Psychometric evaluation of a modified version of the family satisfaction in the ICU survey in parents/caregivers of critically ill children*

Abstract

Objectives: The Family Satisfaction in the Intensive Care Unit 24 (FS-ICU 24) survey consists of two domains (overall care and medical decision-making) and was validated only for family members of adult patients in the ICU. The purpose of this study was to evaluate the internal consistency and construct validity of the FS-ICU 24 survey modified for parents/caregivers of pediatric patients (Pediatric Family Satisfaction in the Intensive Care Unit 24 [pFS-ICU 24]) by comparing it to McPherson's PICU satisfaction survey, in a similar racial/ethnic population as the original Family Satisfaction in the Intensive Care Unit validation studies (English-speaking Caucasian adults). We hypothesized that the pFS-ICU 24 would be psychometrically sound to assess satisfaction of parents/caregivers with critically ill children.

Design: A prospective survey examination of the pFS-ICU 24 was performed (1/2011-12/2011). Participants completed the pFS-ICU 24 and McPherson's survey with the order of administration alternated with each consecutive participant to control for order effects (nonrandomized). Cronbach's alphas (α) were calculated to examine internal consistency reliability, and Pearson correlations were calculated to examine construct validity.

Setting: University-affiliated, children's hospital, cardiothoracic ICU.

Subjects: English-speaking Caucasian parents/caregivers of children less than 18 years old admitted to the ICU (on hospital day 3 or 4) were approached to participate if they were at the bedside for greater than or equal to 2 days.

Measurements and main results: Fifty parents/caregivers completed the surveys (mean age ± SD = 36.2±9.6 yr; 56% mothers). The α for the pFS-ICU 24 was 0.95 and 0.92 for McPherson's survey. Overall, responses for the pFS-ICU 24 and McPherson's survey were significantly correlated (r = 0.73; p < 0.01). The average overall pFS-ICU 24 satisfaction score was 92.6 ± 8.3. The average pFS-ICU 24 satisfaction with care domain and medical decision-making domain scores were 93.3 ± 8.8 and 91.2 ± 8.9, respectively.

Conclusions: The pFS-ICU 24 is a psychometrically sound measure of satisfaction with care and medical decision-making of parents/caregivers with children in the ICU.

Figure 1.

Parent/caregiver satisfaction with care. 1. Courtesy, respect, and compassion toward your child. 2. Symptom management: pain. 3. Symptom management: breathlessness. 4. Symptom management: agitation. 5. Staff showed an interest in family needs. 6. Staff provided family emotional support. 7. Teamwork and coordination of care. 8. Courtesy, respect, and compassion toward family. 9. How well nurses cared for your child--skill and competence. 10. How often nurses communicated to you about your child’s condition. 11. How well physicians cared for your child--skill and competence. 12. Atmosphere of the ICU. 13. Atmosphere of the waiting room. 14. Satisfaction with level of healthcare that your child received in the ICU.

Figure 2.

Parent/caregiver satisfaction with decision-making. 15. Frequency of communication with ICU doctors about your child’s condition. 16. Willingness of ICU caregivers to answer your questions. 17. How well ICU caregivers provided you with explanations that you understood. 18. Honesty of information provided to you about your child’s condition. 19. How well ICU caregivers informed you what was happening to your child and why things were being done. 20. Consistency of information provided to you by the ICU caregivers about your child’s condition. 21. Parent/caregiver feeling included during the decision-making process. 22. Parent/caregiver feeling of support during the decision-making process. 23. Parent/caregiver feeling of control over the care of his/her child. 24. Adequate time to have parent’s/caregiver’s concerns addressed and questions answered [only 2 response options: (1) I could have used more time = poor; (2) I had adequate time = excellent].