Measuring family engagement in intensive care: Validation of the FAME tool

INTRODUCTION: Engaging family members in patient care in the intensive care unit (ICU) is a recommended practice by critical care societies. However, there are currently no validated tools to measure family engagement in the ICU setting. The objective of this study was to validate the FAMily Engagement (FAME) tool in the ICU. METHODS: The FAME study was a multicenter prospective cohort study of family members of ICU patients in 8 Canadian ICUs. Family members completed the FAME questionnaire during the ICU stay. The FAME questionnaire comprised 12 items that assessed various domains of family engagement behavior. FAME scores were reported in a 0-100 scoring system with higher scores indicating increased care engagement. Following hospital discharge, we assessed associations between the FAME score and family satisfaction with care and mental health (anxiety and depression). The internal consistency (reliability), convergent validity, and predictive validity of the FAME tool were evaluated. RESULTS: There were 269 family members (age 56.8 ± 15.1; 68.4 % women) included in the analysis. The most common relationships to the patient were spouse/partner (40.5 %) and daughter/son (33.8 %). The overall mean FAME score was 77.7 ± 14.8. The FAME score had high internal consistency (Cronbach's α = 0.83) and the tool demonstrated convergent and predictive validity. The FAME score was associated with family satisfaction, but not with mental health outcomes. CONCLUSION: The FAME tool demonstrated reliability, convergent, and predictive validity in this multicenter ICU cohort. The FAME tool could be used to evaluate the effectiveness of family engagement interventions.