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Journal of patient experience
2024;11 23743735241272148.

Communication in the ICU: An Unintended Nocebo Effect?

Irene Riestra Guiance, Lindsey Wallace, Katalin Varga, Alexander Niven, Megan Hosey, Jillene Chitulangoma, Kemuel Philbrick, Ognjen Gajic, Madeline Weiman, Emily Schmitt, David Pasko, Lioudmila Karnatovskaia
Author Information
  1. Irene Riestra Guiance: Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA.
  2. Lindsey Wallace: Department of Critical Care Multidisciplinary Program, Mayo Clinic, Rochester, MN, USA.
  3. Katalin Varga: Department of Affective Psychology, E��tv��s Lor��nd University, Budapest, Hungary.
  4. Alexander Niven: Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA.
  5. Megan Hosey: Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA. ORCID
  6. Jillene Chitulangoma: Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA.
  7. Kemuel Philbrick: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.
  8. Ognjen Gajic: Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA.
  9. Madeline Weiman: Department of Nursing, Mayo Clinic, Rochester, MN, USA.
  10. Emily Schmitt: Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA.
  11. David Pasko: Department of Respiratory Care, Mayo Clinic, Rochester, MN, USA.
  12. Lioudmila Karnatovskaia: Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA. ORCID
PMID: 39130130 DOI: 10.1177/23743735241272148

Abstract

To identify medical phrases utilized by the critical care team that may have an unintended impact on the critically ill patient, we administered an anonymous survey to multi-professional critical care team members. We elicited examples of imprecise language that may have a negative emotional impact on the critically ill. Of the 1600 providers surveyed, 265 offered 1379 examples (912 unique) which were clustered into 5 categories. Medical jargon (eg, "riding the vent") was most prevalent (n���=���549). There were 217 negative suggestions (eg, "you will feel a stick and a burn"). Hyperboles (eg, "black cloud") were common (n���=���198) while homonyms (ie "he fibbed") accounted for 150 examples. Phrases such as "code brown in there" were categorized as metonyms (n���=���144). 121 metaphors/similes (eg, "rearranging deck chairs on the Titanic") were provided. Phrases that have the potential to negatively impact critically ill patient perceptions are commonplace in critical care practice. Whether these everyday communication habits lead to an unintended nocebo effect on mental health outcomes of the critically ill deserves further study.

Keywords

ICU PTSD communication nocebo effect psychology

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Grants

  1. K23 HL146741/NHLBI NIH HHS
Journal Article
Article has an altmetric score of 21

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