scholarly journals Family satisfaction with critical care in the UK: a multicentre cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e028956 ◽  
Author(s):  
Paloma Ferrando ◽  
Doug W Gould ◽  
Emma Walmsley ◽  
Alvin Richards-Belle ◽  
Ruth Canter ◽  
...  
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
Family Member ◽  
Family Members ◽  
Severity Of Illness ◽  
Patient Characteristics ◽  
Family Satisfaction ◽  
General Icus ◽  
The Family ◽  
The Uk

ObjectiveTo assess family satisfaction with intensive care units (ICUs) in the UK using the Family Satisfaction in the Intensive Care Unit 24-item (FS-ICU-24) questionnaire, and to investigate how characteristics of patients and their family members impact on family satisfaction.DesignProspective cohort study nested within a national clinical audit database.SettingStratified, random sample of 20 adult general ICUs participating in the Intensive Care National Audit & Research Centre Case Mix Programme.ParticipantsFamily members of patients staying at least 24 hours in ICU were recruited between May 2013 and June 2014.InterventionsConsenting family members were sent a postal questionnaire 3 weeks after the patient died or was discharged from ICU. Up to four family members were recruited per patient.Main outcome measuresFamily satisfaction was measured using the FS-ICU-24 questionnaire.Main resultsA total of 12 346 family members of 6380 patients were recruited and 7173 (58%) family members of 4615 patients returned a completed questionnaire. Overall and domain-specific family satisfaction scores were high (mean overall family satisfaction 80, satisfaction with care 83, satisfaction with information 76 and satisfaction with decision-making 73 out of 100) but varied significantly across adult general ICUs studied and by whether the patient survived ICU. For family members of ICU survivors, characteristics of both the family member (age, ethnicity, relationship to patient (next-of-kin and/or lived with patient) and visit frequency) and the patient (acute severity of illness and receipt of invasive mechanical ventilation) were significant determinants of family satisfaction, whereas, for family members of ICU non-survivors, only patient characteristics (age, acute severity of illness and duration of stay) were significant.ConclusionsOverall family satisfaction in UK adult general ICUs was high but varied significantly. Adjustment for differences in family member/patient characteristics is important to avoid falsely identifying ICUs as statistical outliers.Trial registration numberISRCTN47363549

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

2015 ◽  
Vol 3 (45) ◽  
pp. 1-250 ◽  
Author(s):  
Stephen E Wright ◽  
Emma Walmsley ◽  
Sheila E Harvey ◽  
Emily Robinson ◽  
Paloma Ferrando-Vivas ◽  
...  
Keyword(s):  
Family Member ◽  
Phase 1 ◽  
Family Members ◽  
Severity Of Illness ◽  
Family Satisfaction ◽  
Study Phase ◽  
Free Text ◽  
Phase 2 ◽  
Factors Associated ◽  
The Family

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.

Abstract 13410: Patient and Family Perspectives of Early Mobilization in Acute Cardiovascular Care

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Caroline Najjar ◽  
Michael Goldfarb
Keyword(s):  
Family Member ◽  
Tertiary Care ◽  
Family Members ◽  
Early Mobilization ◽  
Recovery Process ◽  
Family Satisfaction ◽  
Care Providers ◽  
Tertiary Care Centre ◽  
The Family ◽  
Cv Disease

Introduction: Early mobilization (EM) is safe, feasible, and associated with good outcomes in people with acute CV disease. While studies have explored the perspectives of care providers on mobilization, little is known about patient and family member perspectives and experience with mobilization. Methods: Patient and family member surveys were developed using previously validated surveys (Family Satisfaction with Care in the ICU and the Patient Mobilization Attitudes & Beliefs survey). The survey assessed attitudes toward and knowledge of mobilization, the family member’s role in providing care and the mobilization care they received. Surveys were distributed to patients and their family members in an acute CV unit of a tertiary care centre in Montreal, Canada over a 4-month period. Results: 102 participants completed the survey (78 patients and 24 family members). Most patients (N=54; 69.2%) agreed or strongly agreed that EM should be routinely performed, although nearly half of the patients (N=37, 47.4%) felt that mobilization soon after admission was potentially dangerous. Out of 64 patients who underwent EM, 60 (93.8%) felt that mobilization helped their recovery (Figure). 35 patients (54.7%) felt that family member participation helped their mobilization. Family members included 12 (50.0%) spouses/partners, 10 (41.7%) children, 1 (4.2%) siblings, and 1 parent (4.2%). Most family members felt that mobilizing their relatives too soon after admission was potentially dangerous (N=17, 70.8%). However, family members were interested in being involved with mobilization (N=22; 91.7%) and only a few felt that mobilization should not be routinely performed (N=2; 8.3%). Conclusion: Patients felt that EM helped with their recovery process. Family members were interested in being involved in mobilizing their relatives. Our findings should inform efforts to overcome patient and family-related barriers to mobilization and design an EM program for acute CV care.

