Titre
Prevalence and factors of intensive care unit conflicts: the conflicus study.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Auteur(s)
Azoulay, E.
Auteure/Auteur
Timsit, J.F.
Auteure/Auteur
Sprung, C.L.
Auteure/Auteur
Soares, M.
Auteure/Auteur
Rusinová, K.
Auteure/Auteur
Lafabrie, A.
Auteure/Auteur
Abizanda, R.
Auteure/Auteur
Svantesson, M.
Auteure/Auteur
Rubulotta, F.
Auteure/Auteur
Ricou, B.
Auteure/Auteur
Benoit, D.
Auteure/Auteur
Heyland, D.
Auteure/Auteur
Joynt, G.
Auteure/Auteur
Français, A.
Auteure/Auteur
Azeivedo-Maia, P.
Auteure/Auteur
Owczuk, R.
Auteure/Auteur
Benbenishty, J.
Auteure/Auteur
de Vita, M.
Auteure/Auteur
Valentin, A.
Auteure/Auteur
Ksomos, A.
Auteure/Auteur
Cohen, S.
Auteure/Auteur
Kompan, L.
Auteure/Auteur
Ho, K.
Auteure/Auteur
Abroug, F.
Auteure/Auteur
Kaarlola, A.
Auteure/Auteur
Gerlach, H.
Auteure/Auteur
Kyprianou, T.
Auteure/Auteur
Michalsen, A.
Auteure/Auteur
Chevret, S.
Auteure/Auteur
Schlemmer, B.
Auteure/Auteur
Contributrices/contributeurs
Azoulay, E.
Lafabrie, A.
Schlemmer£££Benoît£££ B.,
Soares, M.
Azoulay, E.
Abizanda, R.
Svantesson, M.
Rubulotta, F.
Rusinova, K.
Benoit, D.
Heyland, D.
Joynt, G.
Owczuk, R.
Maia, PA.
Moreno, R.
Ricou, B.
de Vita, D.
Valentin, A.
Cohen, S.
Winter, B.
Ksomos, A.
Ho, K.
Kompan, L.
Srung, CL.
BenBenishty, J.
Abroug, F.
Kaarlola, A.
Rubulotta, F.
Gelarch, H.
Kyprianou, T.
Timsit, JF.
Français, A.
Bonniot, A.
Chevret, S.
Ho, K.
Bersten, A.
Blythe, D.
Ho, K.
Liang, J.
English, S.
Mc Arthur, C.
Bell, J.
Valentin, A.
Filzwieser, G.
Wernig, U.
Kliegel, A.
Janko, H.
Reiter, A.
Elliott, P.
Wolfgang, P.
Poradek, T.
Strohmeyer, GW.
Hipfl, J.
Firlinger,
Benoît£££Benoît£££ B.,
Vincent, JL.
Ludovic, L.
Decock, C.
Denys, D.
Anne-Pascale, M.
Nonneman, B.
Van Utterbeeck, M.
Swinnen, W.
Eerens, J.
Vanbiervliet, P.
Vanderveire, B.
Janssens, B.
Benoît, D.
Benoît, D.
Soares, M.
da Rocha MG.,
Dal-Pizzol, F.
de Carvalho AG.,
Guimarães, HP.
de Castro JE.,
de Castro JE.,
de Castro JE.,
de Castro JE.,
Salluh, JI.
Dias, FS.
Visconti Rdos, R.
Deheinzelin, D.
Arruda, AP.
de C Mello PM.,
Azevedo, LC.
Lobo, SM.
Lobo, SM.
Lobo, SM.
Westphal, GA.
Hoher, JA.
Ribeiro, SP.
Teles£££José Mário Meira£££ JM.,
Moritz, RD.
de Souza PC.,
de Souza PC.,
de Souza PC.,
de Souza PC.,
de Souza PC.,
de Souza PC.,
Bozza, FA.
Miranda£££Fábio£££ F.,
Rocco, JR.
Japiassú, AM.
Gusman, PB.
Filho£££Mário Lúcio Alves Baptista£££ ML.,
Brandão, N.
Knibel, MF.
Knibel, MF.
Knibel, MF.
Piras£££Cláudio£££ C.,
Piras£££Cláudio£££ C.,
Piras£££Cláudio£££ C.,
Macedo, GL.
Coelho, CD.
Falcão, AL.
Brilhante£££Yuzeth Nóbrega de Assis£££ YN.,
Rezegue, L.
Rezegue, L.
Silva, E.
