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Sharieff S, Sajjal A, Idrees A, Rafai W. Patient and Family Satisfaction in the Intensive Care Unit of a Quaternary Care Center. Cureus 2023; 15:e45795. [PMID: 37872908 PMCID: PMC10590672 DOI: 10.7759/cureus.45795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2023] [Indexed: 10/25/2023] Open
Abstract
Patient and family satisfaction is an indicator of quality assessment of care provided in the intensive care unit (ICU) ensuring that the quality of services provided meets not only the patients' but also their families' needs. Investigating how different variables affect their satisfaction ratings is important. We assessed patient and family satisfaction in a quaternary care center in Pakistan. METHODS The study was a cross-sectional survey of adult patients and families treated between December 1, 2022 and April 30, 2023 in the ICU at Pakistan Kidney and Liver Institute and Research Center (PKLI-RC), Lahore, Pakistan. We used family satisfaction in ICU 24 (FS-ICU 24) to measure satisfaction in a number of domains on a scale of 1-5 (1 = Very Dissatisfied, 5 = Fully Satisfied). RESULTS Of the 330 patients admitted to ICU during the study period, all patients and/or one of their family members (100%) participated in the study. Out of these, 209 (63%) were male. The mean age was 42 ± 15 years, and the overall mean patient and family satisfaction scores were 4.69 ± 0.69 and 4.55 ± 0.52, respectively. The mean score in all domains was > 4, with the exception of pain management in which it was 3.98 ± 0.53. CONCLUSION Patients and their families' satisfaction is an important measure of ICU quality. Not only the patients and their families were satisfied with our ICU quality of care but they also appreciated involvement in the decision-making process and quality assessment. There is a need for further research for improvement in the pain domain.
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Affiliation(s)
- Saleem Sharieff
- Intensive Care Unit, Pakistan Kidney and Liver Institute and Research Center, Lahore, PAK
- Intensive Care Unit, Grand River Hospital, Kitchener, CAN
| | - Ayesha Sajjal
- Intensive Care Unit, Pakistan Kidney and Liver Institute and Research Center, Lahore, PAK
| | - Asim Idrees
- Critical Care Medicine, Pakistan Kidney and Liver Institute and Research Center, Lahore, PAK
| | - Wajid Rafai
- Critical Care Medicine, Pakistan Kidney and Liver Institute and Research Center, Lahore, PAK
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Padilla-Fortunatti C, Rojas-Silva N, Molina-Muñoz Y, Avendaño-Jara S. Cultural adaptation and psychometric properties of the Chilean-Spanish version of the Family Satisfaction in the Intensive Care Unit - 24 questionnaire. Med Intensiva 2023; 47:140-148. [PMID: 36068147 DOI: 10.1016/j.medine.2022.07.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/31/2022] [Accepted: 02/03/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To adapt and validate the Spanish version of the Family Satisfaction in the Intensive Care Unit - 24 (FS ICU-24) questionnaire among relatives of critically ill patients in a teaching hospital in Chile. DESIGN Prospective observational study aimed to validate a measuring instrument. SETTING Medical-surgical intensive care unit (ICU) of a teaching hospital in Chile. PATIENTS OR PARTICIPANTS Two hundred and forty relatives of critically ill patients with at least48 h in the ICU, older than 18 years, and with at least one visit to the patient. INTERVENTIONS None. MAIN VARIABLES OF INTEREST Content validity, construct validity, and reliability analysis of the Spanish version of the FS ICU-24 were evaluated. RESULTS The Spanish version of the FS ICU-24 was adapted, improving its understanding and clarity. The factor analysis showed an optimal solution of 3 factors for the Chilean-Spanish version of the FS ICU-24, which explain 51% of the total variance. Reliability was adequate for the global scale (α = 0.93) and the dimensions of satisfaction with patient and family care (α = 0.82), satisfaction with communication (α = 0.91) and satisfaction with decision-making (α = 0.71). CONCLUSIONS The Chilean-Spanish version of the FS ICU-24 proved to be valid and reliable for the evaluation of family satisfaction in the ICU. Having a valid instrument will allow health institutions to accurately identify areas for improvement in the care of the family members and the critically ill patient.
