According to the present study, the average satisfaction with care rate is 88.9%. 35.9% of the participants were completely satisfied with the care provided. The average value of satisfaction with decision-making is slightly lower, 79.1%. A small percentage of the participants (9.7%) declared absolutely satisfied with decision making. Average overall satisfaction was calculated at 85%, while 8.8% of the participants were completely satisfied. Recent studies have addressed the issue of family members’ satisfaction of ICU treated patients. Kourti et al (2014) carried out a study in a public hospital in Athens and Chalkidi et al (2016) conducted a study in a public hospital in northern Greece both used the FS-ICU 24, Carlson et al (2015) used the FSCCQ and Jacob et al (2016) used the FS-ICU 24 both conducted studies in hospitals in United States. High satisfaction with care scores were reported in all studies (32–35)
The findings of the present study show that satisfaction with care, decision making, and overall satisfaction are not related to the participant’s gender, age or relationship with the patient. Similarly, Chalkidi et al (2016) found that participant’s age and relationship with the patient is not associated with satisfaction with care and decision-making. In contrast, Sottile et al (2016) demonstrated that spouses expressed more satisfaction than other relatives, while no correlation was found between satisfaction and age, gender and previous ICU experience (35, 36).
A significant negative correlation was found between CD-RISC-25 and PSS-14 (p < 0.001). This may be due to the fact that resilient participants are able to adapt to stressful situations, use protective mechanisms, modify the risks and limit the negative effects. This corroborates previous findings. According to Sottile et al (2016), individuals with high resilience score experience less stress symptoms (36). According to Min et al (2013) and Davidson et al (2005), resilience protects against mental disorders such as depression, anxiety and acute stress (18, 19). The present study provided evidence that CD-RISC-25 is positively associated with DSES (p = 0.019). In agreement, Rahmati et al (2017) demonstrated that the application of spiritual interventions increases resilience (37). Even though the Greek literature concerning spirituality of family members of ICU treated patients is limited, Plakas et al (2011), found that spirituality is the basic source of power and courage for relatives of ICU treated patients and it helps them relieve of negative emotions (38). Literature has also reported that spirituality, and faith in a higher power are used by individuals of any religion in order to manage stressful situations related to health problems (39).
In the present study no significant association was found between the DSES and the PSS-14. However, according to Casarini et al (2009), spirituality was classified as the second most common way to manage stressful situations by relatives of ICU treated patients (26). In addition, according to Schleder et al (2013), spirituality prevents and reduces negative emotions (23). Finally, according to Chan & Twinn, (2007), the shift to religion is one of the basic strategies used by relatives of ICU treated patients when they experience stressful situations (40).
The findings of the present study suggest that the DSES is positively and significantly associated with overall satisfaction, satisfaction with care, and decision-making. This may be due to the fact that participants’ connection with a higher power helps them understand and accept pain and discomfort, thus limiting their needs and increasing their satisfaction (23, 26). Moreover, it has emerged that CD-RISC-25 and PSS-14 are not significantly related to overall satisfaction, satisfaction with care and decision-making. Different results have been demonstrated by Sottile et al (2016). They found that resilience is significantly associated with satisfaction from care and decision-making (36). Bailey et al (2010) did not find either a significant correlation between perceived stress and satisfaction with care and decision-making (41).
Only gender was found to be significantly associated with PSS-14 (p = 0.050). Women had higher scores, indicating more perceived stress than men. Similar results have been demonstrated by Plaszewska-Zywko & Gazda (2012), Paparigopoulos et al (2006), Chui & Chan (2007) and Pochard et al (2005) (42–45). Conversely, according to Anderson et al (2009), stress is associated with young age, low educational level, and is not correlated with gender, ethnicity, religion, or relationship with the patient (9).
The participants’ relationship with the patients (p = 0.030) and the frequency that they went to the church (p < 0.001) were independently associated with the DSES. Participants who were brothers of the patients had higher spirituality score than those who were spouses. Moreover, the more frequently the participants went to the church, the higher their spirituality score. This finding agrees with Plakas et al (2011). They analyzed that spirituality is expressed by visiting places of worship (38).
The participants’ gender (p = 0.033) and their relationship with the patient (p = 0.046) were independently associated with the CD-RISC-25. Women were significantly less resilient than men, and patients’ sons and daughters were significantly less resilient than spouses. This may be due to the fact that sons and daughters could not adapt to the critical situation (17). In contrast, Sottile et al (2016) found that resilience is not significantly related to gender (36).