Conflict Management Strategies in the ICU Differ Between Palliative Care Specialists and Intensivists

Critical Care Medicine
Jared ChiarchiaroRobert M Arnold

Abstract

Conflict is common between physicians and surrogate decision makers around end-of-life care in ICU. Involving experts in conflict management improve outcomes, but little is known about what differences in conflict management styles may explain the benefit. We used simulation to examine potential differences in how palliative care specialists manage conflict with surrogates about end-of-life treatment decisions in ICUs compared with intensivists. Subjects participated in a high-fidelity simulation of conflict with a surrogate in an ICU. In this simulation, a medical actor portrayed a surrogate decision maker during an ICU family meeting who refuses to follow an advance directive that clearly declines advanced life-sustaining therapies. We audiorecorded the simulation encounters and applied a coding framework to quantify conflict management behaviors, which was organized into two categories: task-focused communication and relationship building. We used negative binomial modeling to determine whether there were differences between palliative care specialists' and intensivists' use of task-focused communication and relationship building. Single academic medical center ICU. Palliative care specialists and intensivists. None. We enro...Continue Reading

References

Jan 1, 1989·American Journal of Epidemiology·R M Mickey, S Greenland
Mar 1, 1989·American Journal of Public Health·S Greenland
Nov 28, 1985·The New England Journal of Medicine·N Cousins
Jul 5, 1984·The New England Journal of Medicine·T G GutheilA Brodsky
Oct 15, 1996·Annals of Internal Medicine·C LaineT L Delbanco
Aug 24, 1999·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·L A FogartyM R Somerfield
Jan 12, 2001·Critical Care Medicine·L J SchneidermanH D Teetzel
May 22, 2001·Journal of General Internal Medicine·C M BreenJ A Tulsky
Jan 17, 2004·Environmental Management·Mark Lubell
Jan 11, 2005·Critical Care Medicine·Elie Azoulay, Charles L Sprung
Jan 25, 2005·American Journal of Respiratory and Critical Care Medicine·Elie AzoulayUNKNOWN FAMIREA Study Group
Nov 18, 2006·American Journal of Respiratory and Critical Care Medicine·Marie Cécile PoncetElie Azoulay
Dec 6, 2006·The Journal of Law, Medicine & Ethics : a Journal of the American Society of Law, Medicine & Ethics·Ashok J BharuchaCharles F Reynolds
Jan 20, 2007·American Journal of Respiratory and Critical Care Medicine·Nathalie EmbriacoLaurent Papazian
Apr 14, 2009·American Journal of Epidemiology·Hsin-Yi WengIrva Hertz-Picciotto
Jun 11, 2009·Medical Teacher·Nancy PoselBruce M Shore
Aug 1, 2009·American Journal of Respiratory and Critical Care Medicine·Elie AzoulayUNKNOWN Conflicus Study Investigators and for the Ethics Section of the European Society of Intensive Care Medicine
Jan 3, 2013·The Journal of Continuing Education in the Health Professions·Michael A RosenSallie J Weaver
Aug 15, 2013·Medical Teacher·Ivette MotolaS Barry Issenberg
Jan 18, 2014·Critical Care Medicine·Rachel A SchusterDouglas B White
Dec 24, 2014·Journal of Critical Care·Robert M ArnoldJudith E Nelson
Feb 3, 2015·Annals of the American Thoracic Society·Jared ChiarchiaroDouglas B White

❮ Previous
Next ❯

Citations

Jul 4, 2020·Critical Care Medicine·Joshua B Kayser, Lewis J Kaplan
Nov 4, 2017·Annals of the American Thoracic Society·Hashim M MehterRenda Soylemez Wiener
Aug 7, 2019·Proceedings·Bobbie Ann Adair WhiteAlejandro C Arroliga
Sep 4, 2020·Journal of Graduate Medical Education·Karen P BarrSara Kim
Apr 1, 2020·Anaesthesia Critical Care & Pain Medicine·Erwan L'HerChirine Mossadegh
Feb 3, 2021·Enfermería clínica·Francisca PutzJose M Maestre
Aug 3, 2019·Chest·Nitin SeamLillian Emlet

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.