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

Health and Quality of Life Outcomes

the IPREA Study group¹  Karine Baumstarck²  Mohamed Boucekine²  Pascal Auquier²  Isabelle Villard³  Marie-Agnès Geantot⁴  Maïté Garrouste-Orgeas⁵  Olivier Collange⁶  Mélanie Fromentin⁷  Coralie Vigne⁸  Arnaud Follin⁹  Julien Pottecher^1,10  Anne Renault^1,11  René Robert^1,12  Olivier Mimoz^1,12  Marion Venot^1,13  Elie Azoulay^1,13  Nathalie Revel^1,14  Martine Nyunga^1,15  Bernard Floccard^1,16  Audrey Berric^1,17  Pierre Kalfon^1,18  Juliette Audibert^1,18  René-Gilles Patrigeon^1,19  Achille Sossou^2,20  Didier Thevenin^2,21  Georges Simon^2,22  Philippe Estagnasie^2,23  Quentin Levrat^2,24  Thomas Signouret^2,25 

[1] ;Aix-Marseille Univ, School of medicine - La Timone Medical Campus, EA 3279 CEReSS - Health Service Research and Quality of Life Center;Anesthésie Réanimation, CHU Beaujon, AP-HP;Département d’Anesthésie Réanimation, CHU Dijon Bourgogne;Médecine intensive et réanimation, Groupe Hospitalier Paris Saint-Joseph;Réanimation chirurgicale polyvalente, Hôpital Civil, CHU Strasbourg;Réanimation chirurgicale, CHU Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP);Réanimation chirurgicale, CHU Hôpital Nord, Assistance Publique–Hôpitaux de Marseille;Réanimation chirurgicale, Hôpital Européen Georges Pompidou, AP-HP;Réanimation chirurgicale, Hôpital Hautepierre, CHU Strasbourg;Réanimation médicale, CHU Brest;Réanimation médicale, CHU La Milétrie;Réanimation médicale, CHU Saint-Louis, AP-HP;Réanimation médico-chirurgicale, Hôpital Pasteur, CHU Nice;Réanimation polyvalente, CH Victor Provo;Réanimation polyvalente, CHU Edouard Herriot, Hospices Civils de Lyon;Réanimation polyvalente, Centre Hospitalier Intercommunal Toulon/La Seyne sur mer;Réanimation polyvalente, Hôpital Louis Pasteur, CH de Chartres;Réanimation, CH Auxerre;Réanimation, CH Emile Roux;Réanimation, CH Lens;Réanimation, CH Troyes;Réanimation, Clinique Ambroise Paré;Réanimation, Groupe Hospitalier de La Rochelle-Ré-Aunis;Réanimation, Hôpital Européen de Marseille;

关键词: IPREA;    Discomfort;    Critical care;    Validation;    Questionnaire;   

DOI  :  10.1186/s12955-019-1101-5

来源: DOAJ

【 摘 要 】

Abstract Background and aims We 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. Methods The 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. Results A 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. Conclusion The 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 registration clinicaltrial.gov NCT02442934 (registration date: May 18, 2015, retrospectively registered).

【 授权许可】

Unknown