Quality of life on admission to the intensive care: can we query the relatives?

Abstract

To study whether the Short Form-36 questionnaire can be used to assess the patient's quality of life on admission to the ICU by use of proxies in both scheduled and emergency admissions. Prospective study involving direct interviews of patients and relatives before or during ICU stay in a 10-bed mixed intensive care unit in a 654-bed university affiliated hospital. Patients before major elective surgery ( n=55) or following emergency admissions ( n=57). Patients and proxies completed a health questionnaire in the first 72 h following emergency admission or the day before a scheduled admission to the ICU. Internal consistency was evaluated by measurement of Cronbach's alpha. All dimensions of the SF-36 had adequate internal consistency. On all eight dimensions a significant correlation was found between the patient and their proxy. In general, proxies underestimated the patient's quality of life although differences were small (less than 5%). On most items a good to very good agreement was found (alpha>0.6). Quality of life assessment was not affected by the admission status of the patient (acute or elective admission and surgical or medical diagnosis). The SF-36 questionnaire completed by a proxy can reliable assesses the quality of life of the critically ill patient on admission to the ICU. Proxies underestimated the patient's quality of life, although the differences were small.