Relative Caregivers’ Satisfaction towards Nursing Care of Neuro Patients in Hospital Universiti Sains Malaysia (USM)

Over the past decade, the provision of medical care had received increased attention in the general critical care community [1]. In the neurointensive care unit (neuro ICU), it is important to build a good rapport with their family member as the patient unable to decide for themselves. Assessing relative satisfaction level toward nursing care of neuro patients provides a way to determine whether the nursing care goals were attained.  Directly measuring this in patients in the neuro ICU is difficult because of their clinical status. Thus, relative (surrogate) satisfaction is used as a proxy measure [3].   The satisfaction survey, Family Satisfaction-ICU (FS-ICU), has been thoroughly validated in the general critical care population [2]. The survey has been used in many countries which helped in improving the satisfaction of care of the relative caregivers with nursing care [4]. The assessment of the level of satisfaction among relative caregivers towards nursing care is important to enhance the decision-making for the patients. The current study aimed to assess the level of satisfaction among relative caregivers towards nursing care of neuro patients and to determine the relationship between the satisfaction among relative caregivers towards nursing care and decision-making related to patient care in neuro ICU, Hospital USM. The study was conducted in the neuro ICU ward, Hospital USM. A cross-sectional study was conducted among 80 respondents using the Malay version of the Family Satisfaction Intensive Care Unit (FS-ICU) questionnaire. The statistical analysis was conducted using descriptive statistics and the Pearson correlation test. There are three items to measure the satisfaction level among relative caregivers towards nursing care which are concern and quality of care toward patients; the service and efforts in meeting their needs; and skills, care, and the atmosphere in the ICU. These items were given the score of 1-5 (very dissatisfied) and 6-10 (very satisfied).   In this study, a total of 80 patients’ relatives were included. The sociodemographic characteristics and the frequency of distribution among participants and their percentage were shown in Table 1. The items for service and effort in meeting their needs (Question 1-6) showed the highest mean score, 9.21 (SD=0.58). Next, the concern and quality of care towards patients (Question 7-12) stated a mean score of 9.20 (SD=0.56), and the items for skills, care, and the atmosphere in the ICU (Question 13-18) stated a mean score of 8.71 (SD=0.71). Taken together, the relative caregivers were satisfied with the treatment and care for the patient. The scores of a single item of the FS-ICU were presented in Table 2. There was a significant correlation between the satisfaction level among relative caregivers towards nursing care and decision-making related to patient care in the neuro ICU, Hospital USM (r = 0.805, p < 0.001) (Table 3). A previous study reported a significant improvement in client satisfaction scores when a proper education of staff and the development of good strategies for addressing the concerns of family members were applied [5]. Furthermore, the delivery of nursing care was improved by identifying the right communication technique for patients’ care with their relatives [5]. The nurses also created an awareness of good communication with patients’ family members to reduce their anxiety regarding patients’ current progress of treatment [5]. In general, collaboration in deciding has been promoted to incorporate patient and family preferences into the customized treatment plan for an individual [6]. Taken together, a high satisfaction level with the collaboration in decision-making shown in this study might use to enhance the opportunity to improve the satisfaction level among relative caregivers in the ICU.   In conclusion, relative caregivers’ satisfaction has become an important measurement in improving the quality of care for patients in neuro ICU wards. They are expecting the nurses to give the best quality of care to their family members’ despite being unable to express their wishes, lack of knowledge, and fear. Hence, nurses play a major role in understanding the relatives’ concerns and needs in determining the best decision-making for the patients.