1
40
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Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1007/s00134-003-1853-5" target="_blank" rel="noreferrer">http://doi.org/10.1007/s00134-003-1853-5</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Conflict in the care of patients with prolonged stay in the ICU: types, sources, and predictors
Publisher
An entity responsible for making the resource available
Intensive Care Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2003
Subject
The topic of the resource
Female; Humans; Male; Adult; Prospective Studies; Aged; Middle Aged; Family Relations; Professional-Family Relations; Boston; Communication Barriers; Length of Stay; Dissent and Disputes; Interprofessional Relations; Time Factors; Reproducibility of Results; Case-Control Studies; 80 and over; decision making; ICU Decision Making; Intensive Care Units/statistics & numerical data; Intensive Care/statistics & numerical data
Creator
An entity primarily responsible for making the resource
Studdert DM; Mello MM; Burns JP; Puopolo AL; Galper BZ; Truog RD; Brennan T
Description
An account of the resource
OBJECTIVE: To determine types, sources, and predictors of conflicts among patients with prolonged stay in the ICU. DESIGN AND SETTING: We prospectively identified conflicts by interviewing treating physicians and nurses at two stages during the patients' stays. We then classified conflicts by type and source and used a case-control design to identify predictors of team-family conflicts. DESIGN AND SETTING: Seven medical and surgical ICUs at four teaching hospitals in Boston, USA. PATIENTS: All patients admitted to the participating ICUs over an 11-month period whose stay exceeded the 85th percentile length of stay for their respective unit ( n=656). MEASUREMENTS AND RESULTS: Clinicians identified 248 conflicts involving 209 patients; hence, nearly one-third of patients had conflict associated with their care: 142 conflicts (57%) were team-family disputes, 76 (31%) were intrateam disputes, and 30 (12%) occurred among family members. Disagreements over life-sustaining treatment led to 63 team-family conflicts (44%). Other leading sources were poor communication (44%), the unavailability of family decision makers (15%), and the surrogates' (perceived) inability to make decisions (16%). Nurses detected all types of conflict more frequently than physicians, especially intrateam conflicts. The presence of a spouse reduced the probability of team-family conflict generally (odds ratio 0.64) and team-family disputes over life-sustaining treatment specifically (odds ratio 0.49). CONCLUSIONS: Conflict is common in the care of patients with prolonged stays in the ICU. However, efforts to improve the quality of care for critically ill patients that focus on team-family disagreements over life-sustaining treatment miss significant discord in a variety of other areas.
2003
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1007/s00134-003-1853-5" target="_blank" rel="noreferrer">10.1007/s00134-003-1853-5</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2003
80 And Over
Adult
Aged
Backlog
Boston
Brennan T
Burns JP
Case-Control Studies
Communication Barriers
Decision Making
Dissent And Disputes
Family Relations
Female
Galper BZ
Humans
ICU Decision Making
Intensive Care Medicine
Intensive Care Units/statistics & numerical data
Intensive Care/statistics & numerical data
Interprofessional Relations
Journal Article
Length Of Stay
Male
Mello MM
Middle Aged
Professional-family Relations
Prospective Studies
Puopolo AL
Reproducibility of Results
Studdert DM
Time Factors
Truog RD
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1097/01.PCC.0000102413.32891.E5" target="_blank" rel="noreferrer">http://doi.org/10.1097/01.PCC.0000102413.32891.E5</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Decision making and satisfaction with care in the pediatric intensive care unit: findings from a controlled clinical trial
Publisher
An entity responsible for making the resource available
Pediatric Critical Care Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2004
Subject
The topic of the resource
Child; Female; Humans; Male; Intensive Care Units; Prospective Studies; Professional-Family Relations; Boston; Life Support Care; Conflict (Psychology); Consumer Satisfaction; Counseling; Pediatric; decision making; Nonparametric; Statistics; ICU Decision Making
Creator
An entity primarily responsible for making the resource
Mello MM; Burns JP; Truog RD; Studdert DM; Puopolo AL; Brennan T
Description
An account of the resource
OBJECTIVE: To facilitate critical decision making and improve satisfaction with care among families of patients in a pediatric intensive care unit. DESIGN: Prospective observational study followed by a nonrandomized controlled trial of a clinical intervention to identify conflicts and facilitate communication between families and the clinical team. SETTING: The pediatric intensive care unit of a Boston teaching hospital. PATIENTS: A total of 127 patients receiving care in the pediatric intensive care unit in 1998-1999 and their families. INTERVENTIONS: Interviews were conducted with surrogates and decisionally capable older children concerning the adequacy of information provided, understanding, communication, and perceived decisional conflicts. Findings were relayed to the clinical team, who then developed tailored follow-up recommendations. MEASUREMENTS AND MAIN RESULTS: A survey administered to surrogates at baseline and day 7 or intensive care unit discharge measured satisfaction with care. Information on patient acuity and hospital stay were extracted from medical records and hospital databases. Wilcoxon rank-sum tests and incidence rate comparisons were used to assess the impact of the intervention on satisfaction and sentinel decision making, respectively. Incidence rates of care plan decision making, including decisions to adopt a comfort-care-only plan and decisions to forego resuscitation, were lower among families who received the intervention. The intervention did not significantly affect satisfaction with care. CONCLUSIONS: Prospectively screening for and intervening to mitigate potential conflict did not increase decision making or parental satisfaction with the care provided in this pediatric intensive care unit.
