Patient satisfaction in the ICU: level of satisfaction and influencing factors

Introduction

To optimize patient care, knowledge of patient satisfaction and its determinants is essential. So far few researchers have focused on this subject in intensive care medicine. The purpose of this study was to measure the level of patient satisfaction and determine its influencing factors in ICU patients.

Methods

In a pilot study, we developed a questionnaire that consisted of 60 questions in eight domains (General satisfaction, Reception, Physical care, Mental care, Empathy and attention, Communication and information, Surroundings and Physical discomfort). Answering possibilities ranged from 1 (not satisfied) to 5 (completely satisfied). In the final study, 23 March to 29 May 2008, all consecutive adult patients from a 29-bed, tertiary-care, medical, surgical, neurosurgical and thoracic–surgical ICU were interviewed within 4 days after discharge. Demographics and clinical characteristics were obtained from electronic records. General linear modeling (GLM) with Bonferroni–Holmes correction was used to study the relationship between overall patient satisfaction scores and the eight domains, corrected for patient and ICU-related factors. The model was tested for clinically relevant interaction between determinants.

Results

Ninety-eight patients were interviewed. The mean overall patient satisfaction score was 4.60 (SD = 0.93). Of the eight domains, only Communication and information (P = 0.039) appeared to be significant in predicting general satisfaction. Also sex (P = 0.046), length of ICU stay (P = 0.042), the interaction between Communication and information and age (P = 0.016), and the interaction between Communication and information and Minimal Mental State Examination score (P = 0.013) were significant. An indepth analysis of Communication and information showed that the interaction of communication with birth country (P < 0.0001) and with duration of mechanical ventilation (P = 0.041) was significant. This implies that, for Dutch versus non-Dutch patients and patients longer on mechanical ventilation, clear communication with doctors and nurses was particularly important.

Conclusion

Patient satisfaction was high in this mixed population of ICU patients. From an especially developed questionnaire, Communication and information was the most important predictor. In addition, older age, female sex, Dutch nationality, longer ICU stay, long duration of mechanical ventilation and a high Minimal Mental State Examination score were related to less satisfied patients.