable analysis identified one factor associated with less information time (room with more than one bed) and seven factors associated with more information time, including five patient-related factors (surgery on the study day, higher Logistic Organ Dysfunction score, coma, mechanical ventilation, and worsening clinical status) and two family-related factors (first contact with family and interview with the spouse). Median information time was 20 (interquartile range, 10-39) mins when three factors were present and 106.5 (interquartile range, 103-110) mins when five were present.
This study identifies factors associated with information time provided by critical care physicians to family members of critically ill patients. Whether information time correlates with communication difficulties or communication skills needs to be evaluated. Information time provided by residents and nurses should be studied.
为家庭成员提供清晰、真实且及时的信息是重症监护病房医生的一项主要任务。告知家属的时间与信息传递效果相关，但尚未在专门设计的研究中进行测量。
测量告知重症监护病房患者家属的时间。
在法国的90个重症监护病房进行为期一天的横断面研究。
记录医生在24小时内告知951名入住重症监护病房患者家属的时间。
每位患者的中位家属告知时间为16分钟（四分位间距为8 - 30分钟），其中20%的时间用于解释诊断，20%用于解释治疗，60%用于解释预后。三分之一的时间用于倾听家属意见。多变量分析确定了一个与告知时间较短相关的因素（有不止一张床的病房）以及七个与告知时间较长相关的因素，包括五个与患者相关的因素（研究当天进行手术、较高的逻辑器官功能障碍评分、昏迷、机械通气以及临床状况恶化）和两个与家属相关的因素（首次与家属接触以及与配偶面谈）。当存在三个因素时，中位告知时间为20分钟（四分位间距为10 - 39分钟）；当存在五个因素时，中位告知时间为106.5分钟（四分位间距为103 - 110分钟）。
本研究确定了与重症监护医生向重症患者家属提供信息的时间相关的因素。信息时间是否与沟通困难或沟通技巧相关需要进行评估。住院医生和护士提供信息的时间也应予以研究。
