好色先生

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Abstract Details

Empathy from Clinicians in the Neurocritical Care Unit: Using Vr-CoDES to Investigate Family Decision-making Meetings
Neuro Trauma and Critical Care
P7 - Poster Session 7 (8:00 AM-9:00 AM)
18-002
To examine clinician expressed empathy during neurocritical care family meetings and how different types of empathetic statements influence surrogate decision-making. 
When neurocritical care patients are unable to speak for themselves, empathy fosters a clinician-family relationship grounded in trust and respect. Although family meetings provide opportunities to discuss patient values and preferences, communication priorities often diverge. Understanding clinicians’ responses to family distress may identify communication strategies to support shared decision-making.  
We qualitatively analyzed 30 de-identified audio-recorded family meeting transcripts of an ongoing multi-center cross-sectional study using the internationally validated Verona Coding Definitions of Emotional Sequences (Vr-CoDES). Family and clinician utterances were coded using two complementary systems: (1) consensus definition of cues and concerns expressed by patients in medical consultations and (2) coding of health provider talk related to cues and concerns. Empathic statements initiated by clinicians without a preceding family cue/concern were coded and classified by their target (family or patient).   
Across 30 meetings, we identified a total of 178 total empathic statements, 150 clinician responses, and 58 clinician-prompted empathic statements. Family cues/concerns were present in 93.3% of meetings, 66.7% of which were family initiated. 26.7% of family cues involved explicit expressions of negative emotion, and 34% were indirect verbal hints to hidden concerns. 47.3% of clinician responses reduced emotional space for continued discussion, and 33.3% were non-explicit acknowledgement. The most frequent clinician response type was information/advice giving (38%); affective exploration or switching occurred the least often (1.3%). 
Empathetic communication occurred in most NCCU family meetings, predominantly in response to family cues/concerns. However, many clinician responses reduced space for continued discussion of emotions by ignoring or by defaulting to informational explanations. These findings highlight opportunities to improve empathetic communication by promoting response styles that validate emotion and foster trust. Strengthening targeted empathic responses may improve both surrogate decision-making and family satisfaction.  
Authors/Disclosures
Taila Lehrer
PRESENTER 		Ms. Lehrer has nothing to disclose.
Miriam Quinlan, MD, MPH Dr. Quinlan has nothing to disclose.
Susanne Muehlschlegel, MD, MPH, FAAN (Johns Hopkins School of Medicine) Dr. Muehlschlegel has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Grace Pharmaceuticals Inc.. Dr. Muehlschlegel has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Grace Pharmaceuticals Inc.. The institution of Dr. Muehlschlegel has received research support from NIH. The institution of Dr. Muehlschlegel has received research support from NIH. The institution of an immediate family member of Dr. Muehlschlegel has received research support from NIH. The institution of Dr. Muehlschlegel has received research support from Johns Hopkins Stimulating and Advancing Anesthesiology & Critical Care Medicine Research (StAAR) Award. The institution of Dr. Muehlschlegel has received research support from Trustees of The Patrick and Catherine Weldon Donaghue Medical Research Foundation. The institution of Dr. Muehlschlegel has received research support from Harkin Family Fund (Johns Hopkins Dept. of Neurology). Dr. Muehlschlegel has received personal compensation in the range of $500-$4,999 for serving as a Speaker and Author with 好色先生. Dr. Muehlschlegel has a non-compensated relationship as a Member of Board of Directors with Neurocritical Care Society that is relevant to AAN interests or activities. Dr. Muehlschlegel has a non-compensated relationship as a Officer of the Board of Directors with Neurocritical Care Society that is relevant to AAN interests or activities.