The concept of a surrogate is ill adapted to intensive care: Criteria for recognizing a reference person

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• 作者：Jean-Philippe Rigaud ; MD ; PhD^a ; ^{JRigaud@ch-dieppe.fr" class="auth_mail" title="E-mail the corresponding author} ; Jean-Baptiste Hardy ; MD^a ; ^{jeanbaptistehardy@hotmail.fr" class="auth_mail" title="E-mail the corresponding author} ; Nicolas Meunier-Beillard^b ; ^c ; ^{nicolas.meunier-beillard@u-bourgogne.fr" class="auth_mail" title="E-mail the corresponding author} ; Hervé ; Devilliers ; MD ; PhD^d ; ^e ; ^{herve.devilliers@chu-dijon.fr" class="auth_mail" title="E-mail the corresponding author} ; Fiona Ecarnot ; MSc^f ; ^{fiona.ecarnot@univ-fcomte.fr" class="auth_mail" title="E-mail the corresponding author} ; Corinne Quesnel ; MD^a ; ^{cquesnel@ch-dieppe.fr" class="auth_mail" title="E-mail the corresponding author} ; Sté ; phanie Gelinotte ; MD^a ; ^{sgelinotte@ch-dieppe.fr" class="auth_mail" title="E-mail the corresponding author} ; Pierre-Louis Declercq ; MD^a ; ^{pldeclercq@ch-dieppe.fr" class="auth_mail" title="E-mail the corresponding author} ; Jean-Pierre Eraldi ; MD^a ; ^{jeraldi@ch-dieppe.fr" class="auth_mail" title="E-mail the corresponding author} ; Franç ; ois Bougerol ; MD^a ; ^{fbougerol@ch-dieppe.fr" class="auth_mail" title="E-mail the corresponding author} ; Jean-Pierre Quenot ; MD ; PhD^b ; ^e ; ^g ; ^{jean-pierre.quenot@chu-dijon.fr" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Ethics ; Surrogate ; Questionnaire ; Intensive care
• 刊名：Journal of Critical Care
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：32
• 期：Complete
• 页码：89-92
• 全文大小：253 K

文摘

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.