Family Satisfaction in Adult Intensive Care

The current ANS featured article is titled “Family Satisfaction in the Adult Intensive Care Unit: A Concept Analysis” authored by Cristobal Padilla Fortunatti, MSN; Joseph P. De Santis, PhD, APRN, ACRN, FAAN and Cindy L. Munro, PhD, RN, ANP-BC, FAAN, FAANP, FAAAS. The article is available for download at no cost while it is featured, and we welcome you comments here about this work. Here is the message for ANS readers from the authors about this work:

            In the context of family-centered care, the concept of family satisfaction has received increased attention as a construct that attempts to encompass the evaluation of salient experiences by family members while navigating the critical illness of a loved one. This concept analysis provides an initial framework for family satisfaction in the adult ICUs that includes attributes such as adequate communication with health care providers, emotional support, closeness to the patient, comforting environment, decision-making involvement, and nursing care of the patient. In light of this work, some of the challenges that remain in the understanding, conceptualization, and measurement of family satisfaction in the ICU are:

• Studies on family satisfaction in the ICU studies only assessed a single-family member rather than the entire family. The use of the concept of “family satisfaction” may incorrectly suggest that the satisfaction of all the members of the family is measured.
• Fulfilling ICU family members´ needs and expectations fall on healthcare providers. ICU’s stressful nature, high workload, and lack of communication skills training may prevent them, particularly nurses, to have more frequent and meaningful interactions with family members.
• Current family satisfaction in the ICU questionnaires does not involve the evaluation of the expectations regarding the items/topics measured. Thus, higher family satisfaction levels may be the reflection of lower expectations and conversely, lower family satisfaction may be attributed to higher expectations.
• Within family satisfaction in the ICU literature, the use of the concept “dissatisfaction” or to classify family members as satisfied v/s dissatisfied based on arbitrary cut-off scores may not have enough theoretical support. Furthermore, it oversimplifies the complex nature of family satisfaction, leading to an inaccurate picture of the quality of care delivered to ICU family members.
• Incentives for healthcare institutions to improve family satisfaction in the ICU are almost non-existent. The high costs of the ICUs and the absence of incentives to support and improve the experiences of family members in current reimbursement schemes represent a significant barrier to the improvement of family satisfaction.