Reasons for dissatisfaction

Malacrida, Roberto; Bettelini, Cristina Molo; Degrate, Alessandro; Martínez, Marina; Badia, F. Barbal; Piazza, Jocelyne; Vizzardi, Nicoletta; Wullschleger, Roberta; Rapin, Charles‐Henri

doi:10.1097/00003246-199807000-00018

Cited by 131 publications

(8 citation statements)

References 1 publication

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“…We also found that both concern and caring for patients by ICU staff and completeness of information were very highly correlated with overall satisfaction. This validates previous findings that many family members would prefer more time with caregivers for information transfer and for addressing the emotional distress caused by the ICU experience (9, 46–50). A survey of family members of patients dying in the ICU found that key determinants of family satisfaction were good communication, good decision making, and respect and compassion shown to both the patient and the family (51).…”

Section: Discussionsupporting

confidence: 91%

Predictors and correlates of dissatisfaction with intensive care*

Hunziker

McHugh

Sarnoff-Lee

et al. 2012

Critical Care Medicine

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Objective Dissatisfaction is an important threat to high-quality care. The aim of this study was to identify factors independently associated with dissatisfaction with critical care. Design Prospectively collected observational cohort study. Setting Nine intensive care units at a tertiary care university hospital in the United States. Participants Four hundred forty-nine family members of adult intensive care unit patients who completed the Family Satisfaction with Care in the Intensive Care Unit instrument. Intervention None. Measurements and Main Results Four family-and patient-related factors ascertainable at intensive care unit admission independently predicted low overall satisfaction: living in the same city as the hospital, disagreement within the family regarding care, having a cardiac comorbidity but being hospitalized in a noncardiac-care intensive care unit, and living in a different household than the patient. When three or more risk factors were present, 63% (95% confidence interval 48%–78%) of families were dissatisfied. Among factors ascertained at the end of the intensive care unit stay, dissatisfaction with six items was independently associated with overall dissatisfaction: 1) perceived competence of nurses (odds ratio for dissatisfaction = 5.9, 95% confidence interval 2.3–15.2); 2) concern and caring by intensive care unit staff (odds ratio 5.0, 95% confidence interval 1.9–12.6); 3) completeness of information (odds ratio 4.4, 95% confidence interval 2.4–8.1); 4) dissatisfaction with the decision-making process (odds ratio 3.0, 95% confidence interval 1.6– 5.6); 5) atmosphere of the intensive care unit (odds ratio 2.6, 95% confidence interval 1.4–4.8); and 6) atmosphere of the waiting room (odds ratio 2.7, 95% confidence interval 1.2–6.0). Conclusion Specific factors ascertainable at intensive care unit admission identify families at high risk of dissatisfaction with care. Other discrete aspects of the patient/family experience that develop during the intensive care unit stay are also strongly associated with dissatisfaction with the critical care experience. These results may provide insight into the design of future evidence-based strategies to improve satisfaction with the intensive care unit experience.

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Section: Discussionsupporting

confidence: 91%

Predictors and correlates of dissatisfaction with intensive care*

Hunziker

McHugh

Sarnoff-Lee

et al. 2012

Critical Care Medicine

View full text Add to dashboard Cite

show abstract

“…This is in concordance with several western studies that describe families, in general being highly satisfied with the ICU care that their loved ones receive. [ 10 11 12 ] When examining individual item scores, “Patient care” scored the highest, “staff interaction” scored the second highest. Communication to attendants scored third in our study, while, in several studies, this had scored the least.…”

Section: Discussionmentioning

confidence: 99%

“…Communication to attendants scored third in our study, while, in several studies, this had scored the least. [ 7 13 ] Malacrida et al .,[ 12 ] in a survey on family satisfaction of patients who died in the ICU found that a high percentage of respondents were satisfied with the care but primarily complained about the information received and the way it was communicated. A study on family satisfaction with end-of-life care emphasizes the need for better communication and greater access to physicians and suggests that these factors are strongly associated with satisfaction.…”

Section: Discussionmentioning

confidence: 99%

Critical care: Are we customer friendly?

