It is therefore important to identify effective ways to manage team-family conflicts in the NICU, PICU, and ICU. Likewise, unresolved conflicts have been shown to contribute to feelings of anxiety and moral distress, as well as the risk of burnout in healthcare providers. If conflicts remain unresolved, they may incite feelings of regret, distress and distrust in families and reduce families’ satisfaction with the provided care. Team-family conflicts mainly concern the following topics: disagreement about the treatment, discordant ideas on what is best for the patient, poor communication, inappropriate doctor or family behavior, and the unavailability of legal surrogate decision-makers. However, these percentages may well be an underestimation, as healthcare professionals seem less likely to identify conflicts in comparison to families of critically ill patients. By contrast, conflicts have been reported in 12% of patients in neonatal intensive care units (NICU). Healthcare professionals reported conflicts in up to 48% and 31% of patients, respectively in adult intensive care units (ICU) and pediatric intensive care units (PICU). The incidence of team-family conflicts seems to differ per IC setting. The lack of a longer lasting relationship between doctors and families and the constant stress families have to endure further increase the risk that conflicts will arise. Team-family conflicts seem to be reinforced by factors that are inextricably linked with the IC setting: the life-threatening situation of patients, the ensuing emotions of families, and the difficult decisions regarding (dis)continuation of LST. Accordingly, conflict mediation has been identified as an essential competency needed by IC-doctors to provide high-quality care to patients and their families. Conflicts, such as disagreements, disputes or differences of opinion between doctors and families commonly occur in this setting. Consequently, patients’ families function as their surrogate decision-makers. In intensive care (IC), patients are often unable to participate in decisions regarding their life-sustaining treatment (LST).
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