Understanding Response Rates to Surveys about Family Members’ Psychological Symptoms after Patients’ Critical Illness

Abstract Context Achieving adequate response rates from family members of critically ill patients can be challenging, especially when assessing psychological symptoms. Objectives To identify factors associated with completion of surveys about psychological symptoms among family members of critically ill patients. Methods Using data from a randomized trial of an intervention to improve communication between clinicians and families of critically ill patients, we examined patient- and family-level predictors of the return of usable surveys at baseline, 3- and 6-months (N=181, 171, and 155, respectively). Family-level predictors included baseline symptoms of psychological distress, decisional independence preference, and attachment style. We hypothesized that family with fewer symptoms of psychological distress, a preference for less decisional independence, and secure attachment style would be more likely to return questionnaires. Results We identified several predictors of the return of usable questionnaires. Better self-assessed family-member health status was associated with a higher likelihood, and stronger agreement with a support-seeking attachment style with a lower likelihood, of obtaining usable baseline surveys. At 3 months, family-level predictors of return of usable surveys included having usable baseline surveys, status as the patient’s legal next-of-kin, and stronger agreement with a secure attachment style. The only predictor of receipt of surveys at 6 months was the presence of usable surveys at 3 months. Conclusion We identified several predictors of the receipt of surveys assessing psychological symptoms in family of critically ill patients, including family member health status and attachment style. Using these characteristics to inform follow-up mailings and reminders may enhance response rates.