Background
Methods
Hospitals of Study-City | İntensive care unit bads | The patients’ relatives included in the study | The physician included in the study |
---|---|---|---|
Konya Numune State hospital-Konya | 30 | 62 (34.5%) | 31 (30.0%) |
Selcuk University, Medical Faculty Hospital-Konya | 8 | 17 (9.2%) | 19 (18.4%) |
Private Medicana Hospital-Konya | 15 | 31 (17.2%) | 8 (7.8%) |
Konya Training and Education Hospital-Konya | 12 | 25 (13.8%) | 17 (16.5%) |
Gazi University, Medical Faculty Hospital-Ankara | 14 | 29 (16.1%) | 16 (15.5%) |
Bursa Training and Education Hospital-Bursa | 8 | 17 (9.2%) | 12 (11.7%) |
Over all | 87 | 181 (100%) | 103 (100%) |
Result
The patients’ relatives
QUESTIONNAIRE ITEMS FOR THE PATIENTS’ RELATIVES | |||||
---|---|---|---|---|---|
Always % | Very Often % | Some times % | Rarely % | Never % | |
SUBDIMENSION OF INFORMING | |||||
1- I believe that the frequency of being informed about my patient is sufficient. | 59.1 | 16.0 | 14.4 | 9.4 | 1.1 |
2- After speaking to the physician, I still feel that I am informed insufficiently. | 29.8 | 9.9 | 22.7 | 17.1 | 20.4 |
3- I believe I am learning about the medical situations regarding my family member in the most comprehensive way. | 62.4 | 23.2 | 7.7 | 4.4 | 2.2 |
4- I receive all possible information about my family member whenever I speak to the physician. | 71.3 | 20.4 | 3.9 | 3.3 | 1.1 |
5- The physician uses language that I can understand. | 69.1 | 17.1 | 8.3 | 4.4 | 1.1 |
6- I would like to receive the medical information about my family member while I am next to the patient himself/herself. | 38.7 | 19.3 | 7.7 | 16.0 | 18.2 |
7- Physicians respond to all my questions. | 64.6 | 19.9 | 8.8 | 4.4 | 2.2 |
8- Physicians have difficulty giving bad news. | 38.1 | 31.5 | 12.2 | 8.3 | 9.9 |
SUBDIMENSION OF EMPATHY | |||||
9- I believe the physician cares about my family member. | 72.9 | 15.5 | 0.0 | 1.1 | 10.5 |
10- I believe that the physician cares about me as the patient relative. | 71.8 | 14.9 | 2.2 | 1.1 | 9.9 |
11- When I have a problem with the physician, I make an effort to think about it calmly. | 40.9 | 33.1 | 12.7 | 9.9 | 3.3 |
12- It makes it easier for me to communicate when the physician approaches me in a friendly manner. | 69.1 | 15.5 | 7.7 | 2.2 | 5.5 |
16- When the physician tells me what to do about my family member, this makes things easier for me. | 75.7 | 18.2 | 1.7 | 4.4 | 0.0 |
17- I believe that my physician treats everyone equally. | 73.5 | 9.9 | 9.9 | 3.3 | 0.0 |
18- ICU physicians are friendly and smiling. | 56.9 | 24.9 | 11.6 | 6.6 | 0.0 |
19- ICU physicians have an understanding attitude. | 66.3 | 18.8 | 9.4 | 6.1 | 2.2 |
20- I believe that I receive the necessary support from the physicians. | 61.9 | 20.4 | 9.4 | 6.1 | 2.2 |
SUBDIMENSION OF TRUST | |||||
