Prevalence and factors of intensive care unit conflicts: the conflicus study.
Details
Serval ID
serval:BIB_AA1187B450E6
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Prevalence and factors of intensive care unit conflicts: the conflicus study.
Journal
American Journal of Respiratory and Critical Care Medicine
Working group(s)
Conflicus Study Investigators, for the Ethics Section of the European Society of Intensive Care Medicine
Contributor(s)
Azoulay E., Lafabrie A., Schlemmer£££Benoît£££ B. , Soares M., Azoulay E., Abizanda R., Svantesson M., Rubulotta F., Rusinova K., Benoit D., Heyland D., Joynt G., Owczuk R., Maia PA., Moreno R., Ricou B., de Vita D., Valentin A., Cohen S., Winter B., Ksomos A., Ho K., Kompan L., Srung CL., BenBenishty J., Abroug F., Kaarlola A., Rubulotta F., Gelarch H., Kyprianou T., Timsit JF., Français A., Bonniot A., Chevret S., Ho K., Bersten A., Blythe D., Ho K., Liang J., English S., Mc Arthur C., Bell J., Valentin A., Filzwieser G., Wernig U., Kliegel A., Janko H., Reiter A., Elliott P., Wolfgang P., Poradek T., Strohmeyer GW., Hipfl J., Firlinger , Benoît£££Benoît£££ B. , Vincent JL., Ludovic L., Decock C., Denys D., Anne-Pascale M., Nonneman B., Van Utterbeeck M., Swinnen W., Eerens J., Vanbiervliet P., Vanderveire B., Janssens B., Benoît D., Benoît D., Soares M., da Rocha MG. , Dal-Pizzol F., de Carvalho AG. , Guimarães HP., de Castro JE. , de Castro JE. , de Castro JE. , de Castro JE. , Salluh JI., Dias FS., Visconti Rdos R., Deheinzelin D., Arruda AP., de C Mello PM. , Azevedo LC., Lobo SM., Lobo SM., Lobo SM., Westphal GA., Hoher JA., Ribeiro SP., Teles£££José Mário Meira£££ JM. , Moritz RD., de Souza PC. , de Souza PC. , de Souza PC. , de Souza PC. , de Souza PC. , de Souza PC. , Bozza FA., Miranda£££Fábio£££ F. , Rocco JR., Japiassú AM., Gusman PB., Filho£££Mário Lúcio Alves Baptista£££ ML. , Brandão N., Knibel MF., Knibel MF., Knibel MF., Piras£££Cláudio£££ C. , Piras£££Cláudio£££ C. , Piras£££Cláudio£££ C. , Macedo GL., Coelho CD., Falcão AL., Brilhante£££Yuzeth Nóbrega de Assis£££ YN. , Rezegue L., Rezegue L., Silva E., Lucchesi£££Fátima£££ F. , Westphal GA., Westphal GA., Filho MC., Ferreira Bda S., Maia Mde O., Maia Mde O., Maia Mde O., Daren H., Bailey J., Rogovein TS., Denny L., Lewis MJ., Richard H., Sheldon M., Dan S., Keenan SP., Wood G., Auld F., Laura H., Cooper AB., Smith O., Dawson P., Smith O., Smith O., Gavin J., Buckley T., Civa A., Young K., Au Yeung KW. , Cheng C., Buckley T., Kyprianou T., Ergatoudes P., Constantinou E., Kaarlola A., Azoulay E., Bleichner G., Cohen Y., Paugam C., Capellier G., Wolff M., Du Cheyron D., Descorps-Declère A., Bertrand S., Cariou A., Darmon M., Djibre M., Kaidomar M., Barnoud D., Timsit JF., Rabbat A., Reignier J., Jourdain M., Megarbane B., Mohammedi I., Bollaert PE., Boussat S., Sanchez O., Bonmarchand G., Joly LM., Thuong M., Zeni F., Hayon J., Garrouste-Orgeas M., Fieux F., Castellain V., Georges H., Bruneel F., Galliot R., Annane D., Kouatchet A., Lefrant JY., Mokart D., Das V., Bornstain C., Saulnier F., Cheval C., Payen D., Goldgram-Toledano D., Kouatchet A., Gerlach H., Toussaint S., Steinke E., Zachow G., Freitag A., Metzger M., Hartung HJ., Michalsen A., Akos C., Darvas K., Futó J., Csepregi G., Bede A., Szentkereszty£££Zoltán£££ Z. , Bogdán£££Zoltán£££ Z. , Bodnár J., Suto B., Charles S., Julie B., Jonathan C., Farkash N., Remus H., Francesca R., Fumagalli R., Rossi G., Sganga G., Pezzi A., Adembri C., Tulli G., Vivaldi N., Lugano M., Bianchin A., Columbo R., Modano P., Radeschi G., Conti A., Mantovani G., Occhipinti G., Michele I., Mercante D., Giordano D., Garofalo G., Prondi E., Fabbri G., Radoslaw O., Wujtewicz MA., Lango R., Karpel E., Misiołek H., Nestorowicz A., Przesmycki K., Sobczyński£££Paweł£££ P. , Mikstacki A., Maciejewski D., Drobnik L., Kusza K., Karwacki Z., Kołacki T., Dończyk A., Wenski W., Bielski J., Kot J., Czajkowska£££Małgorzata£££ M. , Onichimowski D., Sowa-Szpajer J., Skoczylas-Stoba B., Szudzińska A., Moreno R., Maia PA., Almeida E., Esteves F., Faria F., Aguiar AM., Pimentel J., Ferro I., Correia M., Honrado T., Rhodes A., Brnadão JL., Mota A., Lidija K., Pareznik R., Kozjek-Rotovnik N., Esteban A., Ricardo A., Cabré L., Roca J., Baigorri F., Romero JM., Camps VL., Delgado MC., Zarallo AR., Guardiola F., Monzon JL., Urionabarrenetxea KM., Fernandez PR., Duran JS., Palencia E., Martin SM., Galdos , Jiménez£££Antonio García£££ AG. , Svantesson M., Tegsten U., Svantesson M., Nilsson M., Glimelius-Petersson C., Forsgren L., Hollman G., Hollman G., Eriksson SL., Sjöberg M., Yttergren K., Bäckman C., Lindbladh-Fridh M., Martinsson L., Hollman G., Svantesson M., Bengtsson EM., Bogmark E., Ricou B., Maggiorini M., Michot M., Barandun U., Zender H., Eggimann P., Souheil E., Mounir B., Abroug F., Messadi A., Simon C., Brian C., Bob W., Jeremy B., McQuillan PJ., Paul R., Pinsky MR., Marion D., Sulmasy D., Nenic SDj., Manjuck J., Moine P., Pelnar P., Rocen M., Cerny V., Berlinger G., Herold I., Tretina J., Marek O., Sevcik P., Krejci M., Janda R., Zykova I., Fortova M., Kopelent P., Dostalova V., Stritezsky M., Jahoda J., Zdenka K., Nalos D., Brezina A., Aquilina A.
