1
|
Baumstarck K, Boucekine M, Estagnasie P, Geantot MA, Berric A, Simon G, Floccard B, Signouret T, Fromentin M, Nyunga M, Sossou A, Venot M, Robert R, Follin A, Audibert J, Renault A, Garrouste-Orgeas M, Collange O, Levrat Q, Villard I, Thevenin D, Pottecher J, Patrigeon RG, Revel N, Vigne C, Azoulay E, Mimoz O, Auquier P, Kalfon P. Assessment of patients' self-perceived intensive care unit discomforts: Validation of the 18-item version of the IPREA. Health Qual Life Outcomes 2019; 17:29. [PMID: 30732654 PMCID: PMC6367827 DOI: 10.1186/s12955-019-1101-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 01/24/2019] [Indexed: 01/29/2023] Open
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).
Collapse
Affiliation(s)
- Karine Baumstarck
- Aix-Marseille Univ, School of medicine - La Timone Medical Campus, EA 3279 CEReSS - Health Service Research and Quality of Life Center,
- 27 bd Jean Moulin cedex 05, F-13385, Marseille, France.
| | - Mohamed Boucekine
- Aix-Marseille Univ, School of medicine - La Timone Medical Campus, EA 3279 CEReSS - Health Service Research and Quality of Life Center,
- 27 bd Jean Moulin cedex 05, F-13385, Marseille, France
| | | | | | - Audrey Berric
- Réanimation polyvalente, Centre Hospitalier Intercommunal Toulon/La Seyne sur mer, Toulon, France
| | | | - Bernard Floccard
- Réanimation polyvalente, CHU Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | | | - Mélanie Fromentin
- Réanimation chirurgicale, CHU Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Martine Nyunga
- Réanimation polyvalente, CH Victor Provo, Roubaix, France
| | | | - Marion Venot
- Réanimation médicale, CHU Saint-Louis, AP-HP, Paris, France
| | - René Robert
- Réanimation médicale, CHU La Milétrie, Poitiers, France
| | - Arnaud Follin
- Réanimation chirurgicale, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - Juliette Audibert
- Réanimation polyvalente, Hôpital Louis Pasteur, CH de Chartres, Le Coudray, France
| | | | | | - Olivier Collange
- Réanimation chirurgicale polyvalente, Hôpital Civil, CHU Strasbourg, Strasbourg, France
| | - Quentin Levrat
- Réanimation, Groupe Hospitalier de La Rochelle-Ré-Aunis, La Rochelle, France
| | | | | | - Julien Pottecher
- Réanimation chirurgicale, Hôpital Hautepierre, CHU Strasbourg, Strasbourg, France
| | | | - Nathalie Revel
- Réanimation médico-chirurgicale, Hôpital Pasteur, CHU Nice, Nice, France
| | - Coralie Vigne
- Réanimation chirurgicale, CHU Hôpital Nord, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Elie Azoulay
- Réanimation médicale, CHU Saint-Louis, AP-HP, Paris, France
| | - Olivier Mimoz
- Réanimation médicale, CHU La Milétrie, Poitiers, France
| | - Pascal Auquier
- Aix-Marseille Univ, School of medicine - La Timone Medical Campus, EA 3279 CEReSS - Health Service Research and Quality of Life Center,
- 27 bd Jean Moulin cedex 05, F-13385, Marseille, France
| | - Pierre Kalfon
- Réanimation polyvalente, Hôpital Louis Pasteur, CH de Chartres, Le Coudray, France
| | | |
Collapse
|