Lucchesi£££Fátima£££ F.,
Westphal, GA.
Westphal, GA.
Filho, MC.
Ferreira Bda, S.
Maia Mde, O.
Maia Mde, O.
Maia Mde, O.
Daren, H.
Bailey, J.
Rogovein, TS.
Denny, L.
Lewis, MJ.
Richard, H.
Sheldon, M.
Dan, S.
Keenan, SP.
Wood, G.
Auld, F.
Laura, H.
Cooper, AB.
Smith, O.
Dawson, P.
Smith, O.
Smith, O.
Gavin, J.
Buckley, T.
Civa, A.
Young, K.
Au Yeung KW.,
Cheng, C.
Buckley, T.
Kyprianou, T.
Ergatoudes, P.
Constantinou, E.
Kaarlola, A.
Azoulay, E.
Bleichner, G.
Cohen, Y.
Paugam, C.
Capellier, G.
Wolff, M.
Du Cheyron, D.
Descorps-Declère, A.
Bertrand, S.
Cariou, A.
Darmon, M.
Djibre, M.
Kaidomar, M.
Barnoud, D.
Timsit, JF.
Rabbat, A.
Reignier, J.
Jourdain, M.
Megarbane, B.
Mohammedi, I.
Bollaert, PE.
Boussat, S.
Sanchez, O.
Bonmarchand, G.
Joly, LM.
Thuong, M.
Zeni, F.
Hayon, J.
Garrouste-Orgeas, M.
Fieux, F.
Castellain, V.
Georges, H.
Bruneel, F.
Galliot, R.
Annane, D.
Kouatchet, A.
Lefrant, JY.
Mokart, D.
Das, V.
Bornstain, C.
Saulnier, F.
Cheval, C.
Payen, D.
Goldgram-Toledano, D.
Kouatchet, A.
Gerlach, H.
Toussaint, S.
Steinke, E.
Zachow, G.
Freitag, A.
Metzger, M.
Hartung, HJ.
Michalsen, A.
Akos, C.
Darvas, K.
Futó, J.
Csepregi, G.
Bede, A.
Szentkereszty£££Zoltán£££ Z.,
Bogdán£££Zoltán£££ Z.,
Bodnár, J.
Suto, B.
Charles, S.
Julie, B.
Jonathan, C.
Farkash, N.
Remus, H.
Francesca, R.
Fumagalli, R.
Rossi, G.
Sganga, G.
Pezzi, A.
Adembri, C.
Tulli, G.
Vivaldi, N.
Lugano, M.
Bianchin, A.
Columbo, R.
Modano, P.
Radeschi, G.
Conti, A.
Mantovani, G.
Occhipinti, G.
Michele, I.
Mercante, D.
Giordano, D.
Garofalo, G.
Prondi, E.
Fabbri, G.
Radoslaw, O.
Wujtewicz, MA.
Lango, R.
Karpel, E.
Misiołek, H.
Nestorowicz, A.
Przesmycki, K.
Sobczyński£££Paweł£££ P.,
Mikstacki, A.
Maciejewski, D.
Drobnik, L.
Kusza, K.
Karwacki, Z.
Kołacki, T.
Dończyk, A.
Wenski, W.
Bielski, J.
Kot, J.
Czajkowska£££Małgorzata£££ M.,
Onichimowski, D.
Sowa-Szpajer, J.
Skoczylas-Stoba, B.
Szudzińska, A.
Moreno, R.
Maia, PA.
Almeida, E.
Esteves, F.
Faria, F.
Aguiar, AM.
Pimentel, J.
Ferro, I.
Correia, M.
Honrado, T.
Rhodes, A.
Brnadão, JL.
Mota, A.
Lidija, K.
Pareznik, R.
Kozjek-Rotovnik, N.
Esteban, A.
Ricardo, A.
Cabré, L.
Roca, J.
Baigorri, F.
Romero, JM.
Camps, VL.
Delgado, MC.
Zarallo, AR.
Guardiola, F.
Monzon, JL.
Urionabarrenetxea, KM.
Fernandez, PR.
Duran, JS.
Palencia, E.
Martin, SM.
Galdos,
Jiménez£££Antonio García£££ AG.,
Svantesson, M.
Tegsten, U.
Svantesson, M.
Nilsson, M.
Glimelius-Petersson, C.
Forsgren, L.
Hollman, G.
Hollman, G.
Eriksson, SL.
Sjöberg, M.
Yttergren, K.
Bäckman, C.
Lindbladh-Fridh, M.
Martinsson, L.