21- I feel peaceful after speaking to the physician. | 63.9 | 21.1 | 9.9 | 5.0 | 0.0 |
22- I feel nervous while speaking to the physician. | 18.2 | 19.9 | 16.0 | 21.5 | 24.3 |
23- While speaking to the physician, I trust in what he/she says. | 78.5 | 15.5 | 2.2 | 3.9 | 0.0 |
24- I can access my family member’s physician whenever I need to. | 51.9 | 16.6 | 16.6 | 6.6 | 8.3 |
25- If a problem occurs regarding my family member, the physician is responsible for solving it. | 30.4 | 26.5 | 8.8 | 8.8 | 25.4 |
26- ICU physicians are very reassuring. | 64.6 | 25.4 | 6.6 | 3.3 | 0.0 |
N
| INFORMING | EMPATY | TRUST | ||||
---|---|---|---|---|---|---|---|
Median (25th-75th Percentile) |
p
| Median (25th–75th Percentile) |
p
| Median (25th–75th Percentile) |
p
| ||
Gender | |||||||
Male | 116 | 37 (21–44) | 0.378 | 41 (18–44) | 0.087 | 25 (16–30) |
0.011
|
Female | 65 | 36 (20–45) | 40 (30–45) | 24 (12–28) | |||
Education | |||||||
No education | 8 | 41 (34–41)a
|
0.006
| 40.5 (40–45) |
0.015
| 26 (26–26) |
0.003
|
Primary school | 56 | 37 (26–44)b
| 41 (32–45)a
| 24 (17–29) | |||
Middle school | 25 | 36 (27–41)a,b
| 41 (18–44) | 22 (16–28) | |||
High school | 58 | 37 (21–45) | 41 (31–45) | 26 (19–30)a
| |||
University | 34 | 37 (20–42) | 38 (24–45)a
| 22 (11–29)a
| |||
Descriptions of physicians | |||||||
Legal-technical consultant | 74 | 37 (21–43)a
|
0.036
| 40 (24–45)a
|
0.041
| 25.5 (16–30) | 0.181 |
Advisor | 50 | 37 (20–41) | 41 (18–45)b
| 22 (11–29) | |||
Friend | 12 | 38.5 (31–42) | 42 (34–45) | 26 (22–29) | |||
Protector | 32 | 41 (29–45)a
| 45 (24–45)a,b
| 24 (16–29) | |||
Others | 13 | 34 (32–41) | 40 (34–45) | 25,823–28) | |||
Age groups | |||||||
< 35 | 54 | 33 (20–45)a,b
|
0.001
| 37 (18–45)a,b
|
0.001
| 22 (11–30) | 0.131 |
35–50 | 65 | 37 (27–43)a
| 42 (31–45)a
| 25 (17–29) | |||
> 50 | 62 | 39 (26–44)b
| 42 (32–45)b
| 26 (16–29) | |||
How close the patients’ relatives were to the patient | |||||||
Spouses | 31 | 40 (31–42) | 41,824–45) | 26 (19–27)a
| |||
Children | 104 | 37 (22–44) | 41 (18–44) | 24 (11–29)b
| |||
Sister/Brother | 17 | 36 (29–41) | 0.082 | 42 (37–45) | 0.332 | 25 (16–30) |
0.043
|
Grandson | 14 | 41 (28–45) | 37 (24–44) | 22 (22–30) | |||
Parents | 5 | 40 (26–43) | 40 (31–45) | 23 (19–26) | |||
Cousin/distant relative | 10 | 37.5 (34–41) | 40.5 (36–45) | 20.5 (19–22)a,b
| |||
The frequency of patient relatives’ seeing the patients before they were taken to the ICU | |||||||
More than once a day | 41 | 37 (20–43)a
| 41 (30–44)a
| 25 (11–29)a
| |||
Once a day | 102 | 38 (28–44) | 41 (18–44)b
| 25 (16–30)b
| |||
Once in every 2 or 3 days | 32 | 35.5 (21–45)b
|
0.015
| 40 (31–44)c
|
0.002
| 22.5 (16–28) |
0.009
|
Once in a week or less | 6 | 45 (31–45)a,b
| 37 (24–37)a,b,c
| 28 (26–28)a,b
| |||
The frequency of visits to the patients in the ICU by patient relatives | |||||||
