Agreement between Family Members and the Physician’s View in the ICU Environment: Personal Experience as a Factor Influencing Attitudes towards Corresponding Hypothetical Situations

Abstract

Background: It is not known whether intensive care unit (ICU) patients’ family members realistically assess patients’ health status. Objectives: The aim was to investigate the agreement between family and intensivists’ assessment concerning changes in patient health, focusing on family members’ resilience and their perceptions of decision making. Methods: For each ICU patient, withdrawal criteria were assessed by intensivists while family members assessed the patient’s health development and completed the Connor–Davidson Resilience Scale and the Self-Compassion Scale. Six months after ICU discharge, follow-up contact was established, and family members gave their responses to two hypothetical scenarios. Results: 162 ICU patients and 189 family members were recruited. Intensivists’ decisions about whether a patient met the withdrawal criteria had 75,9% accuracy for prediction of survival. Families’ assessments were statistically independent of intensivists’ opinions, and resilience had a significant positive effect on the probability of agreement with intensivists. Six months after discharge, family members whose relatives were still alive were significantly more likely to consider that the family or patient themselves should be involved in decision-making. Conclusions: Resilience is related to an enhanced probability of agreement of the family with intensivists’ perceptions of patients’ health progression. Family attitudes in hypothetical scenarios were found to be significantly affected by the patient’s actual health progression.