Satisfaction in the Intensive Care Unit (ICU). Patient opinion as a cornerstone

Area of Science:

• Critical Care Medicine
• Patient Experience Research
• Health Services Research

Background:

• Assessing patient satisfaction in Intensive Care Units (ICUs) is vital for quality improvement.
• Family members often provide feedback on patient care, but their perspective may differ from the patient's.
• Understanding the agreement between patient and family satisfaction levels is crucial for accurate care assessment.

Purpose of the Study:

• To determine the level of agreement between patient and family satisfaction with care received during ICU admission.
• To evaluate the reliability of family members as proxies for patient satisfaction in the ICU setting.

Main Methods:

• A prospective, observational, and descriptive study conducted over 5 months.
• Involved adult patients with ICU stays >24 hours and their relatives at Marqués de Valdecilla University Hospital.
• Utilized the FS-ICU 34 questionnaire for family satisfaction and an adapted version for patients; Cohen's kappa index assessed agreement.

Main Results:

• Analyzed 148 pairs of surveys (296 questionnaires) from family units.
• The Cohen kappa index ranged from 0.278 to 0.558, indicating mild to moderate agreement between patient and family satisfaction.
• This suggests families are not consistently accurate proxies for patient satisfaction.

Conclusions:

• Families of ICU patients, particularly competent ones, should not be considered reliable proxies for patient satisfaction.
• Direct patient input is essential for understanding their true feelings, perceptions, and experiences during ICU admission.
• Family feedback should primarily be sought when patients are unable to participate in the care evaluation process.