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Rigaud JP, Hardy JB, Meunier-Beillard N, Devilliers H, Ecarnot F, Quesnel C, Gelinotte S, Declercq PL, Eraldi JP, Bougerol F, Quenot JP. The concept of a surrogate is ill adapted to intensive care: Criteria for recognizing a reference person. J Crit Care 2015; 32:89-92. [PMID: 26787167 DOI: 10.1016/j.jcrc.2015.12.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 11/22/2015] [Accepted: 12/10/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE In the intensive care unit (ICU), caregivers may find it difficult to identify a suitable person in the patient's entourage to serve as a reference when there is no official surrogate. METHODS We developed a 12-item questionnaire to identify factors potentially important for caregivers when identifying a reference person. Each criterion was evaluated as regards its importance for the role of reference. Responses were on a scale of 0 (not important) to 10 (extremely important). We recorded respondent's age, job title, and number of years' ICU experience. The questionnaire was distributed to all health care professionals in 2 French ICUs. RESULTS Among 144 staff, 128 were contacted; 99 completed the questionnaire (77% response rate; 20 physicians [11 residents], 51 nurses, 28 nurse's aides). Items classed as most important attributes for a reference person were knowledge of patient's wishes and values, emotional attachment, adequate understanding of the clinical history, and designation as a surrogate before admission. There were no significant differences according to respondent's age, job title, or experience. CONCLUSION Caregivers identify a reference person based on criteria such as knowledge of the patient's wishes, emotional bond with the patient, an adequate understanding of the clinical history, and designation as surrogate before admission.
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Affiliation(s)
| | - Jean-Baptiste Hardy
- Department of Intensive Care, Dieppe General Hospital, 76202 Dieppe, France.
| | - Nicolas Meunier-Beillard
- Department of Intensive Care, François Mitterrand University Hospital, 21079 Dijon, France; UMR 7366 CNRS, University of Burgundy, Dijon, France.
| | - Hervé Devilliers
- Department of Internal Medicine, François Mitterrand University Hospital, 21079 Dijon, France; INSERM CIC 1432, Clinical Epidemiology, University of Burgundy, Dijon, France.
| | - Fiona Ecarnot
- Department of Cardiology, EA3920, University Hospital Jean Minjoz, Besançon, France.
| | - Corinne Quesnel
- Department of Intensive Care, Dieppe General Hospital, 76202 Dieppe, France.
| | - Stéphanie Gelinotte
- Department of Intensive Care, Dieppe General Hospital, 76202 Dieppe, France.
| | | | - Jean-Pierre Eraldi
- Department of Intensive Care, Dieppe General Hospital, 76202 Dieppe, France.
| | - François Bougerol
- Department of Intensive Care, Dieppe General Hospital, 76202 Dieppe, France.
| | - Jean-Pierre Quenot
- Department of Intensive Care, François Mitterrand University Hospital, 21079 Dijon, France; INSERM CIC 1432, Clinical Epidemiology, University of Burgundy, Dijon, France; Lipness Team, INSERM Research Center UMR 866, University of Burgundy, Dijon, France.
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