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Affiliation(s)
| | - Noelia Rojas-Silva
- Escuela de Enfermería, Pontificia Universidad Católica de Chile, Macul, Santiago, Chile
| | - Yerko Molina-Muñoz
- Escuela de Psicología, Universidad Adolfo Ibáñez, Peñalolén, Santiago, Chile
| | - Stefany Avendaño-Jara
- Escuela de Enfermería, Pontificia Universidad Católica de Chile, Macul, Santiago, Chile
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Padilla-Fortunatti C, Rojas-Silva N, Molina-Munoz Y, Avendano-Jara S. Adaptación cultural y propiedades psicométricas de la versión en español-chileno del cuestionario Family Satisfaction in the Intensive Care Unit – 24. Med Intensiva 2022. [DOI: 10.1016/j.medin.2022.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Avcı M, Ayaz-Alkaya S. Anxiety, social support and satisfaction of patients' families in intensive care units: A descriptive-correlational study. J Clin Nurs 2021; 31:2765-2773. [PMID: 34693581 DOI: 10.1111/jocn.16094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 08/20/2021] [Accepted: 10/12/2021] [Indexed: 11/29/2022]
Abstract
AIMS & OBJECTIVES This study was conducted with family members of patients' in the intensive care unit (ICU) to identify their anxiety level, social support and satisfaction with the ICU. BACKGROUND Admission of critical patients to the ICU usually involves the participation of family members. DESIGN A descriptive-correlational design was used and reported according to the STROBE checklist. METHODS The sample consisted of 250 family members in ICUs in a city of Turkey. Data were collected by the Multidimensional Perceived Social Support Scale, the State-Trait Anxiety Inventory and the Family Satisfaction in the Intensive Care Unit scale. RESULTS A negative correlation was found between family satisfaction of the ICU and state anxiety (r = -0.349, p < 0.001), and a negative relationship between the satisfaction of the ICU and trait anxiety of the participants (r = -0.151, p < 0.05). There was a significant relationship between the state anxiety level (Adjusted R² = 0.080, F = 8.247, p < 0.001), trait anxiety level (Adjusted R² = 0.185, F = 19.821, p < 0.001), the perceived social support (Adjusted R² = 0.094, F = 9.640, p < 0.001) and satisfaction (Adjusted R² = 0.013, F = 4.161, p < 0.001) of family members and their sociodemographic characteristics. CONCLUSIONS The study concluded that anxiety levels of relatives of the families were high, their social support and satisfaction with the intensive care unit were at a moderate level. There was a correlation between anxiety levels, satisfaction with the intensive care unit, and the perceived social support of families. RELEVANCE TO CLINICAL PRACTICE Holistic care for the psychosocial needs of families who have a member in the ICU should be planned to increase satisfaction. Nurses should observe families closely for anxiety, allow them to ask questions and include them in the care of their family member.
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Affiliation(s)
- Miyase Avcı
- Nursing Department, Aksaray University Faculty of Health Sciences, Aksaray, Turkey
| | - Sultan Ayaz-Alkaya
- Nursing Department, Gazi University Faculty of Health Sciences, Ankara, Turkey
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Tajarernmuang P, Chittawatanarat K, Dodek P, Heyland DK, Chanayat P, Inchai J, Pothirat C, Liwsrisakun C, Bumroongkit C, Deesomchok A, Theerakittikul T, Limsukon A. Validity and Reliability of a Thai Version of Family Satisfaction with Care in the Intensive Care Unit Survey. Indian J Crit Care Med 2020; 24:946-954. [PMID: 33281320 PMCID: PMC7689133 DOI: 10.5005/jp-journals-10071-23559] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose To examine reliability and validity of a Thai version of the Family Satisfaction with Intensive Care Unit (FS-ICU 24) questionnaire and use this survey in intensive care units (ICUs) in Thailand. Materials and methods The standard English FS-ICU questionnaire was translated into the Thai language using translation and culture adaptation guidelines. After reliability and validity testing, we consecutively surveyed the satisfaction of family members of ICU patients over 1 year. Adult family members of patients admitted to medical or surgical ICUs for 48 hours or more who had visited the patients at least once during the ICU stay were included. Results In all, 315 (95%) of 332 surveys were returned from