ABSTRACT
Objective:
To understand the perception of patients about medical communication as well as their needs during hospitalization in the intensive care unit.
Methods:
This study was cross-sectional descriptive and qualitative exploratory including 103 patients admitted to or recently discharged from the intensive care units of four hospitals in Greater Florianópolis, Santa Catarina state, Brazil. The patients’ sociodemographic and clinical variables were studied, as were the score they gave to the quality of medical communication through the Quality of Communication Questionnaire and their spontaneous comments with reflections or justifications for the scores given, and their responses on how they felt and what complementary help they would have liked to receive. The quantitative data were analyzed by descriptive and analytical statistics, and the qualitative data were analyzed by thematic content analysis.
Results:
The mean Quality of Communication Questionnaire score was 5.1 (standard deviation - SD = 1.3), with 8.6 (SD = 1.3) on the general communication subscale and 2.1 (SD = 1.8) on the end-of-life communication subscale. The patients had a variable understanding of medical language. Some physicians seemed to be “rushed”, according to some patients. Other patients would like to receive more frequent and detailed information and/or be respected and taken “more seriously” when they reported pain. Anxiety, sadness, and fear were among the reported feelings. Other needs included silence, more time for visits, the presence of a companion, psychological and social-work care, a bathroom that they could use, and better food in the intensive care unit.
Conclusion:
The quality of medical communication with patients is good but could improve if physicians and the healthcare team had more time for patients. Other felt needs included respect, pain relief, and adjustments in the intensive care unit dynamics and environment.
Keywords:
Critical care; Communication; Patient preference; Patient satisfaction; Patient comfort; Physician-patient relations
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QoC - Quality of Communication Questionnaire. *The Quality of Communication Questionnaire items are answered on a scale from 0 (“worst imagined”) to 10 (“best imagined”). There are two response options: “Did not do” (scored as 0) and “Do not know” (replaced by the median of the scores on the other items);(21,22) †all participants answered items 1, 2, 4, and 6; 1 participant answered “Did not do” for item 3; 5 answered “Do not know” for item 5, and 2 of these also answered “Do not know” for item 12; 87 answered “Did not do” for item 7; 33 in 8; 70 in 9; 89 in 10; 86 in 11; 77 in 12; and 81 in 13. No participant gave a score of 0 to the physician in any of the items, so the zeros all came from the replacement of the answer “Did not do”; ‡mean QoC score by marital status: single: 5.5 (SD = 1.2); married/stable relationship: 5.1 (SD = 1.3); divorced/separated: 5.3 (SD = 0.2); widower: 4.5 (SD = 1.1); and by educational level: incomplete primary education: 5.0 (SD = 1.1); complete primary education: 5.3 (SD = 1.3); incomplete or complete secondary education: 5.2 (SD = 1.5); above secondary education: 5.3 (SD = 1.7); §two-way between-group analysis of variance: interaction between marital status and educational level: F (4, 103) = 0.11, p = 0.98; main effect of marital status: F (3, 103) = 0.30, p = 0.82; main effect of educational level: F (3, 103) = 0.29, p = 0.99; ¶mean of the QoC subscale general communication by marital status: single: 8.7 (SD = 1.3); married/in a stable relationship: 8.6 (SD = 1.4); divorced/separated: 8.6 (SD = 1.5); widower: 8.3 (SD = 1.4); and by educational level: incomplete primary education: 8.5 (SD = 1.4); complete primary education: 8.8 (SD = 1.1); incomplete or complete secondary education: 8.5 (SD = 1.6); above secondary education: 8.6 (SD = 1.2); ||two-way between-group analysis of variance groups: interaction between marital status and educational level: F (4, 103) = 0.57, p = 0.68; main effect of marital status: F (3, 103) = 0.24, p = 0.87; main effect of educational level: F (3, 103) = 0.29, p = 0.83; #mean of the QoC subscale end-of-life communication: by marital status: single: 2.7 (SD = 1.5); married/stable relationship: 2.2 (SD = 1.9); divorced/separated: 2.6 (SD = 1.6); widower: 1.3 (SD = 1.4); and by educational level: incomplete primary education: 1.9 (SD = 1.5); complete primary education: 2.3 (SD = 2.0); incomplete or complete secondary education: 2.4 (SD = 2.0); above secondary education: 2.4 (SD = 2.6); **two-way between-group analysis of variance: interaction between marital status and educational level: F (4, 103) = 0.589, p = 0.672; main effect of marital status: F (3, 103) = 0.89, p = 0.45; main effect of educational level: F (3, 103) = 0.29, p = 0.83.
ICU - intensive care unit.