Impact of Shared Decision-Making on Family Satisfaction With Intensive Care Services: 'Share With Care' has a New Meaning in ICU

Margiben Tusharbhai Bhatt; Souvik Chaudhuri; Sunil Ravindranath; Viha Atri; Sagar Shanmukhappa Maddani; Vishwas P; Roshan Fernandes

doi:10.1177/10499091241287861

Impact of Shared Decision-Making on Family Satisfaction With Intensive Care Services: 'Share With Care' has a New Meaning in ICU

Am J Hosp Palliat Care. 2024 Oct 9:10499091241287861. doi: 10.1177/10499091241287861. Online ahead of print.

Authors

Margiben Tusharbhai Bhatt¹, Souvik Chaudhuri¹, Sunil Ravindranath¹, Viha Atri¹, Sagar Shanmukhappa Maddani¹, Vishwas P¹, Roshan Fernandes¹

Affiliation

¹ Department of Critical Care Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India.

PMID: 39382903
DOI: 10.1177/10499091241287861

Abstract

Background: Physician's clinical inputs and informed bystander opinions are essential for successful intensive care unit (ICU) patient outcomes. There is insufficient data regarding the impact of shared decision-making on treatment outcomes and family satisfaction in Indian ICU settings. We aimed to determine the effect of shared decision-making factors on family satisfaction with ICU services. Patients and Methods: Family bystanders of 336 ICU patients with a stay >72 hours were conveniently surveyed across 13 months prospectively using Family Satisfaction in the Intensive Care Unit 24 Revised (FS-ICU 24R) questionnaire. We analyzed the responses to determine shared decision-making factors impacting family satisfaction. Results: Univariate analysis of ten variables of FS-ICU 24R questionnaire decision-making subscale revealed that consistency of information (OR 8.71, P < 0.001), honesty of information (OR 7.04, P < 0.001), and frequency of communication with doctors (OR 6.25, P < 0.001) were associated with highest odds of family involvement and satisfaction. Multivariable logistic regression showed that consistency of information (adjusted OR 3.85, P < 0.001) and frequent doctor communication (adjusted OR 2.22, P = 0.02) were independent predictors associated with family satisfaction. The number of decision-makers (P = 0.463) or family's prior ICU experience (P = 0.430) was not associated with family satisfaction. Conclusion: A consistent and honest effort to cater to the family's information needs and frequent physician-bystander interaction is essential for family's satisfaction with ICU services. This even outweighs other decision-making factors such as number of decision-makers and their prior ICU experience. Incorporating shared decision-making in counseling should be a continuing practice.Trial registry name: Clinical Trials Registry - India.Registration number: CTRI/2022/09/045571.

Keywords: communication; consistency of information; family needs; intensive care; perception; satisfaction; shared decision-making; treatment outcome.