Everyday | 86 | 37.5 (20–44) | 0.159 | 41 (18–45)a
|
<0.001
| 26 (11–29)a,b
|
0.001
|
Once in every 2 or 3 days | 60 | 36 (21–43) | 40 (24–45)b
| 22 (16–30)a,c
| |||
Once a week | 12 | 38.5 (29–45) | 37 (32–43)c
| 21 (19–28)d
| |||
Less than once a week | 23 | 37 (31–41) | 26 (24–45)abc
| 26 (14–29)bcd
| |||
The duration of how long the patient relatives spoke to the physicians | |||||||
1–2 min | 43 | 37 (20–459 | 0.289 | 38 (24–45)a
|
0.001
| 24 (11–28) | 0.079 |
5 min | 93 | 37 (26–44) | 40 (18–45)b,c
| 25 (17–29) | |||
10 min | 44 | 35.5 (27–43) | 42 (32–45)a,b
| 23 (16–29) | |||
> 10 min | 15 | 37 (35–41) | 45 (41–45)c
| 22 (21–30) | |||
The situations that relieved the stress of patient relatives* | |||||||
Speaking with the doctor | |||||||
Yes | 121 | 37 (20–43) | 0.487 | 41 (24–45) |
0.002
| 26 (11–30) |
0.001
|
No | 60 | 36 (21–44) | 38 (18–44) | 22 (16–29) | |||
Being with the patient | |||||||
Yes | 93 | 37 (21–45) |
0.001
| 40 (18–45) |
0.001
| 24 (11–29) | 0.537 |
No | 88 | 37.5 (26–45) | 42 (32–459 | 24.5 (17–30) | |||
Praying | |||||||
Yes | 70 | 36.5 (20–43) |
0.004
| 40 (18–45) | 0.245 | 24 (11–30) | 0.855 |
No | 111 | 38 (21–45) | 41 (24–45) | 25 (16–29) | |||
Getting good news | |||||||
Yes | 104 | 37 (22–45) | 0.508 | 41 (18–45) | 0.742 | 24 (11–29) | 0.594 |
No | 77 | 37 (21–43) | 41 (24–45) | 25 (16–30) | |||
The characteristics of ICU physicians that were important to patient relatives* | |||||||
Getting good news | |||||||
Yes | 83 | 37 (29–44) |
0.001
| 42 (24–45) |
0.001
| 24 (16–29) | 0.308 |
No | 98 | 36 (20–45) | 40 (18–45) | 24 (11–30) | |||
Giving accurate information | |||||||
Yes | 128 | 39 (28–44) |
0.042
| 43 (18–45) |
0.002
| 25 (11–30) |
0.009
|
No | 53 | 37 (22–45) | 40 (24–45) | 22 (16–29) | |||
Having a sympathetic attitude | |||||||
Yes | 37 | 37 (20–42) |
0.016
| 40 (24–45) | 0.324 | 26 (11–29) |
0.003
|
No | 144 | 37 (21–43) | 41 (18–43) | 24 (16–31) | |||
Detailed medical explanation | |||||||
Yes | 54 | 37 (18–42) | 0.569 | 41 (18–45) | 0.760 | 25 (19–29) |
0.008
|
No | 127 | 37 (20–45) | 40 (24–45) | 24 (11–30) | |||
Interest and relevance | |||||||
Yes | 73 | 37 (20–43) | 0.522 | 41 (24–45) | 0.871 | 24 (11–30) | 0.676 |
No | 108 | 37 (21–45) | 41 (18–45) | 24.5 (16–29) |
QUESTIONNAIRE ITEMS FOR THE PHYSICIANS | |||||
---|---|---|---|---|---|
Always % | Very Often % | Some times % | Rarely % | Never % | |
SUBDIMENSION OF INFORMING | |||||
1- I believe that the frequency of informing the patient relative about my patient is sufficient. | 35.0 | 47.6 | 15.5 | 1.9 | 0.0 |
2- After speaking to the patient relative, I still feel like I have provided insufficient information. | 14.6 | 52.4 | 26.2 | 2.9 | 3.9 |
3- I believe I describe the medical condition of my patient in the most comprehensive way. | 26.2 | 54.4 | 14.6 | 4.9 | 0.0 |