family members. Cronbach's α of the Thai FS-ICU 24 questionnaire was 0.95. Factor analysis demonstrated good construct validity. The mean (±SD) of total satisfaction score, overall ICU care subscale, and decision-making subscale were 81.5 ± 14.3, 81.0 ± 15.6, and 82.0 ± 14.0. Items with the lowest scores were the waiting room atmosphere and the frequency of doctors communicating with family members about the patient's condition. The mean total satisfaction score tended to be higher in family members of survivors than in family members of nonsurvivors (81.9 ± 13.8 vs 77.7 ± 16.2, p value = 0.059). The overall satisfaction scores between medial ICU and surgical ICU were not significantly different. Conclusion The Thai version of FS-ICU questionnaire was found to have acceptable reliability and validity in a Thai population and can be used to drive improvements in ICU care. Trial registration www.clinicaltrials.in.th, TCR20160603002 How to cite this article Tajarernmuang P, Chittawatanarat K, Dodek P, Heyland DK, Chanayat P, Inchai J, et al. Validity and Reliability of a Thai Version of Family Satisfaction with Care in the Intensive Care Unit Survey. Indian J Crit Care Med 2020;24(10):946–954.
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Affiliation(s)
| | | | - Peter Dodek
- Center for Health Evaluation and Outcome Sciences, St Paul's Hospital, University of British Columbia, Vancouver, BC, Canada; Division of Critical Care Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Daren K Heyland
- Clinical Evaluation Research Unit, Queen's University; Department of Critical Care Medicine, Queen's University, Kingston, Ontario, Canada
| | - Panida Chanayat
- Department of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Juthamas Inchai
- Department of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | | | | | | | | | - Atikun Limsukon
- Department of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Ferrando P, Gould DW, Walmsley E, Richards-Belle A, Canter R, Saunders S, Harrison DA, Harvey S, Heyland DK, Hinton L, McColl E, Richardson A, Richardson M, Wright SE, Rowan KM. Family satisfaction with critical care in the UK: a multicentre cohort study. BMJ Open 2019; 9:e028956. [PMID: 31434771 PMCID: PMC6707657 DOI: 10.1136/bmjopen-2019-028956] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE To assess family satisfaction with intensive care units (ICUs) in the UK using the Family Satisfaction in the Intensive Care Unit 24-item (FS-ICU-24) questionnaire, and to investigate how characteristics of patients and their family members impact on family satisfaction. DESIGN Prospective cohort study nested within a national clinical audit database. SETTING Stratified, random sample of 20 adult general ICUs participating in the Intensive Care National Audit & Research Centre Case Mix Programme. PARTICIPANTS Family members of patients staying at least 24 hours in ICU were recruited between May 2013 and June 2014. INTERVENTIONS Consenting family members were sent a postal questionnaire 3 weeks after the patient died or was discharged from ICU. Up to four family members were recruited per patient. MAIN OUTCOME MEASURES Family satisfaction was measured using the FS-ICU-24 questionnaire. MAIN RESULTS A total of 12 346 family members of 6380 patients were recruited and 7173 (58%) family members of 4615 patients returned a completed questionnaire. Overall and domain-specific family satisfaction scores were high (mean overall family satisfaction 80, satisfaction with care 83, satisfaction with information 76 and satisfaction with decision-making 73 out of 100) but varied significantly across adult general ICUs studied and by whether the patient survived ICU. For family members of ICU survivors, characteristics of both the family member (age, ethnicity, relationship to patient (next-of-kin and/or lived with patient) and visit frequency) and the patient (acute severity of illness and receipt of invasive mechanical ventilation) were significant determinants of family satisfaction, whereas, for family members of ICU non-survivors, only patient characteristics (age, acute severity of illness and duration of stay) were significant. CONCLUSIONS Overall family satisfaction in UK adult general ICUs was high but varied significantly. Adjustment for differences in family member/patient characteristics is important to avoid falsely identifying ICUs as statistical outliers. TRIAL REGISTRATION NUMBER ISRCTN47363549.