scholarly journals Developing Family Satisfaction with Care in Adult Critical Care Public Hospital Terengganu, Malaysia

2021 ◽  
pp. 31-35
Author(s):  
Wan Nor Aliza Wan Abdul Rahman ◽  
Abdul Karim Othman ◽  
Yuzana Mohd Yusop ◽  
Asyraf Afthanorhan ◽  
Hasnah Zani ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Shared Decision Making ◽  
Family Members ◽  
Family Satisfaction ◽  
Satisfaction With Care ◽  
Shared Decision ◽  
Cross Sectional ◽  
The Family

In admissions to the intensive care unit (ICU), there is a high possibility of a life-threatening condition and possible emotional distress for family members. When the family is distressed and hospitalized, a significant level of stress and anxiety will be generated among family members, thereby decreasing their ability to make responsible decisions. As a result, the family members need full and up-to-date details, helping them to retain hope, and this contributes to lower stress levels. While there is growing evidence of the effectiveness of shared decision-making for family members who are directly involved in decisions, particularly regarding shared decision-making in the Malaysian context, there is less evidence that supported decisions help overall outcome. This study aims to developing the family satisfaction with decision making in the Intensive Care Unit (FS-ICU)-33 Malay language version of family member’s satisfaction with care and decision making during their stay at the intensive care units. A quantitative, cross-sectional validation study and purposive sampling was conducted from 1st November 2017 and 10 October 2018 to January 2020 among 208 of family members.  The family members of the ICU patients involved in this study had an excellent satisfaction level with service care. Higher satisfaction in ICU care resulting in higher decision-making satisfaction and vice versa.

Communication with patients and families in the ICU

2016 ◽  
Author(s):  
Leslie P. Scheunemann ◽  
Robert M. Arnold
Keyword(s):  
Intensive Care ◽  
Family Members ◽  
Ethics Committees ◽  
Family Satisfaction ◽  
Interdisciplinary Teams ◽  
Care Practice ◽  
Family Meeting ◽  
Icu Patients ◽  
Good Communication ◽  
The Family

Regular, consistent communication with families of intensive care unit (ICU) patients is important for family satisfaction, patient-centred decision-making, and reducing the emotional burden of the ICU stay on family members. In fact, the family meeting can appropriately be considered a core procedure of intensive care practice. Good communication requirements include the appropriate clinicians and family members, providing a quiet and undisturbed setting, and choosing appropriate goals for each meeting. Clinicians should strive to develop skills for listening, observing family dynamics, and responding to emotions. ICU administrators should consider building processes of care to promote regular, consistent communication and partnerships with interdisciplinary teams, such as ethics committees and palliative care that can supplement these skills.

scholarly journals Can the UK 24-item family satisfaction in the intensive care unit questionnaire be used to evaluate quality improvement strategies aimed at improving family satisfaction with the ICU? A qualitative study

2019 ◽  
Vol 21 (4) ◽  
pp. 312-319
Author(s):  
Susannah Lyes ◽  
Alvin Richards-Belle ◽  
Bronwen Connolly ◽  
Kathryn M Rowan ◽  
Lisa Hinton ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Improvement ◽  
Family Members ◽  
Family Satisfaction ◽  
Face Validity ◽  
Improvement Strategies ◽  
The Face ◽  
Observational Cohort ◽  
The Uk

