Perceptions of Quality of Communication in Family Interactions in
Neurocritical Care
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.