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Affiliation(s)
- Paloma Ferrando
- Intensive Care National Audit and Research Centre, London, UK
| | - Doug W Gould
- Intensive Care National Audit and Research Centre, London, UK
| | - Emma Walmsley
- Intensive Care National Audit and Research Centre, London, UK
| | | | - Ruth Canter
- Intensive Care National Audit and Research Centre, London, UK
| | - Steven Saunders
- Intensive Care National Audit and Research Centre, London, UK
| | | | - Sheila Harvey
- Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Daren K Heyland
- Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, Ontario, Canada
- Department of Critical Care Medicine, Queens University, Kingston, Ontario, Canada
| | - Lisa Hinton
- Health Experiences Research Group, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Elaine McColl
- Institute for Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Annette Richardson
- Perioperative and Critical Care, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | | | - Stephen E Wright
- Perioperative and Critical Care, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Kathryn M Rowan
- Intensive Care National Audit and Research Centre, London, UK
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Lai VKW, Li JCH, Lee A. Psychometric validation of the Chinese patient- and family satisfaction in the intensive care unit questionnaires. J Crit Care 2019; 54:58-64. [PMID: 31352270 DOI: 10.1016/j.jcrc.2019.07.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 07/02/2019] [Accepted: 07/09/2019] [Indexed: 11/27/2022]
Abstract
PURPOSE To assess the psychometric properties of the Chinese version of the 23-item Patient Satisfaction in the Intensive Care Unit (PS-ICU-23) and 24-item Family Satisfaction in the Intensive Care Unit (FS-ICU-24) questionnaires. MATERIALS AND METHODS Patients (n = 243) discharged from an intensive care unit (ICU) in Hong Kong and family members (n = 237) completed the translated questionnaires. We used confirmatory factor analysis to assess the construct validity and measurement equivalence across groups (gender, mechanical ventilation, casemix, length of stay in ICU), coefficient alpha for internal consistency (reliability) and concordance correlation coefficient (ρc) for agreement between patients' and family members' perspective on satisfaction. RESULTS A three-factor model provided a better fit than the two-factor model for both PS-ICU-23 and FS-ICU-24 questionnaires. Factorial equivalence was present across groups in both questionnaires. Internal consistency was adequate for PS-ICU-23 (coefficient alpha overall domain 0.85; care subscale, 0.83; information subscale, 0.90; decision-making process subscale, 0.67) and for FS-ICU-24 (coefficient alpha overall scale 0.86; care subscale, 0.84; information subscale, 0.89; decision-making process subscale, 0.65). Overall ICU satisfaction agreement was moderate (0.40). CONCLUSIONS Both Chinese PS-ICU-23 and FS-ICU-24 questionnaires have sound psychometric properties but family satisfaction may not be a good proxy for patient satisfaction in ICU.
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Affiliation(s)
- Veronica Ka Wai Lai
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Shatin, Hong Kong.
| | | | - Anna Lee
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Shatin, Hong Kong.
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Dale B, Frivold G. Psychometric testing of the Norwegian version of the questionnaire Family Satisfaction in the Intensive Care Unit (FS-ICU-24). J Multidiscip Healthc 2018; 11:653-659. [PMID: 30510429 PMCID: PMC6231505 DOI: 10.2147/jmdh.s184003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION The questionnaire, Family Satisfaction in the Intensive Care Unit (FS-ICU-24), was developed to assess relatives' satisfaction with care and involvement in decision-making processes when a close family member stays in the ICU. AIM This study was aimed at describing the translation and exploring the psychometric properties of the Norwegian version of the questionnaire. METHODS The study design was a cross-sectional survey. After translating the questionnaire according to recommended procedures, 123 close relatives of patients, recently treated in ICU, responded to a mailed questionnaire including the FS-ICU-24-No. Item-to-total correlations and Cronbach's alpha coefficient were assessed for estimating reliability and construct validity was assessed by the "known groups" technique and explorative factor analysis. RESULTS The Cronbach's alpha coefficient of 0.96 and significant item-to-total correlations supported the homogeneity of the instrument. The construct validity was reflected in significant differences in median scores on the total scale and subscales between the group reporting lower degrees of satisfaction and the group reporting higher degrees of satisfaction. Two fixed factors with an eigenvalue >1, and an explained variance of 62.5%, emerged from the factor analysis. CONCLUSION The FS-ICU-24-No showed promising psychometric properties regarding reliability in this study group, which may indicate that the instrument is suitable for assessing family members' satisfaction with care and decision making in Norwegian ICU.