4- When I speak to a patient relative, I give all the information about the patient. | 25.2 | 58.3 | 12.6 | 3.9 | 0.0 |
5- I use language that patient relatives can understand when I am telling them about the medical situations related to their patients. | 44.7 | 50.5 | 0.0 | 4.9 | 0.0 |
6- I would like to give the medical information about my patient next to the patient himself/herself. | 8.7 | 22.3 | 19.4 | 29.1 | 20.4 |
7- I would like to respond to all the questions that patient relatives ask. | 29.1 | 42.7 | 23.3 | 3.9 | 1.0 |
8- Physicians have difficulty giving bad news. | 39.8 | 37.9 | 16.5 | 5.8 | 0.0 |
SUBDIMENSION OF EMPATHY | |||||
9- I believe that I care about my patient. | 59.2 | 32.0 | 4.9 | 1.9 | 0.0 |
10- I believe that I care about the patient relatives in addition to the patients. | 40.8 | 52.4 | 4.9 | 1.9 | 0.0 |
11- When I have a problem with the patient relative, I try to think in a calm manner. | 23.3 | 47.6 | 13.6 | 11.7 | 3.9 |
12- When patient relatives have a friendly approach, this makes it easier for me to build a close relationship. | 35.9 | 45.6 | 17.5 | 1.0 | 0.0 |
13- When my directions about my patient are followed, this makes things easier for me. | 58.3 | 39.8 | 0.0 | 1.9 | 0.0 |
14- I believe that, as a physician, I treat everyone equally. | 46.6 | 48.5 | 4.9 | 0.0 | 0.0 |
16- ICU physicians are friendly and smiling. | 6.8 | 41.7 | 40.8 | 10.7 | 0.0 |
17- ICU physicians have an understanding attitude. | 19.4 | 59.2 | 20.4 | 1.0 | 0.0 |
18- I believe that, as a physician, I give the required support. | 27.2 | 62.1 | 10.7 | 0.0 | 0.0 |
SUBDIMENSION OF TRUST | |||||
19- I feel peaceful after speaking to the patient relative. | 15.5 | 47.6 | 29.1 | 6.8 | 1.0 |
20- I feel nervous while speaking to the patient relative. | 6.8 | 17.5 | 48.5 | 21.4 | 5.8 |
21- I trust the patient relative while speaking to him/her. | 5.8 | 35.0 | 28.2 | 24.3 | 6.8 |
22- The patient relative can access me whenever he/she needs to see me about the patient. | 22.3 | 55.3 | 13.6 | 6.8 | 1.9 |
23- If a problem occurs about my patient, I am responsible for it. | 6.8 | 8.7 | 23.3 | 34.0 | 27.2 |
24- I would like to foster confidence as an ICU physician. | 67.0 | 33.0 | 0.0 | 0.0 | 0.0 |
The physician
n
|
INFORMING
|
EMPATHY
|
TRUST
| ||||
---|---|---|---|---|---|---|---|
Median (25th–75th Percentile)
|
p
|
Median (25th–75th Percentile)
|
p
|
Median (25th–75th Percentile)
|
p
| ||
Gender | |||||||
Male | 56 | 34 (27–42) | 0.192 | 37 (29–42) |
0.007
| 20 (16–25) | 0.085 |
Female | 47 | 36 (26–44) | 39 (28–45) | 22 (14–28) | |||
Age groups | |||||||
< 35 | 74 | 35 (26–42) | 0.715 | 37 (26–44) | 0.777 | 20 (12–28) | 0.073 |
35–50 | 24 | 33 (26–42) | 38 (29–44) | 22 (17–27) | |||
> 50 | 5 | 35 (31–37) | 38 (35–40) | 19.5 (17–22) | |||
