Evidence map›Paper›PMID 36817963›Full record

ArticleCritical care explorations2023

"You're Socially Distant and Trying Not to Be Emotionally Distant." Physicians' Perspectives of Communication and Therapeutic Relationships in the ICU During the COVID-19 Pandemic: A Qualitative Study.

Shannon M Nugent, Sara E Golden, Joaquin Chapa, Anaïs Tuepker, Christopher G Slatore, Kelly C Vranas

Open access · goldAbstract read
In one paragraph

Article in Critical care explorations, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Pooled it
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Shannon M NugentCenter to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR.
Sara E GoldenCenter to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR.
Joaquin ChapaDivision of Pulmonary, Allergy, and Critical Care Medicine, Oregon Health & Science University, Portland, OR.
Anaïs TuepkerCenter to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR.
Christopher G SlatoreCenter to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR.
Kelly C VranasCenter to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR.
Oregon Health & Science University · USVA Portland Health Care System · US

Funding

Optimizing Critical Care for Patients with Acute Respiratory Failure: A Mixed-Methods StudyIK2HX003005 · VA · PORTLAND VA MEDICAL CENTER · PI VRANAS, KELLY C. · 2020 to 2023
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HSRD VA IK2 HX003005
6 · The paper itself

Abstract

To: 1) characterize how COVID-19-related policies influence patient-clinician communication and relationships in the ICU, with attention to race and ethnicity as factors and 2) identify interventions that may facilitate patient-clinician communication.

designWe conducted a qualitative study between September 2020 and February 2021 that explored facilitators and barriers to patient-clinician communication and the formation of therapeutic relationships. We used thematic analysis to develop findings describing patient-communication and therapeutic relationships within the ICU early in the COVID-19 pandemic.

settingWe purposively selected hospital dyads from regions in the United States that experienced early and/or large surges of patients hospitalized with COVID-19. SUBJECTS: We recruited a national sample of ICU physicians from Veteran Affairs (VA) Health Care Systems and their associated academic affiliate hospitals.

interventionsNone. MEASUREMENTS AND MAIN

resultsTwenty-four intensivists from seven VA hospitals and six academic-affiliate hospitals participated. Intensivists noted the disproportionate impact of the pandemic on among people holding minoritized racial and ethnic identities, describing how language barriers and restrictive visitation policies exacerbated institutional mistrust and compromised physicians' ability to develop therapeutic relationships. We also identified several perceived influences on patient-clinician communication and the establishment of therapeutic relationships. Barriers included physicians' fear of becoming infected with COVID-19 and use of personal protective equipment, which created obstacles to effective physical and verbal interactions. Facilitators included the presence of on-site interpreters, use of web-based technology to interact with family members outside the ICU, and designation of a care team member or specialist service to provide routine updates to families.

conclusionsThe COVID-19 pandemic has threatened patient-clinician communication and the development of therapeutic relationships in the ICU, particularly among people holding minoritized racial and ethnic identities and their families. We identified several facilitators to improve patient-clinician communication as perceived by intensivists that may help improve trust and foster therapeutic alliances.

Indexed as

COVID-19health communicationintensive care unitsminority groupsphysician-patient relations

Identifiers

PMID36817963
PMCPMC9937100
OpenAlexW4321116323

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.