Affect Contagion in the ICU: Does It Impact Patient Care?

This study intends to link affect contagion among clinical staff in a burn ICU to patient outcomes. The study will occur daily for 6 months to understand the patterns of affect within the group. An affect instrument will be administered daily to healthcare providers. This data will be combined, compared, and contrasted with daily staffing assignments leveraged to develop the social networks and computational model. Staff affect will be manipulated through exposure to environmental stimuli (patient death). Affect contagion will be measured on days when death occurs. If affect contagion occurs, similar days without deaths will also be identified. Finally, similar days without affect contagion present will be identified. Patient outcomes for all patients will be evaluated to determine whether outcomes differed between the three days. Affect correlation will be deconstructed to positive and negative affect. Correlations among contagion susceptibility and expressivity traits will be assessed to determine their role in affect contagion and patient outcomes. Text analysis of participant clinical notes will be compared to self-report affect measures to determine if there is a correlation between sentiment expressed notes and affect. Generalizations about characteristics may be derived from the trait affect, state affect, sentiment, contagion susceptibility, and expressivity instruments to describe staff members who are more likely to be working when affect contagion occurs or describe affective states that are common under varying clinical conditions
and the impact on patient care. Parameters for the computational model of the affect contagion will be derived from social network analysis of the unit. This study utilizes military and civilian staff in a clinical setting at the US Army Burn Center. The clinical staff in the BICU care for high acuity patients who have a complex disease process and plan of care. These patients often have comorbidities including polytrauma requiring an acute ability to make decision regarding their care, and a deep understanding of the length and intensity of the healing process of the burn injury. The conditions under which this study will be conducted are standard of practice in military medical treatment facilities and therefore transferable to medical treatment by medically trained military personnel.
Affect contagion has not yet been studied using social network analysis in a clinical military healthcare setting. Most studies of affect focus on dyadic relationships between staff or patient influencing staff members, not vice versa. This study would be the first of its kind to understand affect contagion as a work group phenomena in healthcare.