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Affiliation(s)
- Bjørg Dale
- Centre for Caring Research, Southern Norway, University of Agder, Faculty of Health and Sport Sciences, Grimstad, Norway,
| | - Gro Frivold
- University of Agder, Faculty of Health and Sport Sciences, Grimstad, Norway
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Neves JDL, Schwartz E, Guanilo MEE, Amestoy SC, Mendieta MDC, Lise F. AVALIAÇÃO DA SATISFAÇÃO DE FAMILIARES DE PACIENTES ATENDIDOS EM UNIDADES DE TERAPIA INTENSIVA: REVISÃO INTEGRATIVA. ACTA ACUST UNITED AC 2018. [DOI: 10.1590/0104-070720180001800016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
RESUMO Objetivo: analisar a produção científica relacionada às evidências acerca da satisfação de familiares de pacientes de UTI e os instrumentos utilizados para sua avaliação. Metodo: revisão integrativa na qual foram analisados artigos publicados entre 2005 e 2015, em inglês, português ou espanhol, nas bases de dados PUBMED/MEDLINE e LILACS e a biblioteca SciELO. Utilizou-se como estratégia de busca: personal satisfactional OR satisfaction AND family. Para coleta de dados dos artigos elaborou-se um instrumento com informações como: título, autores, ano de publicação e revista, objetivo do estudo, delineamento, participantes, local da pesquisa, temática principal e resultados. Resultados: atenderam aos critérios de inclusão 27 produções. Foram identificados quatro instrumentos utilizados para avaliar a satisfação de familiares de pacientes na UTI o Critical Care Family Satisfaction Survey, Family Satisfaction in the Intensive Care Unit, Critical Care Family Needs Inventory e o Quality of Dying and Death. Os estudos abordaram a satisfação dos familiares em relação às suas necessidades e tomadas de decisão, satisfação quanto a cuidados paliativos, evidenciou-se, ainda, estudos de adaptação transcultural e validação de instrumentos. Quanto ao nível de evidência, os estudos se concentram nos níveis II a VI. Conclusão: a análise da produção científica sobre a satisfação de familiares de pacientes de UTI permitiu evidenciar que o fator que mais contribui na promoção da satisfação da família foi a qualidade do atendimento.
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Kim Y, Min J, Lim G, Lee JK, Lee H, Lee J, Kim KS, Park JS, Cho YJ, Jo YH, Rhu H, Kim KS, Lee SM, Lee YJ. Transcultural Adaptation and Validation of the Family Satisfaction in the Intensive Care Unit Questionnaire in a Korean Sample. Korean J Crit Care Med 2017; 32:60-69. [PMID: 31723617 PMCID: PMC6786738 DOI: 10.4266/kjccm.2016.00962] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 02/14/2017] [Accepted: 02/14/2017] [Indexed: 11/30/2022] Open
Abstract
Background A number of questionnaires designed for analyzing family members’ inconvenience and demands in intensive care unit (ICU) care have been developed and validated in North America. The family satisfaction in the intensive care Unit-24 (FS-ICU-24) questionnaire is one of the most widely used of these instruments. This study aimed to translate the FS-ICU-24 questionnaire into Korean and validate the Korean version of the questionnaire. Methods The study was conducted in the medical, surgical, and emergency ICUs at three tertiary hospitals. Relatives of all patients hospitalized for at least 48 hours were enrolled for this study participants. The validation process included the measurement of construct validity, internal consistency, and interrater reliability. The questionnaire consists of 24 items divided between two subscales: satisfaction with care (14 items) and satisfaction with decision making (10 items). Results In total, 200 family members of 176 patients from three hospitals completed the FS-ICU-24 questionnaire. Construct validity for the questionnaire was superior to that observed for a visual analog scale (Spearman’s r = 0.84, p < 0.001). Cronbach’s αs were 0.83 and 0.80 for the satisfaction with care and satisfaction with decision making subscales, respectively. The mean (± standard deviation) total FS-ICU-24 score was 75.44 ± 17.70, and participants were most satisfied with consideration of their needs (82.13 ± 21.03) and least satisfied with the atmosphere in the ICU waiting room (35.38 ± 34.84). Conclusions The Korean version of the FS-ICU-24 questionnaire demonstrated good validity and could be a useful instrument with which to measure family members’ satisfaction about ICU care.
