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Perceptions of Quality of Communication in Family Interactions in Neurocritical Care
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  • Russell Stewart,
  • Kyle Hobbs,
  • Kristopher Dixon,
  • Roberto Navarrete,
  • Jannat Khan,
  • Mary Wren,
  • Mollie Canzona,
  • Aarti Sarwal
Russell Stewart
University of South Carolina School of Medicine Greenville Campus
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Kyle Hobbs
Intermountain Medical Center
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Kristopher Dixon
Wake Forest School of Medicine
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Roberto Navarrete
University of Michigan
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Jannat Khan
Rush University Medical Center
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Mary Wren
Washington University in St Louis School of Medicine
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Mollie Canzona
Wake Forest University
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Aarti Sarwal
Wake Forest School of Medicine
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Abstract

Objective: To investigate concordance in perceptions of communication among participants in family discussions and assess the importance of different domains of communication in a neurocritical care unit. Methods: Prospective observational study conducted in a neurocritical care unit. Our study involved family discussions regarding plan of care for patients admitted to the unit. All participants completed a survey. The first 4 questions rated understanding of the discussion and general satisfaction; the remaining questions were open-ended to assess quality of communication by the physician leading the discussion. Responses were scored and compared among participants using a Likert scale. A difference of < 1 in scores among participants was rated as concordance, while > 2 was designated as discordance. All open-ended responses were classified into six domains. Results: We observed 35 family discussions. Questions 1-3 yielded 99 cross-comparisons per question (total of 297 compared responses). Most responses were either “Strongly Agree” or “Agree”; with “Neutral” or “Disagree” responses being more prevalent in Question 2. Overall concordance of responses between participants was 88%. Education was the most frequently cited domain of communication in response to open-ended questions. Among family and neutral observers, empathy was frequently listed, while providers more often listed family engagement. Conclusion: Overall, satisfaction was high among providers, families, and the observer regarding quality of communication during family discussions in the unit. Perceptual differences emerged over whether this communication impacted healthcare decision-making during that encounter.

Peer review status:POSTED

24 Nov 2020Submitted to Journal of Evaluation in Clinical Practice
25 Nov 2020Assigned to Editor
25 Nov 2020Submission Checks Completed