Descriptions of physicians | |||||||
Legal-technical | |||||||
Consultant | 56 | 37 (34–41) | 0.227 | 39.5 (37–41) | 0.183 | 23 (22–24) | 0.153 |
Advisor | 19 | 36 (27–42) | 38 (32–45) | 22 (17–28) | |||
Friend | 10 | 36 (26–42) | 39 (30–45) | 20 (16–27) | |||
Protector | 11 | 35 (28–41) | 38 (29–40) | 20 (16–27) | |||
Others | 7 | 36 (27–41) | 37 (26–40) | 19 (12–23) | |||
The specialties of the ICU physicians | |||||||
Anesthesiology | 57 | 34 (26–42) | 0.051 | 36 (29–37)a
|
0.009
| 21 (16–28)a
|
<0.001
|
Pulmonologist | 14 | 35 (28–42) | 38 (29–45) | 18 (12–22)ab
| |||
Cardiovascular surgery | 9 | 36 (29–37) | 37 (32–39)b
| 20 (16–22)c
| |||
Internal medicine | 8 | 37 (36–42) | 40 (40–44)ab
| 23 (22–24)bc
| |||
Surgery | 3 | 38 (33–38) | 37 (37–38) | 22 (22–22) | |||
Emergency medicine | 12 | 35 (28–37) | 39 (29–45) | 20 (17–23) | |||
How close of the relative being informed by the physician was to the patient | |||||||
Spouses | 38 | 34 (28–42) | 0.348 | 38 (29–45) | 0.342 | 20 (16–25) |
0.035
|
Children | 55 | 35 (26–42) | 37 (26–44) | 22 (12–27)a
| |||
Parents | 5 | 37 (28–41) | 37 (29–45) | 17 (16–28) | |||
Cousin and other distant relatives | 5 | 35 (32–40) | 38 (35–40) | 19.5 (17–22)a
| |||
The frequency of patient relatives’ speaking the physician | |||||||
More than once a day | 22 | 36 (28–41) | 0.287 | 39 (34–45) | 0.272 | 21.5 (16–28) | 0.528 |
Once a day | 66 | 35 (26–42) | 37 (28–45) | 20 (12–28) | |||
Once in every 2 or 3 days | 11 | 34 (27–38) | 38 (31–42) | 22 (20–23) | |||
Once in a week or less | 4 | 33 (30–34) | 35 (35–35) | 19 (17–19) | |||
The duration of how long the ICU physicians spent speaking to patient relatives | |||||||
1–2 min | 13 | 32 (27–37) | 0.129 | 33 (26–37)ab
|
0.001
| 19 (12–23) | 0.141 |
5 min | 60 | 35 (28–42) | 38 (29–45)a
| 21 (16–28) | |||
10 min | 25 | 35 (26–41) | 40 (29–45)b
| 22 (20–22) | |||
> 10 min | 5 | 41 (31–41) | 39 (34–39) | 20 (20–21) | |||
The ICU physician characteristics that were important to patient relatives* | |||||||
Accurate information | |||||||
Yes | 56 | 35 (27–42) | 0.224 | 38.5 (26–45) | 0.205 | 20 (12–18) | 0.081 |
No | 47 | 35 (26–42) | 37 (29–45) | 22 (16–27) | |||
Sympathetic attitude | |||||||
Yes | 28 | 36 (26–41) | 0.350 | 38.5 (29–45) | 0.637 | 22.5 (17–28) |
<0.001
|
No | 75 | 35 (27–42) | 37 (26–45) | 22 (16–27) | |||
Provision of medical support | |||||||
Yes | 11 | 36 (32–40) |
0.032
| 39 (33–44) | 0.487 | 22 (20–28) |
0.001
|
No | 92 | 35 (27–42) | 37 (26–44) | 20 (12–27) | |||
Interest and relevance | |||||||
Yes | 47 | 36 (27–41) | 0.117 | 38 (29–45) | 0.241 | 20 (16–28) | 0.448 |
No | 56 | 34 (26–42) | 37 (26–44) | 20.5 (12–27) | |||
Confidence | |||||||
Yes | 76 | 35 (26–42) | 0.368 | 38 (26–45) | 0.079 | 20 (12–28) | 0.617 |
No | 27 | 35 (27–41) | 36 (29–41) | 21 (16–23) |
