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Junior versus senior physicians for informing families of intensive care unit patients
Authors:Moreau Delphine  Goldgran-Toledano Dany  Alberti Corinne  Jourdain Mercé  Adrie Christophe  Annane Djilali  Garrouste-Orgeas Maité  Lefrant Jean-Yves  Papazian Laurent  Quinio Philippe  Pochard Frédéric  Azoulay Elie
Affiliation:Service de Réanimation Médicale, H?pital Saint-Louis, Paris, France.
Abstract:To compare the effectiveness of information delivered to family members of critically ill patients by junior and senior physicians, we performed a prospective randomized multicenter trial in 11 French intensive care units. Patients (n = 220) were allocated at random to having their family members receive information by only junior or only senior physicians throughout the intensive care unit stay; there were 92 and 93 evaluable cases in the junior and senior groups, respectively, with no significant differences in baseline characteristics. Between Days 3 and 5, one family representative per patient was evaluated for comprehension of the diagnosis, prognosis, and treatment in the patient; satisfaction with information and care; and presence of symptoms of anxiety and depression. No significant differences were found between the two groups for any of these three criteria. Family members informed by a junior physician were more likely to feel they had not been given enough information time (additional time wanted: 3 [0-6.5] vs. 0 [0-5] minutes, p = 0.01) and to have sought additional explanations from their usual doctor (48.9 vs. 34.4%, p = 0.004). Specialty residents, if given opportunities for acquiring experience, can become proficient in communicating with families and share this task with senior physicians.
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