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Affiliation(s)
- Youlim Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jinsoo Min
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Gajin Lim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jung-Kyu Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.,Department of Internal Medicine, Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Hannah Lee
- Department of Anesthesiology, Seoul National University College of Medicine, Seoul, Korea
| | - Jinwoo Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung Su Kim
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jong Sun Park
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Young-Jae Cho
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - You Hwan Jo
- Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hogeol Rhu
- Department of Anesthesiology, Seoul National University College of Medicine, Seoul, Korea
| | - Kyu-Seok Kim
- Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sang-Min Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Yeon Joo Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
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Harrison DA, Ferrando-Vivas P, Wright SE, McColl E, Heyland DK, Rowan KM. Psychometric assessment of the Family Satisfaction in the Intensive Care Unit questionnaire in the United Kingdom. J Crit Care 2016; 38:346-350. [PMID: 27914907 DOI: 10.1016/j.jcrc.2016.10.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 10/06/2016] [Accepted: 10/20/2016] [Indexed: 01/05/2023]
Abstract
PURPOSE To establish the psychometric properties of the Family Satisfaction in the Intensive Care Unit 24-item (FS-ICU-24) questionnaire in the United Kingdom. MATERIALS AND METHODS The Family-Reported Experiences Evaluation study recruited family members of patients staying at least 24 hours in 20 participating intensive care units. Questionnaires were evaluated for nonresponse, floor/ceiling effects, redundancy, and construct validity. Internal consistency was evaluated with item-to-own scale correlations and Cronbach α. Confirmatory and exploratory factor analyses were used to explore the underlying structure. RESULTS Twelve thousand three hundred forty-six family members of 6380 patients were recruited and 7173 (58%) family members of 4615 patients returned a completed questionnaire. One family member per patient was included in the psychometric assessment. Six items had greater than 10% nonresponse; 1 item had a ceiling effect; and 11 items had potential redundancy. Internal consistency was high (Cronbach α, overall .96; satisfaction with care, .94; satisfaction with decision making, .93). The 2-factor solution was not a good fit. Exploratory factor analysis indicated that satisfaction with decision making encompassed 2 constructs-satisfaction with information and satisfaction with the decision-making process. CONCLUSIONS The Family Satisfaction in the Intensive Care Unit 24-item questionnaire demonstrated good psychometric properties in the United Kingdom setting. Construct validity could be improved by use of 3 domains and some scope for further improvement was identified.
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Affiliation(s)
- David A Harrison
- Clinical Trials Unit, Intensive Care National Audit and Research Centre, London, United Kingdom.
