Psychometric properties and structural validity of the traditional Chinese version of the FAMily engagement instrument in intensive care units

Objectives: Family engagement, a key component of the ABCDEF bundle in the intensive care unit (ICU), is associated with improved clinical outcomes in patients and enhanced well-being of family members. The FAMily Engagement instrument is the only validated tool available for assessing family engagement in ICU care. However, it has not been evaluated in Chinese-speaking populations. The study aimed to translate and validate the Traditional Chinese version of the FAMily Engagement instrument (FAME-TC) among family members of ICU patients. Methods: This prospective observational study included family members who were among the most frequent visitors or primary caregivers and had accompanied corresponding patients for at least 3 days after ICU admission. Data collection included demographic information, FAME-TC, the Depression, Anxiety, and Stress Scale-21 Items (DASS21), and the five-level version of EuroQoL–5 dimensions (EQ-5D-5L). Internal consistency, construct validity, and concurrent validity of the FAME-TC were evaluated to confirm the reliability and validity. Results: A total of 200 participants were enrolled (mean age: 48.46 ± 14.52 years; female: 57.5 %). The FAME-TC showed excellent reliability (Cronbach’s α = 0.91). Exploratory factor analysis (EFA) confirmed a two-factor structure: family engagement in care and family perceived support from the healthcare team. No significant correlation was observed between the FAME-TC score and subscales of the DASS21 (p > 0.05), while a statistically significant positive correlation was found between the FAME-TC score and the EQ-5D-5L visual analogue scale level (r = 0.26, p < 0.001). Conclusions: The FAME-TC exhibits satisfactory reliability and validity for assessing family engagement in critical care. Implications for clinical practice: Healthcare providers can use the FAME-TC to evaluate family engagement degree and implement targeted interventions to strengthen family involvement in critical care, thereby improving patients’ clinical outcomes and improving family members’ quality of life.