Meeting the needs of ICU patient families: a multicentre study

Full text

Background

ICU caregivers should specifically seek to develop a collaborative relationship with ICU patient family members, based on a rich and free exchange of information and aimed both at helping family members to cope with their distress and at providing them with the opportunity to speak for the patient if necessary.

Methods

We conducted a prospective multicentre study of family member satisfaction as evaluated using the Critical Care Family Needs Inventory (CCFNI) developed by the Society for Critical Care Medicine. Forty-three French ICUs (37 adult and 6 paediatric) participated in the study; each was required to include 15 consecutive patients hospitalised for longer than two days. ICU characteristics, demographic data on patients and family members and questions about satisfaction were collected. The additive score of all CCFNI items was the dependent variable. Factors associated with dissatisfaction were identified using multivariate analysis.

Results

637 patients were included in the study, and 920 family members completed the questionnaire. The multiple regression model identified 10 factors associated with family dissatisfaction: (i) two patient-related factors, namely age (OR 1.23) and admission for acute respiratory failure (OR 1.62); (ii) three family-related factors, namely younger age (OR 0.98), not the spouse (OR 1.81), and not of French descent (OR 4.34); and (iii) five caregiver-related factors, namely perceived contradictions in information given by caregivers (OR 3.20), information not always provided by the same physician (OR 2.71), no knowledge of the occupational identity of each caregiver (OR 2.32), no help from the family's own doctor (OR 1.45), and insufficient caregiver time spent giving information (OR 1.35).

Conclusion

Among family members visiting the patient, spouses were more satisfied. The caregiver-related factors identified in this study are amenable to intervention and deserve to be the focus of future studies aimed at improving the satisfaction of ICU patient family members.