Cited by 398Family and Patient Care in Intensive Care UnitsPalliative Care and End-of-Life IssuesEthics in medical practice

Randomized trial of communication facilitators to reduce family distress and intensity of end-of-life care

Open access
Curtis, J. Randall, Treece, Patsy D., Nielsen, Elizabeth L., Gold, Julia, Ciechanowski, Paul S., Shannon, Sarah E., Khandelwal, Nita, Young, Jessica P. +1 more·2016·American Journal of Respiratory and Critical Care Medicine

Abstract

Rationale Communication with family of critically ill patients is often poor and associated with family distress. Objectives To determine if an intensive care unit (ICU) communication facilitator reduces family distress and intensity of end-of-life care. Methods We conducted a randomized trial at two hospitals. Eligible patients had a predicted mortality greater than or equal to 30% and a surrogate decision maker. Facilitators supported communication between clinicians and families, adapted communication to family needs, and mediated conflict. Measurements and main results Outcomes included depression, anxiety, and post-traumatic stress disorder (PTSD) among family 3 and 6 months after ICU and resource use. We identified 488 eligible patients and randomized 168. Of 352 eligible family members, 268 participated (76%). Family follow-up at 3 and 6 months ranged from 42 to 47%. The intervention was associated with decreased depressive symptoms at 6 months (P = 0.017), but there were no significant differences in psychological symptoms at 3 months or anxiety or PTSD at 6 months. The intervention was not associated with ICU mortality (25% control vs. 21% intervention; P = 0.615) but decreased ICU costs among all patients (per patient: $75,850 control, $51,060 intervention; P = 0.042) and particularly among decedents ($98,220 control, $22,690 intervention; P = 0.028). Among decedents, the intervention reduced ICU and hospital length of stay (28.5 vs. 7.7 d and 31.8 vs. 8.0 d, respec…

Integrity signals

Registry

Crossref · 10.1164/rccm.201505-0900oc

Cites

35 of 35 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

We couldn’t retrieve this paper’s full text, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Family support interventions may help reduce psychological impacts on family members, as suggested by four systematic reviews and two recent studies.

    “Family support interventions may help to reduce these psychological impacts, as suggested by four systematic reviews, 37,71,72,83 and two recent studies. 84,85”

Cites

Flagged first, then by citations

1 of the 36 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Authors
Curtis, J. R., Treece, P. D., Nielsen, E. L., Gold, J., Ciechanowski, P. S., Shannon, S. E., Khandelwal, N., Young, J. P., & Engelberg, R. A.
Affiliations
  • Cambia (AU)
  • School of Law
  • Department of Psychiatry and Behavioral Sciences, and
  • Department of Biobehavioral Nursing and Health Systems, School of Nursing
  • University of Washington (US)
Corresponding author
Curtis, J. Randall
Venue
American Journal of Respiratory and Critical Care Medicine
Published
2016-01
Volume
193
Issue
2
Pages
154-162
ISSN
  • 1073-449X (ISSN-L)
  • 1535-4970
OpenAlex
W2128195581
Cited by
398
References
36
Citations by year
2026: 34 · 2025: 29 · 2024: 39 · 2023: 32 · 2022: 49 · 2021: 40 · 2020: 35 · 2019: 40 · 2018: 38 · 2017: 33 · 2016: 23 · 2015: 6
FWCI
66.27
Type
journal article
Language
en
Open access
Locations
  • American Journal of Respiratory and Critical Care Medicine (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Nursing Research (R01 NR05226)
Topics
  • Health Sciences › Health Professions › Radiological and Ultrasound Technology › Family and Patient Care in Intensive Care Units
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Health Sciences › Health Professions › General Health Professions › Ethics in medical practice
Keywords
family communication, communication facilitators, family distress, end-of-life care, intensive care unit, critically ill patients, surrogate decision makers, family depression, post-traumatic stress disorder, anxiety, ICU costs, length of hospital stay, family conflict mediation
MeSH terms
Aged, 80 and over, Communication, Costs and Cost Analysis, Decision Making, Depression, Family, Female, Follow-Up Studies, Humans, Intensive Care Units, Length of Stay, Male, Middle Aged, Palliative Care, Professional-Family Relations, Stress, Psychological, Terminal Care, Negotiating, Withholding Treatment

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review