Patient satisfaction with care in the intensive care unit: can we rely on proxies?

Abstract

To investigate whether next of kin can be addressed as proxy to assess patients' satisfaction with care in the intensive care unit (ICU). Prospective observational multicentre study. Two hundred and thirty-five patients with an ICU length of stay of ≥2 days and 266 of their adult next of kin participated. Patient satisfaction was assessed by a questionnaire, distributed upon discharge from an ICU and compared with next of kin's answers. The possible range of answers was 0-100, with higher numbers indicating higher satisfaction. The main outcome measure was the extent of agreement between patients' satisfaction with care and the ratings of their next of kin. Patients were most satisfied concerning physicians' competence (86.7±16.3), while least satisfaction was observed for the management of agitation and restlessness (78.2±23.5). There was no significant difference between next of kin's and patients' ratings. Agreement between patients and proxies was the highest concerning overall satisfaction (Cohen's κ 0.40) and the lowest for coordination of care (0.24). Spouses/partners had a higher agreement with the patients' ratings than other proxies. If the patient is unable to rate his satisfaction with care in the ICU, next of kin may be taken as an appropriate surrogate. The study has been registered at ClinicalTrials.gov, Reg No: NTC 00890513.