title: Measuring family satisfaction with care and quality of dying in the intensive care unit: does patient age matter?
abstract: BACKGROUND
  Few studies have examined the role of patient age on family experiences of end-of-life care.
  
  
  OBJECTIVE
  To assess measurement characteristics of two family-assessed questionnaires across three patient age groups.
  
  
  METHODS
  Four hundred and ninety-six patients who died in an intensive care unit (ICU) at a single hospital were identified and one family member per patient was sent two questionnaires: 1) Family Satisfaction in the ICU (FS-ICU); and 2) Quality of Dying and Death (QODD). Two hundred and seventy-five surveys were returned (55.4%). We analyzed three age groups: <35, 35-64, and ≥65 years. Differences were evaluated using χ(2) tests to evaluate ceiling, floor, and missing responses; Kruskal-Wallis tests to compare median scores on items and total scores; and linear regression controlling for patient sex, race, diagnosis, and family-member sex, race, education, and relationship to provide adjusted comparisons of total and subscale scores.
  
  
  RESULTS
  Measurement characteristics varied by age groups for both questionnaires. Missing values and floor endorsements were more common for the younger age groups for six items and one overall rating score. Ceiling endorsements were more common for the older group for 11 items. Fifteen items and four total scores were significantly higher in the older group.
  
  
  CONCLUSIONS
  The FS-ICU and QODD questionnaires performed differently across patient age groups. Assessments of family satisfaction and quality of dying and death were higher in the oldest group, particularly in the area of clinician-family communication. Studies of the dying experience of older adults may not generalize to patients of other ages, and study instruments should be validated among different age groups.
authors: Seattle Children's Hospital and Regional Medical Center, Division of Pediatric Critical Care Medicine, University of Washington, Seattle, Washington, USA. mithya.lewis-newby@seattlechildrens.org
authors: Mithya
authors: M
authors: Lewis-Newby
authors: J Randall
authors: JR
authors: Curtis
authors: Diane P
authors: DP
authors: Martin
authors: Ruth A
authors: RA
authors: Engelberg
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001293:Attitude to Death; D002423:Cause of Death; D016009:Chi-Square Distribution; D003258:Consumer Behavior; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000592:standards / Q000706:statistics & numerical data; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011368:Professional-Family Relations; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000592:standards*