ArticleJournal of palliative medicine2013
"It hurts to know... and it helps": exploring how surrogates in the ICU cope with prognostic information.
Article in Journal of palliative medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
37 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Post-Traumatic Stress Symptoms in Post-ICU Family Members: Review and Methodological Challenges.Western journal of nursing research · 2016Pooled it
- Mobile Application-Based Communication Facilitation Platform for Family Members of Critically Ill Patients: A Randomized Clinical Trial.JAMA network open · 2024Trial
- Responses to a Daughter's Question about Prognosis When the Patient Is Expected to Die: A Qualitative Analysis.Annals of the American Thoracic Society · 2019Trial
- Decision-Making Approaches Used to Limit Potentially Nonbeneficial Life-Prolonging Interventions.JAMA network open · 2026Article
- Relationship Between Parental Distress and Proxy Symptom Reports in Pediatric Palliative Care.Journal of pain and symptom management · 2025Article
- Impact of a family support intervention on hospitalization costs and hospital readmissions among ICU patients at high risk of death or severe functional impairment.Annals of intensive care · 2024Article
- Translation, Adaptation, and Validation of the Swedish Serious Illness Conversation Guide.Journal of palliative care · 2024Article
- Article
- Early Shared Decision-Making for Older Adults with Traumatic Brain Injury: Using Time-Limited Trials and Understanding Their Limitations.Neurocritical care · 2023Article
- "No Escalation of Treatment" Designations: A Multi-institutional Exploratory Qualitative Study.Chest · 2023Article
- Palliative care phenotypes among critically ill patients and family members: intensive care unit prospective cohort study.BMJ supportive & palliative care · 2022Article
- Assessment of Clinical Palliative Care Trigger Status vs Actual Needs Among Critically Ill Patients and Their Family Members.JAMA network open · 2022Article
- Impact of a Visual Support Dedicated to Prognosis on Symptoms of Stress of ICU Family Members: A Before-and-After Implementation Study.Critical care explorations · 2021Article
- Inter-physician variability in strategies linked to treatment limitations after severe traumatic brain injury; proactivity or wait-and-see.BMC medical ethics · 2021Article
- Patient-centered and efficacious advance care planning in cancer: Protocol and key design considerations for the PEACe-compare trial.Contemporary clinical trials · 2020Article
- Psychosocial care for children receiving chimeric antigen receptor (CAR) T-cell therapy.Pediatric blood & cancer · 2020Review
- Seven Types of Uncertainty When Clinicians Care for Pediatric Patients With Advanced Cancer.Journal of pain and symptom management · 2020Article
- Time-Limited Trials in the Intensive Care Unit to Promote Goal-Concordant Patient Care.Clinical pulmonary medicine · 2019Article
- A Multicenter Study of the Causes and Consequences of Optimistic Expectations About Prognosis by Surrogate Decision-Makers in ICUs.Critical care medicine · 2019Article
- Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundSurrogates of critically ill patients in the intensive care unit (ICU) want honest prognostic information, but they also want to hear good news. There has been little examination of how surrogates navigate these dual needs or how clinicians should respond.
objectiveThe aim of this study was explore how surrogates in the ICU experience and cope with prognostic information and describe their recommendations for clinicians.
methodsWe conducted a qualitative interview study with 30 surrogates facing life-sustaining treatment decisions in five ICUs in Pittsburgh, Pennsylvania. In-depth, semi-structured interviews with surrogates in the ICU focused on general experiences, emotional needs, informational needs, and recommendations for clinicians. We inductively analyzed transcripts for key themes using constant comparative methods.
resultsSurrogates experience a tension between wanting to know what to expect and needing to remain hopeful. This tension underlies their experience receiving prognostic information and may lead to behaviors that allow continued hope in the face of bad news, including: 1) focusing on small details rather than the big picture, 2) relying on gut instincts or personal beliefs about the patient, 3) seeking more positive prognostic information from other sources, and, for a minority, 4) avoiding or disbelieving prognostic information. Surrogates emphasize the importance of frequent communication and call on physicians to gently help them prepare for the worst and hope for the best.
conclusionsSurrogates in the ICU experience conflicting emotional and informational needs. They describe behaviors that give the appearance of avoiding bad news while simultaneously asking physicians to help them cope with prognostic information.
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Registered trials
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