Rose Susannah L, Shelton Wayne
Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
J Soc Work End Life Palliat Care. 2006;2(2):3-23. doi: 10.1300/J457v02n02_02.
The costs associated with Intensive Care Units (ICUs) are high and at times invasive ICU care may not be beneficial, particularly for those patients admitted to ICUs who have little hope of recovery. The process of clarifying medical goals for these patients is often facilitated by addressing psychosocial factors. Social workers in the ICU are uniquely qualified to assess and address many of the complex psychosocial circumstances and can clarify potential misperceptions, enhancing communication among patients (if capacitated), their families, and the medical team members. This can not only help improve quality of life for very sick and dying patients in the ICU and their families, but may also reduce the likelihood of decision-making conflicts from arising. Further studies need to be done to investigate the effectiveness of social work interventions in reducing family distress, avoiding care that is unwanted by patients, and demonstrating cost-saving benefits.
重症监护病房（ICU）的相关费用高昂，而且有时侵入性的ICU护理可能并无益处，尤其是对于那些入住ICU但康复希望渺茫的患者。通过关注心理社会因素，往往有助于明确这些患者的医疗目标。ICU中的社会工作者具备独特的资质，能够评估并处理许多复杂的心理社会情况，还能澄清潜在的误解，加强患者（如果有行为能力）、其家属与医疗团队成员之间的沟通。这不仅有助于提高ICU中病情严重和濒死患者及其家属的生活质量，还可能降低决策冲突发生的可能性。需要开展进一步研究，以调查社会工作干预措施在减轻家庭痛苦、避免患者不希望接受的护理以及显示成本节约效益方面的有效性。
