Chest
Volume 132, Issue 5, November 2007, Pages 1425-1433
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Original Research
CRITICAL CARE MEDICINE
Family Satisfaction in the ICU: Differences Between Families of Survivors and Nonsurvivors

https://doi.org/10.1378/chest.07-0419Get rights and content

Background

We previously noted that the families of patients dying in the ICU reported higher satisfaction with their ICU experience than the families of survivors. However, the reasons for this finding were unclear. In the current study, we sought to confirm these findings and identify specific aspects of care that were rated more highly by the family members of patients dying in the ICU compared to family members of ICU survivors.

Methods

A total of 539 family members with a patient in the ICU were surveyed. Family satisfaction was measured using the 24-item family satisfaction in the ICU questionnaire. Ordinal logistic regression identified which components of family satisfaction were associated with the patient's outcome (ie, whether the patient lived or died).

Results

A total of 51% of respondents had a loved one die in the ICU. Overall, the families of patients dying in the ICU were more satisfied with their ICU experience than were families of ICU survivors, and the largest differences were noted for care aspects directly affecting family members. Significant differences were found for inclusion in decision making, communication, emotional support, respect and compassion shown to family, and consideration of family needs (p < 0.01).

Conclusions

The families of patients dying in the ICU were more satisfied with their ICU experience than were the families of ICU survivors. The reasons for this difference were higher ratings on family-centered aspects of care. These findings suggest that efforts to improve the support of ICU family members should focus not only on the families of dying patients but also on the families of patients who survive their ICU stay.

Section snippets

Populations and Settings

Data for the current analyses come from a prospective before/after study12 that was designed to evaluate a palliative care intervention for ICU patients and their families. There was no data overlap with our prior study.11 The preintervention period occurred from August 2003 through March 2004. The postintervention period occurred from December 2004 through October 2005. The study was conducted at Harborview Medical Center, a 350-bed tertiary care hospital affiliated with the University of

Results

Among 983 eligible family members, 539 returned completed survey packets (overall response rate, 54.8%). The response rate was higher for the families of decedents than for the families of survivors (58.4% vs 51.6%, respectively; p = .034). Table 1displays the self-reported demographics of the sample. Overall, 275 of 539 of the family respondents (51%) had a loved one die in the ICU, and, as expected, dying patients were older and had shorter hospital lengths of stay. A higher number of dying

Discussion

In this study, we compared satisfaction ratings between the family members of patients who died in the ICU and the family members of ICU survivors. Overall, we found that the families of patients dying in the ICU were more satisfied with their ICU experience than families of ICU survivors. This difference was most evident for attributes of care that directly affected family members. For example, the families of patients dying in the ICU were more satisfied with family-centered aspects of care

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    This project was funded by a grant from the National Institute of Nursing Research (R01NR05226) and a grant from the Robert Wood Johnson Foundation. Dr. Wall was also supported by a grant from the American Lung Association (RT21106N).

    The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

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