Background The experiences and satisfaction of family members of patients are important indicators of healthcare quality in the intensive care unit. The family satisfaction in the intensive care unit (FS-ICU-24) questionnaire, developed in Canada and now validated in the UK, is becoming the gold standard measure to evaluate family members’ satisfaction with the intensive care unit. To inform future use of the UK FS-ICU-24 to evaluate quality improvement strategies aimed at improving family satisfaction with the intensive care unit, we set out to explore the extent to which the 24-scored items and domains of the UK FS-ICU-24 reflect common suggestions and priorities for quality improvement self-reported as important to family members in the UK. Methods Two data sources were thematically analysed – (1) open-text responses from family members who completed the UK FS-ICU-24 in a large observational cohort study; (2) a set of quality improvement activities generated by patients, family members and staff through experience-based co-design in a mixed-methods’ intensive care unit quality improvement study. Summarised themes were then mapped to the 24-scored items and domains of the UK FS-ICU-24 to assess coverage by the UK FS-ICU-24. Results We found a good degree of coverage between the topics and themes identified as important to family members with the 24-scored items and domains of the UK FS-ICU-24. Conclusion Our study confirms the face validity of the UK FS-ICU-24 and indicates that its inclusion as an outcome measure for evaluating quality improvement strategies aimed at improving family satisfaction with the intensive care unit is appropriate.

Variation in antibiotic use across intensive care units (ICU): A population-based cohort study in Ontario, Canada

2020 ◽  
Vol 41 (9) ◽  
pp. 1035-1041
Author(s):  
Erika Y. Lee ◽  
Michael E. Detsky ◽  
Jin Ma ◽  
Chaim M. Bell ◽  
Andrew M. Morris
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Ventilatory Support ◽  
Severity Of Illness ◽  
Antibiotic Use ◽  
Patient Factors ◽  
Days Of Therapy ◽  
Level 3 ◽  
Level 2

AbstractObjectives:Antibiotics are commonly used in intensive care units (ICUs), yet differences in antibiotic use across ICUs are unknown. Herein, we studied antibiotic use across ICUs and examined factors that contributed to variation.Methods:We conducted a retrospective cohort study using data from Ontario’s Critical Care Information System (CCIS), which included 201 adult ICUs and 2,013,397 patient days from January 2012 to June 2016. Antibiotic use was measured in days of therapy (DOT) per 1,000 patient days. ICU factors included ability to provide ventilator support (level 3) or not (level 2), ICU type (medical-surgical or other), and academic status. Patient factors included severity of illness using multiple-organ dysfunction score (MODS), ventilatory support, and central venous catheter (CVC) use. We analyzed the effect of these factors on variation in antibiotic use.Results:Overall, 269,351 patients (56%) received antibiotics during their ICU stay. The mean antibiotic use was 624 (range 3–1460) DOT per 1,000 patient days. Antibiotic use was significantly higher in medical-surgical ICUs compared to other ICUs (697 vs 410 DOT per 1,000 patient days; P < .0001) and in level 3 ICUs compared to level 2 ICUs (751 vs 513 DOT per 1,000 patient days; P < .0001). Higher antibiotic use was associated with higher severity of illness and intensity of treatment. ICU and patient factors explained 47% of the variation in antibiotic use across ICUs.Conclusions:Antibiotic use varies widely across ICUs, which is partially associated with ICUs and patient characteristics. These differences highlight the importance of antimicrobial stewardship to ensure appropriate use of antibiotics in ICU patients.

scholarly journals Validation of the German version of the Family Reported Outcome Measure (FROM-16) to assess the impact of disease on the partner or family member

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Susanne A. Elsner ◽  
Sam S. Salek ◽  
Andrew Y. Finlay ◽  
Anna Hagemeier ◽  
Catherine J. Bottomley ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Family Member ◽  
Internal Consistency ◽  
Outcome Measure ◽  
Test Validity ◽  
Family Members ◽  
German Version ◽  
The Family ◽  
The Difference ◽  
The Impact

Abstract Background The Family Reported Outcome Measure (FROM-16) assesses the impact of a patient’s chronic illness on the quality of life (QoL) of the patient’s partner or family members. The aim of the study was to translate, explore the structure of and validate the FROM-16. Methods The questionnaire was translated from English into German (forward, backward, four independent translators). Six interviews with family members were conducted to confirm the questionnaire for linguistic, conceptual, semantic and experiential equivalence and its practicability. The final German translation was tested for internal consistency, reproducibility and test validity. Criterion validity was tested by correlating the scores of the FROM-16 and the Global Health Scale (GHS). Principal component analysis, factor analysis, and confirmatory factor analysis was used to assess the questionnaire’s structure and its domains. Reliability and reproducibility were tested computing the intraclass correlation coefficient (ICC) using one sample t-test for testing the hypothesis that the difference between the scores was not different from zero. Results Overall, 83 family members (61% female, median age: 61 years) completed the questionnaire at two different times (mean interval: 22 days). Internal consistency was good for the FROM-16 scores (Cronbach’s α for total score = 0.86). In those with stable GHS, the ICC for the total score was 0.87 and the difference was not different from zero (p = 0.262) indicating reproducible results. A bi-factor model with a general factor including all items, and two sub-factors comprising the items from the original 2-factor construct had the best fit. Conclusions The German FROM-16 has good reliability, test validity and practicability. It can be considered as an appropriate and generic tool to measure QoL of a patient’s partner or family member. Due to the presence of several cross-loadings we do not recommend the reporting of the scores of the two domains proposed for the original version of FROM-16 when using the German version. Thus, in reporting the results emphasis should be put on the total score. Trial registration: Retrospectively registered: DRKS00021070.

