Emotional strain, communication, and satisfaction of family members in the intensive care unit compared with expectations of the medical staff: experiences from a Norwegian University Hospital

Objectives: To determine satisfaction in regard to information concerning, and support and facilities for relatives in the intensive care unit (ICU), and to compare this with the staff's expectations on these issues; to determine relatives' degree of psychological distress and use of hypnotics, anxiolytics, and antidepressants; finally, to compare the distress of relatives of survivors and relatives of non-survivors. Design: Prospective study. Setting: University-affiliated ICU. Methods: Relatives of 50 patients who survived at least 6 days in the ICU and relatives of 18 non-survivors who stayed for at least 24 h anonymously completed a mailed questionnaire at home 4 weeks after treatment in the ICU. Forty-three staff members (69%) answered the questionnaire. The degree of satisfaction was measured on a five-point scale (0-4). Main results: The average satisfaction scores were 3.4+/-0.6 SD for relatives of survivors and 3.4+/-0.5 for relatives of non-survivors. Staff expected a significantly lower degree of satisfaction, with a score of 2.9+/-0.5 (P<0.001). The distress scores of relatives of survivors (2.7 +/- 1.0) were no higher than the ones of relatives of non-survivors (2.4 +/- 0.6) during the ICU stay, but significantly lower than staff expectations (3.2 +/- 0.5) (P<0.01). The use of medication was moderate. Conclusions: The relatives' satisfaction was greater than anticipated by the staff. Staff generally expected a higher degree of distress among relatives than was actually the case. Relatives were very satisfied with the support and communication in the ICU despite substantial distress. Relatives of survivors and non-survivors were equally satisfied.