title: Patient satisfaction with care in the intensive care unit: can we rely on proxies?
abstract: BACKGROUND
  To investigate whether next of kin can be addressed as proxy to assess patients' satisfaction with care in the intensive care unit (ICU).
  
  
  METHODS
  Prospective observational multicentre study. Two hundred and thirty-five patients with an ICU length of stay of ≥2 days and 266 of their adult next of kin participated. Patient satisfaction was assessed by a questionnaire, distributed upon discharge from an ICU and compared with next of kin's answers. The possible range of answers was 0-100, with higher numbers indicating higher satisfaction. The main outcome measure was the extent of agreement between patients' satisfaction with care and the ratings of their next of kin.
  
  
  RESULTS
  Patients were most satisfied concerning physicians' competence (86.7±16.3), while least satisfaction was observed for the management of agitation and restlessness (78.2±23.5). There was no significant difference between next of kin's and patients' ratings. Agreement between patients and proxies was the highest concerning overall satisfaction (Cohen's κ 0.40) and the lowest for coordination of care (0.24). Spouses/partners had a higher agreement with the patients' ratings than other proxies.
  
  
  CONCLUSIONS
  If the patient is unable to rate his satisfaction with care in the ICU, next of kin may be taken as an appropriate surrogate.
  
  
  BACKGROUND
  The study has been registered at ClinicalTrials.gov, Reg No: NTC 00890513.
authors.affiliation: Department of Anaesthesiology and Pain Therapy, Bern University Hospital, University of Bern, Switzerland.
authors.forename: K H
authors.initials: KH
authors.lastname: Stricker
authors.forename: O
authors.initials: O
authors.lastname: Kimberger
authors.forename: L
authors.initials: L
authors.lastname: Brunner
authors.forename: H U
authors.initials: HU
authors.lastname: Rothen
mesh_terms: D000328:Adult; D000368:Aged; D005190:Family; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010361:Patients; D011361:Professional Competence; D011446:Prospective Studies; D019727:Proxy; D011595:Psychomotor Agitation / Q000628:therapy; D011787:Quality of Health Care; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013557:Switzerland