Assessment of patients’ self-perceived intensive care unit discomforts: Validation of the 18-item version of the IPREA

Abstract

Background and aimsWe reported the validation of the 18-item version of the ‘Inconforts des Patients de REAnimation (IPREA)’ questionnaire that includes 2 new items exploring feeling depressed and shortness of breath during an intensive care unit (ICU) stay.MethodsThe validation process was integrated in a multicenter, cluster-randomized, controlled, two-parallel group study built to assess the effectiveness of a tailored multicomponent program for reducing self-perceived discomfort in the ICU. All patients aged 18 years or older who survived an ICU stay of 3 calendar days or more were eligible for inclusion. Data collection included demographics (sex, age), type of admission (medical and surgical), health status scores at admission (Knaus score and McCabe index, Simplified Acute Physiology Score (SAPS) II), specific ICU therapeutics such as mechanical ventilation (MV), noninvasive ventilation (NIV), use of vasopressors, or renal replacement therapy (RRT), and ICU stay duration.ResultsA total of 994 patients were included. The initial structure of IPREA was confirmed using confirmatory factor analysis showing satisfactory fit (RMSEA at 0.042, CFI at 0.912). No multidimensional structure was identified, allowing the calculation of an overall discomfort score. The three highest discomforts were sleep deprivation, thirst, and perfusion lines and other devices, and the 3 lowest discomforts were limited visiting hours, hunger, and isolation. The overall discomfort score of the 18-item version of IPREA did not differ between men and women. Higher age was significantly correlated with a lower overall discomfort score. While MV was not linked to self-reported discomfort, patients treated by NIV reported higher overall discomfort scores than patients not treated by NIV.ConclusionThe 18-item version of IPREA is easy to use and possesses satisfactory psychometric properties. The availability of a reliable and valid French questionnaire asking about patients’ self-perceived ICU discomforts enables feedback from the health care team to be incorporated in a continuous quality health care improvement strategy.Trial registrationclinicaltrial.gov NCT02442934 (registration date: May 18, 2015, retrospectively registered).

Risk factors and events in the adult intensive care unit associated with pain as self-reported at the end of the intensive care unit stay

“…However, during the IPREA3 study, patients were questioned with a 18-item version of the IPREA questionnaire resulting from the addition of two discomfort items, item 17 and item 18 corresponding to dyspnea and feeling depressed, respectively, to the previous 16-item version. Since then, an ancillary study of the IPREA3 study yielded the psychometric validation of the 18-item version of the IPREA questionnaire [ 16 ].…”

“…The effectiveness of the program was assessed from the French questionnaire on ICU-related self-perceived discomforts (Table 1 ) [ 15 , 16 ].…”

“…For example from needles, catheters, tubes, being turned or washed ”. As each of the discomfort items, the pain-related discomfort was scored from 0 (minimal discomfort) to 10 (maximal discomfort) [ 16 ]. Each participating ICU was supplied with tablets with Internet connection if the patients’ rooms lacked computers or Internet access.…”

Risk Factors and Events in the Adult Intensive Care Unit Associated With Pain as Self-Reported at the End of the Intensive Care Unit Stay

“…We used the validated the French questionnaire on ICU-related self-perceived discomforts (IPREA), which was rst validated through a process based on international guidelines using a large sample of critically ill patients hospitalized in different ICU types (medical, surgical, and mixed ICUs) at different institutions (university and non-university hospitals) [13,14]. The IPREA contains 18 discomfort items, including the pain-related discomfort item (ESM2), each of them being scored from 0 (minimal discomfort) to 10 (maximal discomfort).…”

Risk factors and events in the adult intensive care unit associated with pain as self-reported at the end of the intensive care unit stay

“…We used the recently validated 18-item version of the French questionnaire on ICU-related self-perceived discomforts (IPREA), which was rst validated through a process based on international guidelines using a large sample of critically ill patients hospitalized in different ICU types (medical, surgical, and mixed ICUs) at different institutions (university and non-university hospitals) [14]. IPREA actually contains 18 discomfort items, including the pain-related discomfort item (ESM2), each of them being scored from 0 (minimal discomfort) to 10 (maximal discomfort) [15]. Each participating ICU was supplied with tablets with internet connection if the patients' rooms lacked computers or internet access.…”