ISSN
1535-4970 (Electronic)
ISSN-L
1073-449X
Publication state
Published
Issued date
2009
Peer-reviewed
Oui
Volume
180
Number
9
Pages
853-860
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
Abstract
RATIONALE: Many sources of conflict exist in intensive care units (ICUs). Few studies recorded the prevalence, characteristics, and risk factors for conflicts in ICUs.
OBJECTIVES: To record the prevalence, characteristics, and risk factors for conflicts in ICUs.
METHODS: One-day cross-sectional survey of ICU clinicians. Data on perceived conflicts in the week before the survey day were obtained from 7,498 ICU staff members (323 ICUs in 24 countries).
MEASUREMENTS AND MAIN RESULTS: Conflicts were perceived by 5,268 (71.6%) respondents. Nurse-physician conflicts were the most common (32.6%), followed by conflicts among nurses (27.3%) and staff-relative conflicts (26.6%). The most common conflict-causing behaviors were personal animosity, mistrust, and communication gaps. During end-of-life care, the main sources of perceived conflict were lack of psychological support, absence of staff meetings, and problems with the decision-making process. Conflicts perceived as severe were reported by 3,974 (53%) respondents. Job strain was significantly associated with perceiving conflicts and with greater severity of perceived conflicts. Multivariate analysis identified 15 factors associated with perceived conflicts, of which 6 were potential targets for future intervention: staff working more than 40 h/wk, more than 15 ICU beds, caring for dying patients or providing pre- and postmortem care within the last week, symptom control not ensured jointly by physicians and nurses, and no routine unit-level meetings.
CONCLUSIONS: Over 70% of ICU workers reported perceived conflicts, which were often considered severe and were significantly associated with job strain. Workload, inadequate communication, and end-of-life care emerged as important potential targets for improvement.
OBJECTIVES: To record the prevalence, characteristics, and risk factors for conflicts in ICUs.
METHODS: One-day cross-sectional survey of ICU clinicians. Data on perceived conflicts in the week before the survey day were obtained from 7,498 ICU staff members (323 ICUs in 24 countries).
MEASUREMENTS AND MAIN RESULTS: Conflicts were perceived by 5,268 (71.6%) respondents. Nurse-physician conflicts were the most common (32.6%), followed by conflicts among nurses (27.3%) and staff-relative conflicts (26.6%). The most common conflict-causing behaviors were personal animosity, mistrust, and communication gaps. During end-of-life care, the main sources of perceived conflict were lack of psychological support, absence of staff meetings, and problems with the decision-making process. Conflicts perceived as severe were reported by 3,974 (53%) respondents. Job strain was significantly associated with perceiving conflicts and with greater severity of perceived conflicts. Multivariate analysis identified 15 factors associated with perceived conflicts, of which 6 were potential targets for future intervention: staff working more than 40 h/wk, more than 15 ICU beds, caring for dying patients or providing pre- and postmortem care within the last week, symptom control not ensured jointly by physicians and nurses, and no routine unit-level meetings.
CONCLUSIONS: Over 70% of ICU workers reported perceived conflicts, which were often considered severe and were significantly associated with job strain. Workload, inadequate communication, and end-of-life care emerged as important potential targets for improvement.
Keywords
Adult, Attitude of Health Personnel, Burnout, Professional/epidemiology, Burnout, Professional/psychology, Communication, Conflict (Psychology), Cross-Sectional Studies, Europe/epidemiology, Female, Health Personnel/psychology, Health Personnel/statistics & numerical data, Hospitals, Public/statistics & numerical data, Hospitals, University/statistics & numerical data, Humans, Intensive Care Units/statistics & numerical data, Interpersonal Relations, Male, Perception, Prevalence, Questionnaires, Risk Factors, Social Support, Stress, Psychological/epidemiology, Stress, Psychological/psychology, Terminal Care/psychology, Terminal Care/statistics & numerical data, Workload/psychology
Pubmed
Web of science
Create date
29/12/2009 16:15
Last modification date
20/08/2019 16:14
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