Table 1.
Demographic and clinical characteristics of families, patients, and physicians, by physician-reported conflict
| No Physician-reported Conflict | Physician-reported Conflict | Total | |
|---|---|---|---|
| N/n | 244 | 13 | 257 |
| Family characteristics* | |||
| Randomized to intervention, % | 50.4 | 46.2 | 50.2 |
| Age, median (IQR) | 52.0 (42.0–61.0) | 57.0 (41.0–65.0) | 52.0 (42.0–61.0) |
| Race, % | |||
| White | 80.2 | 53.8 | 78.9 |
| Black | 12.8 | 46.2 | 14.5 |
| Other or multiple race | 7.0 | 0.0 | 6.6 |
| Female gender, % | 74.2 | 92.3 | 75.1 |
| Relationship to patient, % | |||
| Partner | 47.5 | 38.5 | 47.1 |
| Child | 21.7 | 46.2 | 23.0 |
| Parent | 20.9 | 7.7 | 20.2 |
| Other | 9.8 | 7.7 | 9.7 |
| Lacks social support, % | 3.7 | 23.1 | 4.7 |
| Endorses hope for future, %† | 94.7 | 84.6 | 94.2 |
| Health literacy, median (IQR)‡ | 5.0 (3.0–6.0) | 5.0 (5.0–7.0) | 5.0 (3.0–7.0) |
| HADS score, median (IQR)§ | 14.0 (8.0–21.0) | 12.0 (9.5–21.0) | 14.0 (9.0–12.0) |
| PTSS-10 score, median (IQR)‖ | 23.0 (16.0–33.0) | 26.5 (20.5–35.0) | 24.0 (17.0–34.0) |
| Physician-perceived mistrust of ICU team, % | 2.0 | 53.8 | 4.7 |
| Family–physician discordance about patient’s survival prognosis, median (IQR)¶ | 28.5 (10.0–49.0) | 50.0 (25.0–76.0) | 29.0 (11.0–50.0) |
| Family–physician sex concordance, % | |||
| Female–female | 27.0 | 30.8 | 27.2 |
| Male–male | 15.2 | 0.0 | 14.4 |
| Discordant | 57.8 | 69.2 | 58.4 |
| Family–physician race concordance, % | |||
| White family–White physician | 64.2 | 38.5 | 62.9 |
| Black family–Black physician | 0.4 | 0.0 | 0.4 |
| Other concordant | 0.4 | 0.0 | 0.4 |
| All discordant | 35.0 | 61.5 | 36.3 |
| White family–Black physician | 4.5 | 7.7 | 4.7 |
| Black family–White physician | 11.1 | 23.1 | 11.7 |
| Other discordant | 19.3 | 30.8 | 19.9 |
| Patient characteristics | |||
| Age, median (IQR) | 57.0 (40.0–67.0) | 67.0 (61.0–79.0) | 57.0 (40.0–67.0) |
| APACHE II score at enrollment, median (IQR) | 23.0 (18.0–29.0) | 25.0 (20.0–27.0) | 23.0 (18.0–29.0) |
| Charlson comorbidity score, median (IQR) | 3.0 (1.0–6.0) | 5.0 (4.0–7.0) | 3.0 (1.0–6.0) |
| Days in ICU before randomization, median (IQR) | 12.0 (10.0–15.0) | 12.0 (11.0–14.0) | 12.0 (10.0–15.0) |
| Tracheostomy, % | |||
| None | 38.1 | 53.8 | 38.9 |
| Done before family meeting | 30.3 | 30.8 | 30.4 |
| Done after family meeting | 31.6 | 15.4 | 30.7 |
| In-hospital mortality, % | 29.9 | 61.5 | 31.5 |
| Physician characteristics*,** | |||
| N/n | 142 | 13 | 155 |
| Age, median (IQR) | 35.0 (31.0–42.5) | 39.0 (33.0–46.0) | 35.0 (31.0–43.0) |
| Female sex, % | 36.6 | 38.5 | 36.8 |
| Race, % | |||
| White | 78.2 | 61.5 | 76.8 |
| Black | 3.5 | 7.7 | 3.9 |
| Asian | 11.3 | 23.1 | 12.3 |
| Other or mixed race | 7.0 | 7.7 | 7.1 |
| Self-reported aspects of patient care inclination, % | |||
| Social–emotional | 16.7 | 46.2 | 19.2 |
| Equally social–emotional and technological–scientific | 66.7 | 46.2 | 64.9 |
| Technological–scientific | 16.7 | 7.7 | 15.9 |
| Self-reported decision-making style, % | |||
| Leads decision-making | 10.1 | 7.7 | 9.9 |
| Engages patient or family as equal partner | 76.1 | 76.9 | 76.2 |
| Allows patient or family to make decision | 13.8 | 15.4 | 13.9 |
Definition of abbreviations: APACHE = Acute Physiologic Assessment and Chronic Health Evaluation; HADS = Hospital Anxiety and Depression Scale; ICU = intensive care unit; IQR = Q1 to Q3 interquartile range; PTSS = Posttraumatic Stress Symptoms Checklist.
Missing data counts are as follows: 5 for family age from the group with no physician-reported conflict, 1 for family race from the group with no physician-reported conflict, 2 for social support from the group with no physician-reported conflict, 2 for health literacy from the group with no physician-reported conflict, 19 for HADS from the group with no physician-reported conflict, 1 for HADS from the group with physician-reported conflict, 19 for PTSS from the group with no physician-reported conflict, 1 for PTSS from the group with physician-reported conflict, 1 for race concordance from the group with no physician-reported conflict, 14 for physician age from the group with no physician-reported conflict, 2 for physician age from the group with any physician-reported conflict, 4 for aspects of patient care inclination from the group with no physician-reported conflict, and 4 for decision-making style from the group with no physician-reported conflict.
The question assessing hope was, “I look forward to the future with hope”.
Ranging from 3 to 15 in order of decreasing health literacy.
Ranging from 0 to 42 in order of increasing depression and anxiety.
Ranging from 10 to 70 in order of increasing PTSS.
Ranging from 0 to 100 in order of increasing prognostic discordance.
Of 155 physicians, 60 participated in more than one family meeting (range, 2–7). To avoid repeat measures, if a physician reported conflict with any families, they are included in the physician-reported conflict group.