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  • (David M Stoddert and others) they showed in their study conducted by interviews with treating physicians and nurses , on the form of Qualitative study and published in 2003 This study aimed to determine types, sources, and predictors of conflicts among patients with prolonged stay in the ICU.However, efforts to improve the quality of care for critically ill patients that focus on team-family disagreements over life- sustaining treatment miss significant discord in a variety of other areas.[1] (Stoddert, D.M., et al,2003.)
  • (Elie Azoulay and other's) they showed in their study conducted by questionnaire , in the form of One-day cross-sectional survey of ICU clinicians.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 post-mortem care within the last week, symptom control not ensured jointly by physicians and nurses, and no routine unit-level meetings.After comparing the research results, they found that Over 70% of ICU workers reported perceived conflicts, which were often considered severe and were significantly associated with job strain.and published in 2009 This study aimed to record the prevalence, characteristics, and risk factors for conflicts in ICUs and the results showed that Conflicts were perceived by 5,268 (71.6%) respondents.Conflicts perceived as severe were reported by 3,974 (53%) respondents.


Original text


  • (David M Stoddert and others) they showed in their study conducted by interviews with
    treating physicians and nurses , on the form of Qualitative study and published in 2003
    This study aimed to determine types, sources, and predictors of conflicts among patients
    with prolonged stay in the ICU. and the results showed that Clinicians identified 248
    conflicts involving 209 patients; hence, nearly one-third of patients had conflict
    associated with their care: 142 conflicts (57%) were team-family disputes, 76 (31%) were
    intrateam disputes, and 30 (12%) occurred among family members. Disagreements over
    life-sustaining treatment led to 63 team-family conflicts (44%). Other leading sources
    were poor communication (44%), the unavailability of family decision makers (15%),
    and the surrogates' (perceived) inability to make decisions (16%). Nurses detected all
    types of conflict more frequently than physicians, especially intrateam conflicts. The
    presence of a spouse reduced the probability of team-family conflict generally (odds ratio
    0.64) and team-family disputes over life-sustaining treatment specifically (odds ratio
    0.49). After comparing the research results, they found that Conflict is common in the
    care of patients with prolonged stays in the ICU. However, efforts to improve the quality
    of care for critically ill patients that focus on team-family disagreements over life-
    sustaining treatment miss significant discord in a variety of other areas.[1] (Stoddert,
    D.M., et al,2003.)

  • (Elie Azoulay and other's) they showed in their study conducted by questionnaire , in
    the form of 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). and published in 2009 This study aimed to record the prevalence,
    characteristics, and risk factors for conflicts in ICUs and the results showed that Conflicts
    were perceived by 5,268 (71.6%) respondents. Nurse-physician conflicts were the most
    10
    common (32.6%), followed by conflicts among nurses (27.3%) and staff-relative
    conflicts (26.6%). The most common conflict-causing behaviours 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 post-mortem care within the last week, symptom control
    not ensured jointly by physicians and nurses, and no routine unit-level meetings. After
    comparing the research results, they found that 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.[2] (Azoulay, E., et 2009).


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