Venkataraman

Ranganathan

Rajnibala

et al. 2015

Indian Journal of Critical Care Medicine

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Objective:Assessing and enhancing family satisfaction are imperative for the provision of comprehensive intensive care. There is a paucity of Indian data exploring family's perception of Intensive Care Unit (ICU) patients. We wanted to explore family satisfaction and whether it differed in families of patients admitted under intensivists and nonintensivists in our semi-open ICU.Methodology:We surveyed family members of 200 consecutive patients, between March and September 2009 who were in ICU for >3 days. An internationally validated family satisfaction survey was adapted and was administered to a family member, on day 4 of the patient's stay. The survey consisted of 15 questions in five categories - patient care, medical counseling, staff interaction, visiting hours, and facilities and was set to a Likert scale of 1–4. Mean, median, and proportions were computed to describe answers for each question and category.Results:A total of 515 patients were admitted during the study period, of which 200 patients stayed in the ICU >3 days. One family member each of the 200 patients completed the survey with 100% response rate. Families reported the greatest satisfaction with patient care (94.5%) and least satisfaction with visiting hours (60.5%). Chi-square tests performed for each of the five categories revealed no significant difference between satisfaction scores of intensivists and nonintensivists' patients.Conclusion:Family members of ICU patients were satisfied with current care and communication, irrespective of whether they were admitted under intensivists or nonintensivists. Family members preferred open visiting hours policy than a time limited one.

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“…Families of patients who die in the ICU have higher rates of anxiety and depression symptoms [ 40 ],[ 41 ], sleepiness [ 20 ], psychiatric syndromes (e.g., panic attacks, generalized anxiety, and pathological grief reaction) [ 42 ], and posttraumatic stress [ 39 ]. They report overwhelming guilt and regrets about the circumstances of their loved one's death in the ICU [ 6 ],[ 43 ]-[ 46 ]. Clearly, the extreme vulnerability of these families warrants intensified communication efforts [ 47 ].…”

Section: Reviewmentioning

confidence: 99%

Involvement of ICU families in decisions: fine-tuning the partnership

Azoulay

Chaize

Kentish-Barnes

2014

Ann. Intensive Care

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Families of patients are not simple visitors to the ICU. They have just been separated from a loved one, often someone they live with, either abruptly or, in nearly half the cases, because a chronic condition has suddenly worsened. They must cope with a serious illness of a loved one, while having to adapt to the unfamiliar and intimidating ICU environment. In many cases, the outcome of the critical illness is uncertain, a situation that causes considerable distress to the relatives. As shown by our research group and others, families exhibit symptoms of anxiety (70%) and depression (35%) in the first few days after admission, as well as symptoms of stress (33%) and difficulty understanding the information delivered by the healthcare staff (50%). Furthermore, relatives of patients who die in the ICU are at risk for psychiatric syndromes such as generalized anxiety, panic attacks, depression, and posttraumatic stress syndrome. In this setting of psychological distress, families are asked to consider sharing in healthcare decisions about their loved one in the ICU. This article aims to foster the debate about the shared decision-making process. We have three objectives: to transcend the overly simplistic position that opposes paternalism and autonomy, to build a view founded only on an evaluation of actual practice and experience in the field, and to keep the focus squarely on the patient. Families want information and communication time from the staff. Nurses and physicians need to understand that families can share in decisions only if the entire ICU staff actively promotes family involvement and, of course, if the family wants to participate in all or part of the decision-making process.

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Reasons for dissatisfaction

Cited by 131 publications

References 1 publication

Predictors and correlates of dissatisfaction with intensive care*

Predictors and correlates of dissatisfaction with intensive care*

Critical care: Are we customer friendly?

Involvement of ICU families in decisions: fine-tuning the partnership

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