scholarly journals Durable Relationship and Family Members “by Analogy” in the European Union

2018 ◽  
Vol 10 (4) ◽  
pp. 175
Author(s):  
Tanel Feldman ◽  
Marco Mazzeschi
Keyword(s):  
Member State ◽  
Family Member ◽  
Family Members ◽  
The European Union ◽  
Member States ◽  
Registered Partnership ◽  
The Family ◽  
Definition Of ◽  
Union Citizen ◽  
The Eu

Rights of residence derived from a durable relationship with an EU citizen, are left to a relatively wide discretion of the Member States. Pursuant to Article 2.2 (b) Directive 2004/38/EC (&ldquo;Directive&rdquo;), &ldquo;the partner with whom the Union citizen has contracted a registered partnership, on the basis of the legislation of a Member State, if the legislation of the host Member State treats registered partnerships as equivalent to marriage and in accordance with the conditions laid down in the relevant legislation of the host Member State&rdquo; qualifies as family member. Provided that they have a durable relationship (duly attested) with an EU citizen, pursuant to Article 3.2(b), unregistered partners are as well beneficiaries of the Directive. The durable relationship was expressly excluded from the scope of Article 2(2)(b): &ldquo;Unlike the amended proposal, it does not cover de facto durable relationships&rdquo; (EU Commission, Document 52003SC1293). Article 3 (2)(a) covers &ldquo;other family members&rdquo; (no restrictions as to the degree of relatedness) if material support is provided by the EU citizen or by his partner or where serious health grounds strictly require the personal care of the family member by the Union citizen. Pursuant to Article 3.2, &ldquo;other family members&rdquo; and unregistered partners can attest a durable relationship, must be facilitated entry and residence, in accordance to the host Member State&rsquo;s national legislation. In the light of Preamble 6 Directive, the situation of the persons who are not included in the definition of family members, must be considered &ldquo;in order to maintain the unity of the family in a broader sense&rdquo;. The questions discussed in this paper are the following: (i) are Member States genuinely considering the concept of durable relationship in view of maintaining the unity of the family in a broader sense? and (ii) how to overcome legal uncertainty and which criteria, both at EU and at international level, can be taken into account in order to assess whether a durable relationship is genuine and should be granted the rights set forth by the Directive?

scholarly journals Study of Mental Health Status of the Family Members of Disappeared Persons of Kashmir

2015 ◽  
Vol 3 (1) ◽  
Author(s):  
Suhail Ahmad Bhat ◽  
Dr. Shawkat Ahmad Shah
Keyword(s):  
Mental Health ◽  
Family Member ◽  
Family Members ◽  
Family Type ◽  
Emotional Control ◽  
Normal Person ◽  
Frequency Method ◽  
Significant Difference ◽  
The Family ◽  
Anxiety Depression

While trying to portray the picture of mayhem and woes of family members of those who disappeared, it fails to fully convey the agony of the survivors. Their emotions are so intense that a normal person can hardly help his emotional shutters. Even a single experience with a family member of a disappeared person makes one to ponder that how unbearable it is to be a mother, father, wife or son of disappeared person. Their search for the disappeared family member along with hardships of daily life, social stigmas, economic and educational needs have left their mental health par below average level. One finds the words of depression, stress, anxiety, sleeplessness and melancholy in their everyday lexicon. With such a despondent picture of family members of disappeared persons in mind, the present attempt was made to study the nature of their mental health. To achieve this objective, data was collected from 217 family members of disappeared persons of Kashmir. The frequency method and t-test were used to obtain the results. The results of the study showed that majority of the family members scored high in negative dimensions of mental health namely, anxiety, depression and loss of behavioral and emotional control and low in positive dimensions of mental health namely, general positive affect, emotional ties and life satisfaction. A significant difference was found in mental health on the basis of gender, age and family type.

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