Khan Shahrukh, Digby Robin, Giordano Nicholas A, Hade Sharon, Bucknall Tracey K
School of Nursing&Midwifery, Deakin University, Geelong, Australia.
School of Nursing&Midwifery, Deakin University, Geelong, Australia; Centre for Quality and Patient Safety Research-Alfred Health Partnership, Institute for Health Transformation, Deakin University, Australia; Nursing Services, Alfred Health, Melbourne, Australia.
Aust Crit Care. 2022 May;35(3):264-272. doi: 10.1016/j.aucc.2021.05.009. Epub 2021 Aug 9.
Partnering with patients and families to make decisions about care needs is a safety and quality standard in Australian health services that is often not assessed systematically.
The objective of this study was to retrospectively evaluate satisfaction with care and involvement in decision-making among family members of patients admitted to the intensive care unit (ICU).
A retrospective cohort analysis of a satisfaction survey administered to family members of patients admitted to an ICU in an Australian metropolitan tertiary care hospital from 2014 to 2019 was conducted. The Family Satisfaction in the Intensive Care Unit questionnaire (FSICU) questionnaire was used to assess overall satisfaction, satisfaction with care, and satisfaction with decision-making on a scale from "poor" (0) to "excellent" (100).
In total, 1322 family members fully completed the survey. Respondents were typically direct relatives of ICU patients (94.2%) with an average age of 52.6 years. Most patients had an ICU length of stay <7 d (56.8%), with most patients being discharged to the ward (96.8%). The overall mean satisfaction score was high among respondents (90.26%). Similarly, mean satisfaction with care (93.06%) and decision-making (89.71%) scores were high. Satisfaction with decision-making scores remained lower than satisfaction with care scores. Multivariable modeling indicated that those younger than 50 years reported higher satisfaction scores (p = 0.006) and those with prolonged lengths of stay in the ICU were associated with lower overall satisfaction scores (p = 0.039). Despite some criticism of waiting times and noise levels, responses showed sincere gratitude for patients' treatment in the ICU and appreciation for the care, skill, and professionalism of the staff.
Very high satisfaction levels were reported by family members during this study. Routine, prospective evaluations of family member satisfaction with ICU experiences are feasible and can be leveraged to provide insight for clinicians and administrators seeking to improve family satisfaction with decision-making and care in ICU settings and meet national standards.
与患者及其家属合作做出护理需求决策是澳大利亚医疗服务中的一项安全和质量标准，但该标准往往未得到系统评估。
本研究的目的是回顾性评估重症监护病房（ICU）住院患者家属对护理的满意度以及参与决策的情况。
对2014年至2019年在澳大利亚一家大都市三级护理医院ICU住院患者家属进行的满意度调查进行回顾性队列分析。使用重症监护病房家属满意度问卷（FSICU）从“差”（0）到“优秀”（100）的量表来评估总体满意度、对护理的满意度以及对决策的满意度。
共有1322名家属完全完成了调查。受访者通常是ICU患者的直系亲属（94.2%），平均年龄为52.6岁。大多数患者在ICU的住院时间<7天（56.8%），大多数患者出院后返回病房（96.8%）。受访者的总体平均满意度得分较高（90.26%）。同样，对护理的平均满意度（93.06%）和对决策的满意度（89.71%）得分也较高。对决策的满意度得分仍低于对护理的满意度得分。多变量模型表明，年龄小于50岁的受访者满意度得分较高（p = 0.006），而在ICU住院时间延长的受访者总体满意度得分较低（p = 0.039）。尽管对等待时间和噪音水平有一些批评，但受访者对患者在ICU的治疗表示由衷感谢，并对工作人员的护理、技能和专业精神表示赞赏。
本研究中家属报告的满意度非常高。对家属对ICU体验的满意度进行常规、前瞻性评估是可行的，可为寻求提高家属对ICU决策和护理满意度并达到国家标准的临床医生和管理人员提供参考。
