Bhatt Margiben Tusharbhai, Chaudhuri Souvik, Ravindranath Sunil, Atri Viha, Maddani Sagar Shanmukhappa, P Vishwas, Fernandes Roshan
Department of Critical Care Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India.
Am J Hosp Palliat Care. 2025 Sep;42(9):889-898. doi: 10.1177/10499091241287861. Epub 2024 Oct 9.
Physician's clinical inputs and informed bystander opinions are essential for successful intensive care unit (ICU) patient outcomes. There is insufficient data regarding the impact of shared decision-making on treatment outcomes and family satisfaction in Indian ICU settings. We aimed to determine the effect of shared decision-making factors on family satisfaction with ICU services. Family bystanders of 336 ICU patients with a stay >72 hours were conveniently surveyed across 13 months prospectively using Family Satisfaction in the Intensive Care Unit 24 Revised (FS-ICU 24R) questionnaire. We analyzed the responses to determine shared decision-making factors impacting family satisfaction. Univariate analysis of ten variables of FS-ICU 24R questionnaire decision-making subscale revealed that consistency of information (OR 8.71, < 0.001), honesty of information (OR 7.04, < 0.001), and frequency of communication with doctors (OR 6.25, < 0.001) were associated with highest odds of family involvement and satisfaction. Multivariable logistic regression showed that consistency of information (adjusted OR 3.85, < 0.001) and frequent doctor communication (adjusted OR 2.22, = 0.02) were independent predictors associated with family satisfaction. The number of decision-makers ( = 0.463) or family's prior ICU experience ( = 0.430) was not associated with family satisfaction. A consistent and honest effort to cater to the family's information needs and frequent physician-bystander interaction is essential for family's satisfaction with ICU services. This even outweighs other decision-making factors such as number of decision-makers and their prior ICU experience. Incorporating shared decision-making in counseling should be a continuing practice. Clinical Trials Registry - India. CTRI/2022/09/045571.
医生的临床意见和旁观者的知情意见对于重症监护病房（ICU）患者的成功治疗结果至关重要。关于共同决策对印度ICU环境中治疗结果和患者家属满意度的影响，目前数据不足。我们旨在确定共同决策因素对患者家属对ICU服务满意度的影响。前瞻性地在13个月内，对336名入住ICU超过72小时患者的家属旁观者使用《重症监护病房患者家属满意度调查问卷24修订版》（FS-ICU 24R）进行了方便抽样调查。我们分析了这些回答，以确定影响家属满意度的共同决策因素。对FS-ICU 24R问卷决策子量表的10个变量进行单因素分析显示，信息一致性（OR 8.71，<0.001）、信息真实性（OR 7.04，<0.001）以及与医生沟通的频率（OR 6.25，<0.001）与家属参与度和满意度的最高几率相关。多变量逻辑回归显示，信息一致性（调整后OR 3.85，<0.001）和频繁的医患沟通（调整后OR 2.22，=0.02）是与家属满意度相关的独立预测因素。决策者数量（=0.463）或家属之前的ICU经历（=0.430）与家属满意度无关。持续、真诚地满足家属的信息需求以及医生与旁观者之间的频繁互动对于家属对ICU服务的满意度至关重要。这甚至比其他决策因素（如决策者数量及其之前的ICU经历）更为重要。在咨询过程中纳入共同决策应该是一种持续的做法。印度临床试验注册中心。CTRI/2022/09/045571。
