Half the family members of intensive care unit patients do not want to share in the decision-making process: a study in 78 French intensive care units

Critical Care Medicine
Elie AzoulayFAMIREA Study Group

Abstract

To evaluate the opinions of intensive care unit staff and family members about family participation in decisions about patients in intensive care units in France, a country where the approach of physicians to patients and families has been described as paternalistic. Prospective multiple-center survey of intensive care unit staff and family members. Seventy-eight intensive care units in university-affiliated hospitals in France. We studied 357 consecutive patients hospitalized in the 78 intensive care units and included in the study starting on May 1, 2001, with five patients included per intensive care unit. We recorded opinions and experience about family participation in medical decision making. Comprehension, satisfaction, and Hospital Anxiety and Depression Scale scores were determined in family members. Poor comprehension was noted in 35% of family members. Satisfaction was good but anxiety was noted in 73% and depression in 35% of family members. Among intensive care unit staff members, 91% of physicians and 83% of nonphysicians believed that participation in decision making should be offered to families; however, only 39% had actually involved family members in decisions. A desire to share in decision making was express...Continue Reading

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