Questionnaires on family satisfaction in the adult ICU; a systematic review including psychometric properties

Objectives: To perform a systematic review of the literature to determine which questionnaires are currently available to measure family satisfaction with care on the ICU and to provide an overview of their quality by evaluating their psychometric properties. Data Sources: We searched PubMed, Embase, The Cochrane Library, Web of Science, PsycINFO and CINAHL from inception until October 30, 2013. Study Selection: Experimental and observational research articles reporting on questionnaires on family satisfaction and/or needs in the ICU were included. Two reviewers determined eligibility. Data Extraction: Design, application mode, language and the number of studies of the tools were registered. With this information the tools were globally categorized according to validity and reliability: level I (well established quality), II (approaching well-established quality), III (promising quality) or IV (unconfirmed quality). The quality of the highest level (I) tools was assessed by further examination of the psychometric properties and sample size of the studies. Data Synthesis: The search detected 3,655 references, from which 135 articles were included. We found 27 different tools that assessed overall or circumscribed aspects of family satisfaction with ICU care. Only four questionnaires were categorized as level I: the CCFNI, the SCCMFNA, the CCFSS and the FS-ICU. Studies on these questionnaires were of good sample size (>n=100) and showed adequate data on face/content validity and internal consistency. Studies on the CCFNI, the FS-ICU also contained sufficient data on inter-rater/test-retest reliability, responsiveness and feasibility. Generally, data on measures of central tendency and sensitivity to change were scarce. Conclusions: Of all the questionnaires found, the CCFNI and the FS-ICU were the most reliable and valid in relation to their psychometric properties. However, a universal “best questionnaire” is indefinable because it depends on the specific goal, context and population used in the inquiry.