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Factors Associated with Family Satisfaction with End-of-Life Care in the ICU: A Systematic Review.
Chest. 2014 Aug 7;
Authors: Hinkle LJ, Bosslet GT, Torke AM
Abstract
Abstract: Background:Family satisfaction with end-of-life care in the Intensive Care Unit (ICU) has not previously been systematically reviewed. Our objective was to perform a review, synthesizing published data identifying factors associated with family satisfaction with end-of-life care in critically ill, adult populations. Methods:The following electronic databases were searched: MEDLINE, MEDLINE Updated, EMBASE, CINAHL, PsycInfo, and PubMed. Two authors reviewed retrieved titles and abstracts. Studies describing non-adult and non-ICU populations or not addressing end-of-life care, family satisfaction, or factors affecting satisfaction were excluded. The remaining articles underwent full review and data extraction by two authors. Quality was assessed using a checklist based on the recommendations of the CONSORT group. Results:The search yielded 1,072 articles with 23 articles describing 14 studies meeting inclusion criteria. All studies obtained satisfaction data from family members via surveys and structured interviews. Specific communication strategies increasing satisfaction included: expressions of empathy, non-abandonment, and assurances of comfort and provision of written information. Additionally, support for shared decision-making, family presence at time of death, and specific patient care measures such as extubation before death were associated with increased satisfaction. Conclusions:Good quality communication, support for shared decision-making, and specific patient care measures were associated with increased satisfaction with end-of-life care. Assessing the family's desire to participate in shared decision-making may also be an important factor. Few interventions increased satisfaction. Future research is needed to further define optimal communication strategies, understand effective integration of palliative care into the ICU and to define significant score changes in survey instruments.
Background: Family satisfaction with end-of-life care in the Intensive Care Unit (ICU) has not previously been systematically reviewed. Our objective was to perform a review, synthesizing published data identifying factors associated with family satisfaction with end-of-life care in critically ill, adult populations.
Methods: The following electronic databases were searched: MEDLINE, MEDLINE Updated, EMBASE, CINAHL, PsycInfo, and PubMed. Two authors reviewed retrieved titles and abstracts. Studies describing non-adult and non-ICU populations or not addressing end-of-life care, family satisfaction, or factors affecting satisfaction were excluded. The remaining articles underwent full review and data extraction by two authors. Quality was assessed using a checklist based on the recommendations of the CONSORT group.
Results: The search yielded 1,072 articles with 23 articles describing 14 studies meeting inclusion criteria. All studies obtained satisfaction data from family members via surveys and structured interviews. Specific communication strategies increasing satisfaction included: expressions of empathy, non-abandonment, and assurances of comfort and provision of written information. Additionally, support for shared decision-making, family presence at time of death, and specific patient care measures such as extubation before death were associated with increased satisfaction.
Conclusions: Good quality communication, support for shared decision-making, and specific patient care measures were associated with increased satisfaction with end-of-life care. Assessing the family's desire to participate in shared decision-making may also be an important factor. Few interventions increased satisfaction. Future research is needed to further define optimal communication strategies, understand effective integration of palliative care into the ICU and to define significant score changes in survey instruments.
PMID: 25103451 [PubMed - as supplied by publisher]