ATTITUDES OF PHYSICIANS TOWARDS COMMUNICATION WITH PATIENTS AND THEIR RELATIVES IN THE INTENSIVE CARE UNIT: A CROSS-SECTIONAL STUDY FROM A TERTIARY CARE HOSPITAL IN KARACHI, PAKISTAN
Main Article Content
Keywords
communication, intensive care unit, physician attitudes, patient relatives, empathy, trust, Pakistan
Abstract
Background: Effective communication between physicians and the relatives of critically ill patients is central to shared decision-making, family satisfaction and psychological outcomes in the intensive care unit (ICU). Physicians’ communication attitudes have not been studied in Pakistan.
Objective: To assess the attitudes of physicians towards communication with patients and their relatives in the ICU, and to examine whether these attitudes differ by gender, designation, age, experience, specialty and year of training.
Methods: This cross-sectional study was conducted in the Department of Anaesthesiology, The Indus Hospital, Karachi, from 27 May to 24 November 2019. Using non-probability consecutive sampling, we enrolled 238 consultants and residents from critical care and primary teams who communicated with ICU patients or relatives at least once a day. Participants completed a 24-item, 5-point Likert communication attitude scale adapted from Cicekci et al. The scale has three subscales: informing (8 items), empathy (10 items) and trust (6 items). A total or subscale score at or above the scale midpoint was classified as a positive attitude. Groups were compared with the independent t-test, ANOVA and the χ² or Fisher’s exact test.
Results: The median age of participants was 29 years (interquartile range [IQR] 28–40); 132 (55.5%) were men and 173 (72.7%) were residents. The mean total communication attitude score was 92.34 ± 9.98 out of a possible 120. Subscale scores were 30.11 ± 3.31 for informing (out of 40), 39.01 ± 4.79 for empathy (out of 50) and 23.21 ± 3.80 for trust (out of 30). Overall, 233 of 238 physicians (97.9%) had a positive communication attitude. By subscale, 99.2% had a positive attitude in informing, 97.1% in empathy and 94.5% in trust. Total scores did not differ by gender, designation, specialty or year of training. Consultants scored higher than residents on empathy (39.98 ± 4.22 vs 38.65 ± 4.95; p = 0.041). A positive trust attitude was more common among physicians older than 30 years than among those aged 30 or younger (98.8% vs 92.3%; p = 0.034).
Conclusion: Physicians in this ICU reported positive attitudes towards communicating with patients and their relatives. Trust was the weakest dimension, and younger physicians and residents scored slightly lower on trust and empathy. Structured communication-skills training, particularly for junior physicians, and studies that include the perspective of patients’ relatives are recommended.
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