Psychometric Evaluation of a Modified Version of the Family Satisfaction in the ICU Survey in Parents/Caregivers of Critically Ill Children*

Epstein, David; Unger, Jennifer B.; Ornelas, Beatriz; Chang, Jennifer; Markovitz, Barry P.; Moromisato, David; Dodek, Peter; Heyland, Daren K.; Gold, Jeffrey I.

doi:10.1097/pcc.0b013e3182917705

Cited by 27 publications

(19 citation statements)

References 34 publications

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“…9,10,53,54,[59][60][61][62][63][64][65][66][67][68][69][70][71]76,77 These studies are reported between 2002 and 2014.…”

Section: Settingmentioning

confidence: 99%

“…Most of the studies were based in North America -the USA (n = 9) 53,54,[59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][76][77][78][79][80] and Canada (n = 3) 9,10,56,74 -with other studies based in Greece (n = 2), 41,42 Switzerland (n = 2), 17,55 Germany (n = 1), 39 Israel (n = 1), 57 the Netherlands (n = 1), 75 the Philippines (n = 1) 38 and Turkey (n = 1). 40 Nine studies were single centre, with the remainder being multicentre, ranging from 2 to 23 centres.…”

Section: Settingmentioning

confidence: 99%

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Family-Reported Experiences Evaluation (FREE) study: a mixed-methods study to evaluate families’ satisfaction with adult critical care services in the NHS

Wright

Walmsley

Harvey

et al. 2015

Health Serv Deliv Res

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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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“…9,10,53,54,[59][60][61][62][63][64][65][66][67][68][69][70][71]76,77 These studies are reported between 2002 and 2014.…”

Section: Settingmentioning

confidence: 99%

Section: Settingmentioning

confidence: 99%

Family-Reported Experiences Evaluation (FREE) study: a mixed-methods study to evaluate families’ satisfaction with adult critical care services in the NHS

Wright

Walmsley

Harvey

et al. 2015

Health Serv Deliv Res

View full text Add to dashboard Cite

show abstract

“…The original FS-ICU 24 had a Cronbach α of .94 in a sample of mostly English-speaking, white family members of adult ICU patients (89%) [24]. The Cronbach α was .95 for the pFS-ICU 24 in a similar racial/ ethnic population of parents/caregivers [25]. The Flesch-Kincaid reading level grade of the pFS-ICU 24 was equivalent to readers of 10 to 12 years of age in the United States.…”

Section: Pediatric Version Of the Fs-icu 24mentioning

confidence: 99%

“…The Flesch-Kincaid reading level grade may be calculated using the spelling and grammar checking tool in Microsoft Word 2010, in the proofing section, after selecting "show readability statistics." The Likert scale survey responses were converted to a numerical scale of 0 to 100 for easier relative comparisons, using the same scoring procedure as the survey validation of the pFS-ICU 24 [25]. A free, full copy of the pFS-ICU 24 is available online [27].…”

Section: Pediatric Version Of the Fs-icu 24mentioning

confidence: 99%

“…This tool evaluates satisfaction with care and satisfaction with medical decision making. We recently evaluated a pediatric version of the FS-ICU 24 (pFS-ICU 24) using English-speaking nonLatino white (NLW) parents/caregivers of critically ill children and found it to have good construct validity and internal consistency [25]. The purpose of this study was to determine if there are differences in satisfaction with care and decision making between English-speaking NLW and English-speaking Latino parents/caregivers of critically ill children using the pFS-ICU 24.…”

Section: Introductionmentioning

confidence: 99%

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Satisfaction with care and decision making among parents/caregivers in the pediatric intensive care unit: A comparison between English-speaking whites and Latinos

Epstein¹,

Unger²,

Ornelas³

et al. 2015

Journal of Critical Care

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Evaluating Patient and Family Experience Among Spanish-Speaking and LatinX Patients: a Scoping Review of Existing Instruments

Rollins

Wandell

Epstein

et al. 2022

J. Racial and Ethnic Health Disparities

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Psychometric Evaluation of a Modified Version of the Family Satisfaction in the ICU Survey in Parents/Caregivers of Critically Ill Children*

Abstract: The pFS-ICU 24 is a psychometrically sound measure of satisfaction with care and medical decision-making of parents/caregivers with children in the ICU.

Cited by 27 publications

References 34 publications

Family-Reported Experiences Evaluation (FREE) study: a mixed-methods study to evaluate families’ satisfaction with adult critical care services in the NHS

Family-Reported Experiences Evaluation (FREE) study: a mixed-methods study to evaluate families’ satisfaction with adult critical care services in the NHS

Satisfaction with care and decision making among parents/caregivers in the pediatric intensive care unit: A comparison between English-speaking whites and Latinos

Evaluating Patient and Family Experience Among Spanish-Speaking and LatinX Patients: a Scoping Review of Existing Instruments

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