• J Palliat Med · Dec 2011

    Measuring family satisfaction with care and quality of dying in the intensive care unit: does patient age matter?

    • Mithya Lewis-Newby, J Randall Curtis, Diane P Martin, and Ruth A Engelberg.
    • Seattle Children's Hospital and Regional Medical Center, Division of Pediatric Critical Care Medicine, University of Washington, Seattle, Washington, USA. mithya.lewis-newby@seattlechildrens.org
    • J Palliat Med. 2011 Dec 1;14(12):1284-90.

    RationaleFew studies have examined the role of patient age on family experiences of end-of-life care.ObjectivesTo assess measurement characteristics of two family-assessed questionnaires across three patient age groups.MethodsFour hundred and ninety-six patients who died in an intensive care unit (ICU) at a single hospital were identified and one family member per patient was sent two questionnaires: 1) Family Satisfaction in the ICU (FS-ICU); and 2) Quality of Dying and Death (QODD). Two hundred and seventy-five surveys were returned (55.4%). We analyzed three age groups: <35, 35-64, and ≥65 years. Differences were evaluated using χ(2) tests to evaluate ceiling, floor, and missing responses; Kruskal-Wallis tests to compare median scores on items and total scores; and linear regression controlling for patient sex, race, diagnosis, and family-member sex, race, education, and relationship to provide adjusted comparisons of total and subscale scores.ResultsMeasurement characteristics varied by age groups for both questionnaires. Missing values and floor endorsements were more common for the younger age groups for six items and one overall rating score. Ceiling endorsements were more common for the older group for 11 items. Fifteen items and four total scores were significantly higher in the older group.ConclusionsThe FS-ICU and QODD questionnaires performed differently across patient age groups. Assessments of family satisfaction and quality of dying and death were higher in the oldest group, particularly in the area of clinician-family communication. Studies of the dying experience of older adults may not generalize to patients of other ages, and study instruments should be validated among different age groups.

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