Family satisfaction in the intensive care unit: what makes the difference?
OBJECTIVE
To assess family satisfaction in the ICU and to identify parameters for improvement.


METHODS
Multicenter study in Swiss ICUs. Families were given a questionnaire covering overall satisfaction, satisfaction with care and satisfaction with information/decision-making. Demographic, medical and institutional data were gathered from patients, visitors and ICUs.


RESULTS
A total of 996 questionnaires from family members were analyzed. Individual questions were assessed, and summary measures (range 0-100) were calculated, with higher scores indicating greater satisfaction. Summary score was 78 +/- 14 (mean +/- SD) for overall satisfaction, 79 +/- 14 for care and 77 +/- 15 for information/decision-making. In multivariable multilevel linear regression analyses, higher severity of illness was associated with higher satisfaction, while a higher patient:nurse ratio and written admission/discharge criteria were associated with lower overall satisfaction. Using performance-importance plots, items with high impact on overall satisfaction but low satisfaction were identified. They included: emotional support, providing understandable, complete, consistent information and coordination of care.


CONCLUSIONS
Overall, proxies were satisfied with care and with information/decision-making. Still, several factors, such as emotional support, coordination of care and communication, are associated with poor satisfaction, suggesting the need for improvement.


BACKGROUND
The online version of this article (doi:10.1007/s00134-009-1611-4) contains supplementary material, which is available to authorized users.
Stricker
Kay H
KH
Department of Intensive Care Medicine, Bern University Hospital (Inselspital) and University of Bern, 3010 Bern, Switzerland. kay.stricker@insel.ch
Kimberger
Oliver
O
Schmidlin
Kurt
K
Zwahlen
Marcel
M
Mohr
Ulrike
U
Rothen
Hans U
HU
D000368:Aged; D003142:Communication; D003657:Decision Making; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D005791:Patient Care / Q000592:standards*; D017060:Patient Satisfaction; D011368:Professional-Family Relations; D012944:Social Support; D011795:Surveys and Questionnaires