Patient and relative satisfaction with intensive care. Importance of duration and quality of life

Abstract

Objectives: • To determine the satisfaction with intensive care management of surviving patients and the relatives of both surviving and non-surviving patients. • To determine both patients' and relatives' views on the importance of duration and quality of life following intensive care in deciding whether intensive care is justified. • To compare the views of patients and their relatives. Setting: Normal residence of survivors and their relatives. Design: Structured interview and health profiles. Subjects: Surviving adult patients admitted to two intensive care units (ICUs) over a 15-week period; and relatives of all patients including those of non-survivors. Results: There were 80 participants, of whom 30 were patients and 50 relatives (76% uptake of interview). Patients and relatives had high median satisfaction scores that did not vary significantly with outcome as judged on health profile scales. The relatives of non-survivors were as satisfied with ICU as those of survivors. Duration of life was considered less important than quality of life in justifying intensive care by both patients and their relatives. However, relatives felt that short duration of life was more important in determining whether intensive care should be initiated than did the patients (p=0.025). The median score of importance of quality of life for patients was 5.0 (range: 1-7), while for relatives it was slightly more important with a score of 6.0 (range: 1-7) although the difference was not significant (p=0.067). Patients and their relatives were glad that intensive care had been instituted, with a high median score of 7.0 (range: 1-7) in favour of ICU from patients. Relatives of deceased patients were slightly less pleased that intensive care had been instituted, with a median score of 6.0 (range: 1-7), while relatives of survivors had a median score of 7.0 (range: 1-7), although this difference was not significant Conclusions: Patients and their relatives were pleased with ICU care and would elect to undergo it again. Both patients and relatives view the outcome in terms of quality of life as more important than duration of life.