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Caring for critically ill patients often includes discussions with patients' surrogates about prognosis and goals of care. Although expert guidelines exist on how best to communicate prognosis, few studies have been conducted to evaluate best practices. Two recent papers (with some shared authors) shed light on this process. Patients in these studies were adults with acute respiratory distress syndrome at five U.S. medical centers.
In one study, investigators qualitatively analyzed semi-structured interviews to delineate characteristics of effective communication of prognoses. Participants included surrogates (47), physicians (17), nurses (14), social workers (7), chaplains (7), and communication experts (26). Many themes that emerged were c…