INFORMING
|
EMPATHY
|
TRUST
| ||||
---|---|---|---|---|---|---|
β |
p
| β |
p
| β |
p
| |
Gender | ||||||
Female | −1.233 |
0.009
| ||||
Education | ||||||
Middle school | −1.792 |
0.010
| 3.566 |
<0.001
| −1.759 |
0.001
|
University | ||||||
Descriptions of physicians | ||||||
Advisor | 1.347 |
0.004
| ||||
Friend | 1.366 |
0.033
| ||||
Protector | 1.366 |
0.033
| ||||
Age groups | ||||||
< 35 | −3.861 |
<0.001
| −4.134 |
<0.001
| −1.872 |
<0.001
|
How close the patient relatives were to the patient | ||||||
Spouses | ||||||
Grandson | ||||||
Cousin/distant relative | 1.828 |
0.013
| ||||
The frequency of patient relatives’ seeing the patients before they were taken to the ICU | ||||||
Once in a week or less | 7.170 |
<0.001
| 1.052 |
0.014
| ||
Once a day | 8.996 |
<0.001
| ||||
Once a week | 8.996 |
<0.001
| ||||
The frequency of visits to the patients in the ICU by patient relatives | ||||||
Once a week | ||||||
Everyday | 1.363 |
0.038
| ||||
Once in every 2 or 3 days | 3.201 |
<0.001
| ||||
Once a week | ||||||
The duration of how long the patient relatives spoke to the physicians | ||||||
1–2 min | ||||||
5–10 min | −1.974 |
<0.001
| ||||
5–10 min | 4.046 |
0.001
| ||||
> 10 mins | ||||||
The situations that relieved the stress of patient relatives* | ||||||
Being with the patient | ||||||
No | 2.440 |
0.003
| −2.654 |
<0.001
| ||
Praying | ||||||
Yes | 8.917 |
0.004
| ||||
No | 8.962 |
0.004
| 3.369 |
<0.001
| ||
The characteristics of ICU physicians that were important to patient relatives | ||||||
Getting good news | ||||||
No | −3.765 |
<0.001
| −2.165 |
0.001
| ||
Giving accurate information | ||||||
No | −1.952 |
0.019
| ||||
Having a sympathetic attitude | ||||||
No | ||||||
Detailed medical explanation | 2.779 |
0.007
| ||||
No | −1.579 |
0.001
|
INFORMING
|
EMPATHY
|
TRUST
| ||||
---|---|---|---|---|---|---|
β
|
p
| β |
p
| β |
p
| |
Descriptions of physicians | ||||||
Advisor | −2.572 |
0.041
| ||||
Friend | 2.078 |
0.016
| ||||
Legal-technical | −1.825 |
0.016
| ||||
Consultant | −2.504 |
0.002
| ||||
Advisor | ||||||
The specialties of the ICU physicians | ||||||
Pulmonologist | ||||||
Cardiovascular surgery | −2.864 |
<0.001
| ||||
Internal medicine | 4.971 |
<0.001
| −3.247 |
<0.001
| ||
How close of the relative being informed by the physician was to the patient | ||||||
Children | 3.157 |
0.010
| 1.498 |
0.002
| ||
The duration of how long the ICU physicians spent speaking to patient relatives | ||||||
1–2 min | −2.204 |
0.037
| −3.878 |
<0.001
| −2.260 | |
5–10 min |
0.002
| |||||
The ICU physician characteristics that were important to patient relatives | ||||||
Provision of medical support | ||||||
No | −2.493 |
0.036
| ||||
Confidence | ||||||
No | ||||||
Provision of medical support | ||||||
No | −1.841 |
0.012
| −2.418 |
0.003
|