Family Satisfaction with ICU Care

A study has found that family satisfaction with end-of-life care in an intensive care unit (ICU) correlates with the family's involvement in making decisions, the amount of communication between staff and family, and the respect and compassion shown toward the patient and family. The findings were published in the July 2003 issue of Chest.

Researchers from six university-affiliated hospitals in Canada conducted a survey of the experience of patients dying in ICUs from the perspectives of family members of nonsurviving patients who had been supported by mechanical ventilation in the ICU for more than 48 hours. Of the 256 completed surveys, 52% of families rated their satisfaction with overall ICU care as excellent, 31% as very good, and 10% as good.

Family members who rated the courtesy, compassion, and respect shown them by ICU staff as excellent were more than twice as likely to rate their overall experience as completely satisfactory than families who reported the same treatment for the patient. Families not satisfied by patient care or those who felt they were less informed were less likely to be satisfied by their overall ICU experience.

"So much of the pain and suffering around end-of-life care, from both the patients' and families' perspectives, relates to the way in which staff communicates with them,” noted lead author Daren Heyland, M.D., MSc, director of research, Critical Care Program, at Kingston General Hospital (Canada). "When it becomes apparent that a patient is going to die from his or her critical illness, physicians need to direct more supportive care and compassion, to a greater degree, toward family members.”