Hollman, G.
Svantesson, M.
Bengtsson, EM.
Bogmark, E.
Ricou, B.
Maggiorini, M.
Michot, M.
Barandun, U.
Zender, H.
Eggimann, P.
Souheil, E.
Mounir, B.
Abroug, F.
Messadi, A.
Simon, C.
Brian, C.
Bob, W.
Jeremy, B.
McQuillan, PJ.
Paul, R.
Pinsky, MR.
Marion, D.
Sulmasy, D.
Nenic, SDj.
Manjuck, J.
Moine, P.
Pelnar, P.
Rocen, M.
Cerny, V.
Berlinger, G.
Herold, I.
Tretina, J.
Marek, O.
Sevcik, P.
Krejci, M.
Janda, R.
Zykova, I.
Fortova, M.
Kopelent, P.
Dostalova, V.
Stritezsky, M.
Jahoda, J.
Zdenka, K.
Nalos, D.
Brezina, A.
Aquilina, A.
Groupes de travail
Conflicus Study Investigators
for the Ethics Section of the European Society of Intensive Care Medicine
Liens vers les personnes
Liens vers les unités
ISSN
1535-4970
Statut éditorial
Publié
Date de publication
2009
Volume
180
Numéro
9
Première page
853
Dernière page/numéro d’article
860
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
Résumé
RATIONALE: Many sources of conflict exist in intensive care units (ICUs). Few studies recorded the prevalence, characteristics, and risk factors for conflicts in ICUs.
OBJECTIVES: To record the prevalence, characteristics, and risk factors for conflicts in ICUs.
METHODS: One-day cross-sectional survey of ICU clinicians. Data on perceived conflicts in the week before the survey day were obtained from 7,498 ICU staff members (323 ICUs in 24 countries).
MEASUREMENTS AND MAIN RESULTS: Conflicts were perceived by 5,268 (71.6%) respondents. Nurse-physician conflicts were the most common (32.6%), followed by conflicts among nurses (27.3%) and staff-relative conflicts (26.6%). The most common conflict-causing behaviors were personal animosity, mistrust, and communication gaps. During end-of-life care, the main sources of perceived conflict were lack of psychological support, absence of staff meetings, and problems with the decision-making process. Conflicts perceived as severe were reported by 3,974 (53%) respondents. Job strain was significantly associated with perceiving conflicts and with greater severity of perceived conflicts. Multivariate analysis identified 15 factors associated with perceived conflicts, of which 6 were potential targets for future intervention: staff working more than 40 h/wk, more than 15 ICU beds, caring for dying patients or providing pre- and postmortem care within the last week, symptom control not ensured jointly by physicians and nurses, and no routine unit-level meetings.
CONCLUSIONS: Over 70% of ICU workers reported perceived conflicts, which were often considered severe and were significantly associated with job strain. Workload, inadequate communication, and end-of-life care emerged as important potential targets for improvement.
OBJECTIVES: To record the prevalence, characteristics, and risk factors for conflicts in ICUs.
METHODS: One-day cross-sectional survey of ICU clinicians. Data on perceived conflicts in the week before the survey day were obtained from 7,498 ICU staff members (323 ICUs in 24 countries).
MEASUREMENTS AND MAIN RESULTS: Conflicts were perceived by 5,268 (71.6%) respondents. Nurse-physician conflicts were the most common (32.6%), followed by conflicts among nurses (27.3%) and staff-relative conflicts (26.6%). The most common conflict-causing behaviors were personal animosity, mistrust, and communication gaps. During end-of-life care, the main sources of perceived conflict were lack of psychological support, absence of staff meetings, and problems with the decision-making process. Conflicts perceived as severe were reported by 3,974 (53%) respondents. Job strain was significantly associated with perceiving conflicts and with greater severity of perceived conflicts. Multivariate analysis identified 15 factors associated with perceived conflicts, of which 6 were potential targets for future intervention: staff working more than 40 h/wk, more than 15 ICU beds, caring for dying patients or providing pre- and postmortem care within the last week, symptom control not ensured jointly by physicians and nurses, and no routine unit-level meetings.
CONCLUSIONS: Over 70% of ICU workers reported perceived conflicts, which were often considered severe and were significantly associated with job strain. Workload, inadequate communication, and end-of-life care emerged as important potential targets for improvement.
Sujets
PID Serval
serval:BIB_AA1187B450E6
PMID
Date de création
2009-12-29T14:15:35.421Z
Date de création dans IRIS
2025-05-21T00:19:49Z