Division of Adult Palliative Care, Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
Curr Opin Crit Care. 2009 Dec;15(6):569-77. doi: 10.1097/MCC.0b013e328332f524.
Skilled physician-family communication in the ICU has been shown to improve patient outcomes, but until now little attention has been given to the effect of communication on family satisfaction and bereavement outcomes. The aim of this review is to outline the recent evidence that effective physician communication with families, and proactive palliative care interventions, can improve outcomes for both patients and family members in the ICU.
New data from the ICU correlates physician ability to identify and respond to emotion and to effectively share prognostic information with improved outcomes. Furthermore, proactive palliative care interventions that promote family meetings, use of empathic communication skills, and targeted palliative care consultations can improve family satisfaction, reduce length of stay in the ICU and reduce adverse family bereavement outcomes.
Empathic communication, skilful discussion of prognosis, and effective shared decision-making are core elements of quality care in the ICU, represent basic competencies for the ICU physician, and should be emphasized in future educational and clinical interventions.
在 ICU 中，熟练的医患沟通已被证明可以改善患者的预后，但直到现在，人们对沟通对家属满意度和丧亲结局的影响关注甚少。本综述旨在概述最近的证据，即有效的医患沟通和积极的姑息治疗干预措施可以改善 ICU 患者和家属的预后。
来自 ICU 的新数据表明，医生识别和回应情绪的能力以及有效地分享预后信息与改善预后相关。此外，积极的姑息治疗干预措施，如促进家庭会议、使用共情沟通技巧和有针对性的姑息治疗咨询，可以提高家属满意度，缩短 ICU 住院时间，并减少不良的家庭丧亲结局。
共情沟通、熟练讨论预后和有效的共同决策是 ICU 优质护理的核心要素，是 ICU 医生的基本能力，应在未来的教育和临床干预中得到强调。
