Dear Editor,

The next of kin of critically ill patients experience stress during the intensive care unit (ICU) stay and may develop posttraumatic stress disorder [1, 2], which could be related to a lack of understanding between families and doctors [2, 3]. The Internet represents the most easily accessible source of medical information, and 60–80 % of adults have already searched the Internet for medical information [4]. Internet use by family members has already been assessed for patients from specialities other than intensive care medicine [5], but no study has ever focused on families of ICU patients. Before analyzing the impact of medical information research on the Internet on the physician–family relationship, it is necessary to estimate the proportion of families who resort to the Internet and their characteristics.

For this purpose, we conducted a monocentric observational study between May 2012 and April 2013. The study was approved by the hospital’s review board. Patients with ICU length of stay longer than 48 h were prospectively identified. All next of kin visiting the patient were approached for survey completion on ICU days 3–5 if they had met with the physicians at least once. We designed a self-administered questionnaire for visitors (Supplementary Appendix). The questionnaire asked about sociodemographic characteristics, whether the visitors had searched the Internet, and the characteristics of that research. Finally, the respondents estimated the Internet’s influence on their understanding of the situation, their level of anxiety, and their communication with the medical team. The primary end-point was to determine the proportion of family members who carried out medical information Internet searches during the first days of the ICU stay. Secondary end-points included identification of the sociodemographic characteristics of the patients and their families that were associated with Internet information searches, reasons for Internet use, and the search strategy.

During the study period, 726 patients stayed in the ICU for over 48 h. The questionnaire was completed by 222 (36 %) visitors (Supplementary Fig. 1). Before the sixth day, 45 % had used the Internet to search for medical information. Some patient and family member characteristics were associated with increased Internet use, including family age and education as well as patient length of stay (Table 1). The characteristics of the meeting preceding the delivery of the questionnaire are reported in Supplementary Table 1. Results of the survey about Internet use by visitors are described in Supplementary Table 2. According to responders, the Internet seemed to have limited impact on the physician–family relationship, and only 49 % thought that Internet use was unavoidable. Supplementary Fig. 2 shows the percentage distribution of the clarity, reliability, and completeness of the information found on the Internet as estimated by the respondents.

Table 1 Comparison of patient and family characteristics by family Internet use
Full size table

In conclusion, in our study, barely half of families had searched the Internet for medical information, and it was predictable by patient and family characteristics. Further studies are needed to evaluate the impact of Internet use on the comprehension and satisfaction of families and on the physician–family relationship.