Family Satisfaction with Care in the Intensive Care Unit: Psychometric Analysis of FS-ICU 24R

Background: Assessing the quality of ICU care directly from the patient’s perspective is challenging. Therefore, it is essential to train health professionals with resources that allow them to evaluate family satisfaction, with reliable and valid instruments, capable of supporting staff, managers and family members in the management of care centered on the person and family. The Family Satisfaction with Care in the Intensive Care Unit 24 (FS-ICU 24) is the most reliable and valid measure of family satisfaction. Recently the FS-ICU was revised and little psychometric evaluation has been done on the FS-ICU 24R. Objective: This study aimed to evaluate the psychometric properties of FS-ICU 24R using the version, translated and adapted to Brazilian Portuguese. Methods: The data was collected with 200 family members of patients admitted to Intensive Care Units in three hospitals in the state of Rio Grande do Sul between October 2021 and January 2022. The coefficient α-Cronbach was used to determine the internal consistency of FS-ICU 24R. The validity of the revised questionnaire and its subscales was performed by factorial (construct), discriminant, and convergent validity. The construct was tested by exploratory factor analysis with Varimax orthogonal rotation. The relationship between observed variables and latent variables was evaluated through Confirmatory Factor Analysis, with testing of models suggested in exploratory factor analysis and by the main author of the questionnaire, through adequacy indexes and comparison of the models. Results: The evaluation of internal consistency showed a α-Cronbach of 0.97. The results of the exploratory factor analysis showed that the number of items was preserved; however, instead of the two factors present in the original questionnaire, three were retained, explaining 74.20% of the data variance, with a Kaiser-Meyer-Olkin indicator of 0.95 and eigenvalue of 1.10. In the Confirmatory Factor Analysis, the three factors presented factorial loadings above 0.70; the values of the Average Variance extracted were above 0.5, and composite validity indexes above 0.70. The instrument maintained the same items but distributed in three factors (the first factor “overall satisfaction”, includes satisfaction with the atmosphere, communication, and support of professionals to the family; the second factor ‘family satisfaction with patient care’, and the third ‘satisfaction with the decision-making process'). Conclusions: We conclude that the FS-ICU 24R questionnaire was valid and reliable to evaluate the satisfaction of families in Intensive Care Units but that the use of sub-scale scores may be dependent on context or version of the questionnaire.