{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T08:39:40Z","timestamp":1775810380110,"version":"3.50.1"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2009,11,1]],"date-time":"2009-11-01T00:00:00Z","timestamp":1257033600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"European Society of Critical Care Medicine","award":["2007"],"award-info":[{"award-number":["2007"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Many sources of conflict exist in intensive care units (ICUs). Few studies recorded the prevalence, characteristics, and risk factors for conflicts in ICUs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To record the prevalence, characteristics, and risk factors for conflicts in ICUs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>Conflicts were perceived by 5,268 (71.6%) respondents. Nurse\u2013physician conflicts were the most common (32.6%), followed by conflicts among nurses (27.3%) and staff-relative conflicts (26.6%). The most common conflict-causing behaviors 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 postmortem care within the last week, symptom control not ensured jointly by physicians and nurses, and no routine unit-level meetings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.200810-1614oc","type":"journal-article","created":{"date-parts":[[2009,7,30]],"date-time":"2009-07-30T22:00:38Z","timestamp":1248991238000},"page":"853-860","source":"Crossref","is-referenced-by-count":456,"title":["Prevalence and Factors of Intensive Care Unit Conflicts: The Conflicus Study"],"prefix":"10.1093","volume":"180","author":[{"given":"E\u0301lie","family":"Azoulay","sequence":"first","affiliation":[{"name":"AP-HP, H\u00f4pital Saint-Louis, Medical ICU, University Paris-7 Paris-Diderot, UFR de M\u00e9decine, Paris, France"}]},{"given":"Jean-Franc\u0327ois","family":"Timsit","sequence":"additional","affiliation":[{"name":"INSERM U823, Hopital Michallon, CHU de Grenoble, Grenoble, France"}]},{"given":"Charles L.","family":"Sprung","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, Jerusalem, Israel"}]},{"given":"Marcio","family":"Soares","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Instituto Nacional de C\u00e2ncer, Rio de Janeiro, Brazil"}]},{"given":"Kate\u0159ina","family":"Rusinov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Medical ICU, Prague University Hospital, Prague, Czech Republic"}]},{"given":"Ariane","family":"Lafabrie","sequence":"additional","affiliation":[{"name":"AP-HP, H\u00f4pital Saint-Louis, Medical ICU, University Paris-7 Paris-Diderot, UFR de M\u00e9decine, Paris, France"}]},{"given":"Ricardo","family":"Abizanda","sequence":"additional","affiliation":[{"name":"Servei de Medicina Intensiva, Hospital Universitario Asociado General de Castell\u00f3n, Castell\u00f3n, Spain"}]},{"given":"Mia","family":"Svantesson","sequence":"additional","affiliation":[{"name":"Centre for Health Care Sciences, Orebro University Hospital, Orebro, Sweden"}]},{"given":"Francesca","family":"Rubulotta","sequence":"additional","affiliation":[{"name":"Policlinico University Hospital Catania, Italy"}]},{"given":"Bara","family":"Ricou","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Geneva University Hospitals and University of Geneva, Geneva, Switzerland"}]},{"given":"Dominique","family":"Benoit","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Ghent University Hospital, De Pintelaan Ghent, Belgium"}]},{"given":"Daren","family":"Heyland","sequence":"additional","affiliation":[{"name":"Department of Medicine, Queen\u2019s University, Kingston, Ontario, Canada"}]},{"given":"Gavin","family":"Joynt","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong"}]},{"given":"Adrien","family":"Franc\u0327ais","sequence":"additional","affiliation":[{"name":"INSERM U823, Hopital Michallon, CHU de Grenoble, Grenoble, France"}]},{"given":"Paulo","family":"Azeivedo-Maia","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Hospital de S. 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