The importance and challenge of measuring family experience with end-of-life care in the ICU

Excerpt

The ICU is a setting where death is common, and the majority of these deaths involve decisions to withhold or withdraw life-sustaining treatments [1]. These two facts highlight the importance of addressing the quality of end-of-life care in the ICU, as well as the need to support patients and family members through this process. Unfortunately, both quality of care and support for patients and families vary markedly from hospital to hospital, influenced in large part by physician attitudes and hospital norms [1, 2]. Importantly, family members of patients who die in the ICU experience a significant burden of distress, with high levels of symptoms of anxiety, depression, and post-traumatic stress disorder [3, 4] that have long-lasting consequences. Evidence suggests that behaviors of ICU clinicians and the culture of care in the ICU care can increase, or decrease, these symptoms [5, 6]. …