Family ratings of ICU care. Is there concordance within families?

Purpose: To examine heterogeneity of quality-of-care ratings within families and to examine possible predictors of concordance. Materials and methods: We examined two aspects of agreement within families: response similarity and the amount of exact concordance in responses in a cohort of Danish ICU family members participating in a questionnaire survey (the European Quality Questionnaire: euroQ2). Results: Two hundred seventy-four family respondents representing 122 patients were included in the study. Identical ratings between family members occurred in 28%–59% of families, depending upon the specific survey item. In a smaller sample of 28 families whose patients died, between 39% and 86% gave identical responses to items rating end-of-life care. There was more response variance within than between families, yielding low estimates of intrafamily correlation. Statistics correcting for chance agreement also suggested modest within-family agreement. Conclusions: The finding that variance is higher within than between families suggests the value of including multiple participants within a family in order to capture varying points of view.