| | - Paloma Ferrando-Vivas
- Clinical Trials Unit, Intensive Care National Audit and Research Centre, London, United Kingdom
| | - Stephen E Wright
- Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Elaine McColl
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, United Kingdom; Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Daren K Heyland
- Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, Ontario, Canada; Department of Critical Care Medicine, School of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Kathryn M Rowan
- Clinical Trials Unit, Intensive Care National Audit and Research Centre, London, United Kingdom
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12
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Wright SE, Walmsley E, Harvey SE, Robinson E, Ferrando-Vivas P, Harrison DA, Canter RR, McColl E, Richardson A, Richardson M, Hinton L, Heyland DK, Rowan KM. Family-Reported Experiences Evaluation (FREE) study: a mixed-methods study to evaluate families’ satisfaction with adult critical care services in the NHS. HEALTH SERVICES AND DELIVERY RESEARCH 2015. [DOI: 10.3310/hsdr03450] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BackgroundTo improve care it is necessary to feed back experiences of those receiving care. Of patients admitted to intensive care units (ICUs), approximately one-quarter die, and few survivors recollect their experiences, so family members have a vital role. The most widely validated tool to seek their views is the Family Satisfaction in the Intensive Care Unit questionnaire (FS-ICU).ObjectivesTo test face and content validity and comprehensibility of the FS-ICU (phase 1). To establish internal consistency, construct validity and reliability of the FS-ICU; to describe family satisfaction and explore how it varies by family member, patient, unit/hospital and other contextual factors and by country; and to model approaches to sampling for future use in quality improvement (phase 2).DesignMixed methods: qualitative study (phase 1) and cohort study (phase 2).SettingNHS ICUs (n = 2, phase 1;n = 20, phase 2).ParticipantsHealth-care professionals, ex-patients, family members of ICU patients (n = 41, phase 1). Family members of ICU patients (n = 12,303, phase 2).InterventionsNone.Main outcome measuresKey themes regarding each item of the 24-item FS-ICU (FS-ICU-24) (phase 1). Overall family satisfaction and domain scores of the FS-ICU-24 (phase 2).ResultsIn phase 1, face validity, content validity and comprehensibility were good. Adaptation to the UK required only minor edits. In phase 2, one to four family members were recruited for 60.6% of 10,530 patients (staying in ICU for 24 hours or more). Of 12,303 family members, 7173 (58.3%) completed the questionnaire. Psychometric assessment of the questionnaire established high internal consistency and criterion validity. Exploratory factor analysis indicated new domains:satisfaction with care,satisfaction with informationandsatisfaction with the decision-making process. All scores were high with skewed distributions towards more positive scores. For family members of ICU survivors, factors associated with increased/decreased satisfaction were age, ethnicity, relationship to patient, and visit frequency, and patient factors were acute severity of illness and invasive ventilation. For family members of ICU non-survivors, average satisfaction was higher but no family member factors were associated with increased/decreased satisfaction; patient factors were age, acute severity of illness and duration of stay. Neither ICU/hospital factors nor seasonality were associated. Funnel plots confirmed significant variation in family satisfaction across ICUs. Adjusting for family member and patient characteristics reduced variation, resulting in fewer ICUs identified as potential outliers. Simulations suggested that family satisfaction surveys using short recruitment windows can produce relatively unbiased estimates of average family satisfaction.ConclusionsThe Family-Reported Experiences Evaluation study has provided a UK-adapted, psychometrically valid questionnaire for overall family satisfaction and three domains. The large sample size allowed for robust multilevel multivariable modelling of factors associated with family satisfaction to inform important adjustment of any future evaluation.LimitationsResponses to three free-text questions indicate the questionnaire may not be sensitive to all aspects of family satisfaction.Future workReservations remain about the current questionnaire. While formal analysis of the free-text questions did not form part of this proposal, brief analysis suggested considerable scope for improvement of the FS-ICU-24.Study registrationCurrent Controlled Trials ISRCTN47363549.Funding detailsThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Stephen E Wright
- Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Emma Walmsley
- Clinical Trials Unit, Intensive Care National Audit & Research Centre (ICNARC), London, UK
| | - Sheila E Harvey
- Clinical Trials Unit, Intensive Care National Audit & Research Centre (ICNARC), London, UK
| | - Emily Robinson
- Clinical Trials Unit, Intensive Care National Audit & Research Centre (ICNARC), London, UK
| | - Paloma Ferrando-Vivas
- Clinical Trials Unit, Intensive Care National Audit & Research Centre (ICNARC), London, UK
| | - David A Harrison
- Clinical Trials Unit, Intensive Care National Audit & Research Centre (ICNARC), London, UK
| | - Ruth R Canter
- Clinical Trials Unit, Intensive Care National Audit & Research Centre (ICNARC), London, UK
| | - Elaine McColl
- Newcastle Clinical Trials Unit, Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Annette Richardson
- Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | | | - Lisa Hinton
- Health Experiences Research Group, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Daren K Heyland
- Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, ON, Canada
- Department of Critical Care Medicine, School of Medicine, Queen’s University, Kingston, ON, Canada
| | - Kathryn M Rowan
- Clinical Trials Unit, Intensive Care National Audit & Research Centre (ICNARC), London, UK
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