2004
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1097/01.PCC.0000102413.32891.E5" target="_blank" rel="noreferrer">10.1097/01.PCC.0000102413.32891.E5</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2004
Backlog
Boston
Brennan T
Burns JP
Child
Conflict (Psychology)
Consumer Satisfaction
Counseling
Decision Making
Female
Humans
ICU Decision Making
Intensive Care Units
Journal Article
Life Support Care
Male
Mello MM
Nonparametric
Pediatric
Pediatric Critical Care Medicine
Professional-family Relations
Prospective Studies
Puopolo AL
Statistics
Studdert DM
Truog RD
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1542/peds.112.3.553" target="_blank" rel="noreferrer">http://doi.org/10.1542/peds.112.3.553</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Nature of conflict in the care of pediatric intensive care patients with prolonged stay
Publisher
An entity responsible for making the resource available
Pediatrics
Date
A point or period of time associated with an event in the lifecycle of the resource
2003
Subject
The topic of the resource
Female; Humans; infant; Male; Intensive Care Units; Physician-Patient Relations; Prospective Studies; Communication Barriers; Dissent and Disputes; Predictive Value of Tests; Case-Control Studies; infant; Family/psychology; Newborn; ICU Decision Making; Patient Satisfaction/statistics & numerical data; Withholding Treatment/trends; Length of Stay/trends; Patient Care Planning/trends; Pediatric Nursing/trends; Pediatric/trends
Creator
An entity primarily responsible for making the resource
Studdert DM; Burns JP; Mello MM; Puopolo AL; Truog RD; Brennan T
Description
An account of the resource
OBJECTIVE: To determine the frequency, types, sources, and predictors of conflict surrounding the care of pediatric intensive care unit (PICU) patients with prolonged stay. SETTING: A tertiary care, university-affiliated PICU in Boston. PARTICIPANTS: All patients admitted over an 11-month period whose stay exceeded 8 days (the 85th percentile length of stay for the PICU under study), and intensive care physicians and nurses who were responsible for their care. METHODS: We prospectively identified conflicts by interviewing the treating physicians and nurses at 2 stages during the patients' PICU stay. All conflicts detected were classified by type (team-family, intrateam, or intrafamily) and source. Using a case-control design, we then identified predictors of conflict through bivariate and multivariate analyses. RESULTS: We enrolled 110 patients based on the length-of-stay criterion. Clinicians identified 55 conflicts involving 51 patients in this group. Hence, nearly one half of all patients followed had a conflict associated with their care. Thirty-three of the conflicts (60%) were team-family, 21 (38%) were intrateam, and the remaining 1 was intrafamily. The most commonly cited sources of team-family conflict were poor communication (48%), unavailability of parents (39%), and disagreements over the care plan (39%). Medicaid insurance status was independently associated with the occurrence of conflict generally (odds ratio = 4.97) and team-family conflict specifically (odds ratio = 7.83). CONCLUSIONS: Efforts to reduce and manage conflicts that arise in the care of critically ill children should be sensitive to the distinctive features of these conflicts. Knowledge of risk factors for conflict may also help to target such interventions at the patients and families who need them most.
2003
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1542/peds.112.3.553" target="_blank" rel="noreferrer">10.1542/peds.112.3.553</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2003
Backlog
Brennan T
Burns JP
Case-Control Studies
Communication Barriers
Dissent And Disputes
Family/psychology
Female
Humans
ICU Decision Making
Infant
Intensive Care Units
Journal Article
Length of Stay/trends
Male
Mello MM
Newborn
Patient Care Planning/trends
Patient Satisfaction/statistics & Numerical Data
Pediatric Nursing/trends
Pediatric/trends
Pediatrics
Physician-patient Relations
Predictive Value of Tests
Prospective Studies
Puopolo AL
Studdert DM
Truog RD
Withholding Treatment/trends