Ethical decision-making climate in the ICU: theoretical framework and validation of a self-assessment tool

BMJ Quality & Safety
B Van den BulckeD D Benoit

Abstract

Literature depicts differences in ethical decision-making (EDM) between countries and intensive care units (ICU). To better conceptualise EDM climate in the ICU and to validate a tool to assess EDM climates. Using a modified Delphi method, we built a theoretical framework and a self-assessment instrument consisting of 35 statements. This Ethical Decision-Making Climate Questionnaire (EDMCQ) was developed to capture three EDM domains in healthcare: interdisciplinary collaboration and communication; leadership by physicians; and ethical environment. This instrument was subsequently validated among clinicians working in 68 adult ICUs in 13 European countries and the USA. Exploratory and confirmatory factor analysis was used to determine the structure of the EDM climate as perceived by clinicians. Measurement invariance was tested to make sure that variables used in the analysis were comparable constructs across different groups. Of 3610 nurses and 1137 physicians providing ICU bedside care, 2275 (63.1%) and 717 (62.9%) participated respectively. Statistical analyses revealed that a shortened 32-item version of the EDMCQ scale provides a factorial valid measurement of seven facets of the extent to which clinicians perceive an EDM c...Continue Reading

References

Oct 1, 1976·Computers and Biomedical Research, an International Journal·S Kullback, J Cornfield
Apr 12, 2001·Journal of Advanced Nursing·K Oberle, D Hughes
Nov 14, 2001·Journal of Interprofessional Care·J Molyneux
Nov 27, 2002·Nursing Ethics·Mary C Corley
Oct 16, 2004·International Journal of Health Care Quality Assurance Incorporating Leadership in Health Services·Paul Greenall
Nov 1, 2005·Dimensions of Critical Care Nursing : DCCN·Karen M Gutierrez
Nov 18, 2005·Intensive Care Medicine·J Randall Curtis, Sarah E Shannon
Jan 21, 2006·Journal of Advanced Nursing·Sinead KeeneyHugh McKenna
Apr 6, 2006·BMC Health Services Research·John B SextonEric J Thomas
Feb 3, 2007·British Journal of Anaesthesia·T W ReaderB H Cuthbertson
Jun 6, 2007·Journal of Critical Care·Judith Gedney BaggsJill R Quinn
Oct 19, 2007·Intensive Care Medicine·Thomas W ReaderJohan Decruyenaere
Dec 19, 2007·Critical Care : the Official Journal of the Critical Care Forum·Rob J M Strack van Schijndel, Hilmar Burchardi
Jun 10, 2008·Journal of Critical Care·Etienne MinvielleUNKNOWN CUB-REA network
Feb 3, 2009·Clinics in Chest Medicine·Mark D Siegel
May 6, 2009·Journal of Interprofessional Care·Phillip G Clark
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
Sep 11, 2009·The American Psychologist·Daniel Kahneman, Gary Klein
Apr 13, 2010·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·David T HuangDerek C Angus
Oct 12, 2010·Current Opinion in Critical Care·Thomas Fassier, Elie Azoulay
Apr 5, 2011·Critical Care Medicine·Tom W ReaderBrian H Cuthbertson
Dec 23, 2011·Critical Care : the Official Journal of the Critical Care Forum·Bertrand Guidet, Vicente González-Romá
Dec 29, 2011·JAMA : the Journal of the American Medical Association·Ruth D PiersUNKNOWN APPROPRICUS Study Group of the Ethics Section of the ESICM
Jun 6, 2012·Respiratory Care·Judith E Nelson, Aluko A Hope
Jun 28, 2013·The New England Journal of Medicine·Alexander K SmithRobert M Arnold
Feb 14, 2014·Chest·Caroline M QuillScott D Halpern
May 17, 2014·Chest·Ruth D PiersUNKNOWN Appropricus Study Group of the Ethics Section of the European Society of Intensive Care Medicine
Aug 29, 2014·Critical Care Medicine·Rebecca A AslaksonJudith E Nelson
Jun 24, 2015·Critical Care Medicine·Janet A AlexanianScott Reeves
Sep 4, 2015·American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses·Thanh H NevilleNeil S Wenger
Sep 22, 2015·Clinical Medicine & Research·Geoffrey K Lighthall, Cristina Vazquez-Guillamet
May 8, 2016·Journal of Interprofessional Care·Bo Van den BulckeDominique Benoit
Jun 18, 2016·Oncology Nursing Forum·An LievrouwDominique D Benoit

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Citations

Apr 20, 2018·BMJ Quality & Safety·Elizabeth Dzeng, J Randall Curtis
Sep 14, 2018·Der Anaesthesist·Christiane S HartogUNKNOWN SepNet Critical Care Trials Group – Ethicus II Studiengruppe
Mar 8, 2019·BMJ Quality & Safety·Nathan HouchensJennifer Meddings
Dec 8, 2019·Medicine, Health Care, and Philosophy·Hui Yun Chan
Aug 30, 2019·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Annette RobertsenReidun Førde
Sep 8, 2018·Intensive Care Medicine·Julian BionCharles Sprung
May 29, 2018·Intensive Care Medicine·D D BenoitUNKNOWN DISPROPRICUS study group of the Ethics Section of the European Society of Intensive Care Medicine
Jul 2, 2018·Intensive Care Medicine·Samuel M BrownMichael D Howell
Sep 5, 2018·Intensive Care Medicine·Chris BeetJulian Bion
Jul 27, 2018·Intensive Care Medicine·Alison E TurnbullJ Randall Curtis
Nov 7, 2019·Intensive Care Medicine·Bo Van den BulckeUNKNOWN DISPROPRICUS study group of the Ethics Section of the ESICM
Nov 28, 2018·Annals of Intensive Care·Bertrand GuidetHans Flaatten
Jan 13, 2021·Journal of Medical Ethics·Katie M MoynihanMelanie Jansen
Apr 30, 2021·Nursing Ethics·Henry J SilvermanJenni Day
Jun 19, 2021·BMC Medical Ethics·Moniek A DonkersWalther N K A van Mook
Jul 30, 2021·Critical Care Medicine·Rebecca A AslaksonJ Randall Curtis

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