Measures to evaluate clinician communication in the intensive care unit: A systematic review of measurement properties

• Published in: Patient education and counseling Vol. 140; p. 109266
• Main Authors: Morton, Claire R., Raymond-King, Lauren, Brackett, Alexandria, Cooper, Zara R., Liu, Jason B.
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.11.2025
• Subjects: Communication; Critical Care; Humans; Intensive care; Intensive Care Units; Outcome measures; Patient Reported Outcome Measures; Patient Satisfaction; Patient-Centered Care; Physician-Patient Relations; Surveys and Questionnaires; Outcome measures; Intensive care; Communication
• ISSN: 0738-3991; 1873-5134; 1873-5134
• DOI: 10.1016/j.pec.2025.109266

Patients in the intensive care unit (ICU) face barriers to effective communication. Measures to evaluate communication quality remain limited. Patient and proxy reported outcome measures (PROMs and PrROMs) are increasingly being used to evaluate care in a patient-centered manner. We sought to identify validated PROMs and PrROMs for clinician communication quality in the ICU. A systematic literature search was performed according to COSMIN guidelines. The search strategy included text words and subject headings related to communication (construct), ICU patients (population), and questionnaires or surveys (instrument). Studies were included if they focused on the development or measurement properties of a PROM or PrROM for clinician communication in the ICU, included adult patients or proxies, and were published in English after 2000. The results were imported to Covidence, a literature review citation screening tool and manager. 10258 studies were identified. After removal of duplicates, 6210 titles and abstracts were screened for inclusion. 29 full texts were assessed. Six manuscripts assessing three measures, the Family Satisfaction in the ICU (FS-ICU), Critical Care Family Satisfaction Survey (CCFSS), and the Family Inpatient Communication Survey (FICS), met criteria for inclusion. The only measure to have undergone an adequate design process, per COSMIN criteria, was the FICS. The FS-ICU and CCFSS demonstrated sufficient content validity. The FS-ICU demonstrated indeterminate content validity, insufficient structural validity, and sufficient construct validity. The FICS demonstrated sufficient structural validity, internal consistency, and construct validity. Other measurement properties were not reported. None of the identified measures met criteria for recommendation based on the COSMIN framework. Furthermore, none of the measures exclusively or comprehensively assessed communication quality. Proxy measures evaluating the quality of clinician communication in the ICU are limited. New measures or significant revision of current measures is necessary alongside developing multidimensional protocols for assessment. •Evaluating the quality of communication in the intensive care unit is essential.•Current outcome measures fail to fully describe the quality of communication.•Further qualitative work is necessary to validate appropriate measures.