Family satisfaction in the Intensive Care Unit: A multidimensional network analysis approach

Abstract

Introduction: Family satisfaction in the Intensive Care Unit (ICU) is a multidimensional construct for the quality of care. Understanding its structure and interrelationships requires advanced statistical analysis. The aim of this study was to explore the latent structure of family satisfaction, evaluate the instrument's reliability, and analyze its relationships. Materials and methods: A cross-sectional study was conducted with 47 patients' relatives. Cronbach's α, exploratory and confirmatory factor analysis, network analysis, latent class analysis, and a Bayesian approach were applied. Finally, mediation and moderation analyses were performed. Results: The instrument demonstrated excellent reliability (α = 0.954). Factor analysis confirmed a four-factor structure that explained 77.8% of the total variance. Network analysis identified physician skill and honest information as the most central nodes. Latent class analysis revealed three distinct profiles: highly satisfied, moderately satisfied, and dissatisfied. Bayesian analysis provided evidence that physician skill and honest communication are predictors of satisfaction. Mediation and moderation analyses showed that medical communication mediates the relationship between professional competence and satisfaction, with stronger effects in women and family members living with the patient. Discussion: The application of advanced statistical analysis allowed a comprehensive understanding of family satisfaction in the ICU, confirming its multidimensional structure. The skill of physicians, nurses, and transparent communication are the pillars of satisfaction.