title: Assessment of satisfaction with care among family members of survivors in a neuroscience intensive care unit.
abstract: Many prior nursing studies regarding family members specifically of neuroscience intensive care unit (neuro-ICU) patients have focused on identifying their primary needs. A concept related to identifying these needs and assessing whether they have been met is determining whether families explicitly report satisfaction with the care that both they and their loved ones have received. The objective of this study was to explore family satisfaction with care in an academic neuro-ICU and compare results with concurrent data from the same hospital's medical ICU (MICU). Over 38 days, we administered the Family Satisfaction-ICU instrument to neuro-ICU and MICU patients' families at the time of ICU discharge. Those whose loved ones passed away during ICU admission were excluded. When asked about the respect and compassion that they received from staff, 76.3% (95% CI [66.5, 86.1]) of neuro-ICU families were completely satisfied, as opposed to 92.7% in the MICU (95% CI [84.4, 101.0], p = .04). Respondents were less likely to be completely satisfied with the courtesy of staff if they reported participation in zero formal family meeting. Less than 60% of neuro-ICU families were completely satisfied by (1) frequency of physician communication, (2) inclusion and (3) support during decision making, and (4) control over the care of their loved ones. Parents of patients were more likely than other relatives to feel very included and supported in the decision-making process. Future studies may focus on evaluating strategies for neuro-ICU nurses and physicians to provide better decision-making support and to implement more frequent family meetings even for those patients who may not seem medically or socially complicated to the team. Determining satisfaction with care for those families whose loved ones passed away during their neuro-ICU admission is another potential avenue for future investigation.
authors.affiliation: Questions or comments about this article may be directed to David Y. Hwang, MD, at david.hwang@yale.edu. He is an Assistant Professor of Neurology at the Department of Neurology, Yale University School of Medicine, and Neuroscience Intensive Care Unit, Yale-New Haven Hospital, New Haven, CT. Daniel Yagoda, MPH, is a Senior Manager at the Critical Care Center, Massachusetts General Hospital (MGH), Boston, MA. Hilary M. Perrey is an Intern at the Critical Care Center, MGH, Boston, MA. Tara M. Tehan, MSN MBA RN NE-BC, is the Nurse Director at the Neurosciences Intensive Care Unit, MGH, Boston, MA. Mary Guanci, MSN RN CNRN, is a Clinical Nurse Specialist at the Neurosciences Intensive Care Unit, MGH, Boston, MA. Lillian Ananian, BSN MSN, is a Clinical Nurse Specialist at the Medical Intensive Care Unit, MGH, Boston, MA. Paul F. Currier, MD MPH, is an Assistant Professor, Harvard Medical School; and the Director of Quality at the Division of Pulmonology and Critical Care, Director at the Respiratory Acute Care Unit, and Associate Program Director at the Department of Medicine, MGH, Boston, MA. J. Perren Cobb, MD, is an Associate Professor, Harvard Medical School, and the Director at the Critical Care Center, MGH, Boston, MA. Jonathan Rosand, MD MSc, is the Chief at the Division of Neurocritical Care and Emergency Neurology and the Medical Director at the Neurosciences Intensive Care Unit, MGH, and a Professor of Neurology, Harvard Medical School, Boston, MA. Institution at which work was performed: Massachusetts General Hospital, Boston, MA.
authors.forename: David Y
authors.initials: DY
authors.lastname: Hwang
authors.forename: Daniel
authors.initials: D
authors.lastname: Yagoda
authors.forename: Hilary M
authors.initials: HM
authors.lastname: Perrey
authors.forename: Tara M
authors.initials: TM
authors.lastname: Tehan
authors.forename: Mary
authors.initials: M
authors.lastname: Guanci
authors.forename: Lillian
authors.initials: L
authors.lastname: Ananian
authors.forename: Paul F
authors.initials: PF
authors.lastname: Currier
authors.forename: J Perren
authors.initials: JP
authors.lastname: Cobb
authors.forename: Jonathan
authors.initials: J
authors.lastname: Rosand
mesh_terms: D000368:Aged; D001930:Brain Injuries / Q000451:nursing* / Q000523:psychology; D064648:Critical Care Nursing; D016638:Critical Illness / Q000451:nursing / Q000523:psychology; D003625:Data Collection / Q000592:standards; D003657:Decision Making; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D011368:Professional-Family Relations; D011787:Quality of Health Care; D017741:Survivors / Q000523:psychology