Selecting the Best Instrument to Measure Family Perceptions of End-of-Life Communication in Intensive Care Units

Abstract

Background:

Good communication with the family is a clinical imperative for high quality end-of-life (EOL) care in intensive care unit (ICU). Many interventions aim to improve EOL communication, and the choice of an outcome instrument has important implications for evaluating interventions. The purpose of this project is to search and review available instruments’ psychometric properties and determine which best measures family–clinician communication in the ICU.

Method:

A stepwise method was used by searching 2 databases (PsycInfo and Web of Science) to identify instruments and articles that provide information about scale psychometric properties.

Instruments:

Three instruments were identified, including Family Inpatient Communication Survey, Family Perception of Physician–Family Caregiver Communication, and Quality of Communication (QOC).

Results:

Reliability estimates were high (≥ 0.79) in all 3 instruments. The QOC’s convergent validity estimates exceed its discriminant validity values, and the QOC is an intervention-sensitive measure used to examine families’ treatment response in randomized control trials.

Conclusion:

Quality of Communication is the most suitable instrument to measure family’s perceptions of EOL communication in the ICU. Quality of Communication scores provide a deeper understanding of family–clinician communication and data about how to improve EOL care in ICUs.

Keywords

end-of-life family communication intensive care unit instrument reliability validity

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