Perceived discomfort in patients admitted to intensive care (detect discomfort 1) : A prospective observational study

• Published in: Critical care and resuscitation 2019-06, Vol.21 (2), p.103-109
• Main Authors: Jacques, Theresa, Ramnani, Anil, Deshpande, Kush, Kalfon, Pierre
• Format: Article
• Language: English
• Subjects: Admission and discharge; Adolescent; Age factors in disease; Aged; Australia; Care; Critical Care; Critical Illness - psychology; Critical Illness - therapy; Female; Humans; Intensive Care Units; Male; Middle Aged; Outcome assessment (Medical care); Pain perception; Participant observation; Patients; Prospective Studies; Psychological aspects; Psychometrics; Quality of Health Care; Reproducibility of Results; Surveys and Questionnaires - standards
• ISSN: 1441-2772
• DOI: 10.1016/S1441-2772(23)00659-2

"Background: Discomfort experienced by patients admitted to intensive care units (ICUs) is an important indicator of the quality of care provided, but few studies have evaluated the incidence and magnitude of discomfort in critically ill patients. The IPREA (Inconforts des Patients de REAnimation) discomfort questionnaire is a tool developed by French intensivists and validated in the French language with good internal consistency (Cronbach's alpha, 0.78). Objectives: To translate and validate in English the IPREA discomfort questionnaire, to evaluate discomfort perceived by patients in intensive care, and to identify predictors of discomfort. Design, setting and participants: After translating the IPREA questionnaire using published methods that use principles of good practice for translating and culturally adapting patient-reported outcomes measures, all eligible patients (aged > 18 years, Glasgow Coma Scale score of 15, English speaking) admitted to our ICU over the 6-month period from April 2017 to September 2017 were surveyed within 24 hours of ICU discharge. Patient-perceived discomfort was measured using the translated IPREA questionnaire. The patients were asked to score their discomfort for each of 16 items on a scale of 0 (no discomfort) to 100 (maximum discomfort). An overall discomfort score was computed as the mean score of the 16 individual discomfort scores. Multivariate analysis was performed to identify predictors of discomfort. Main outcome measures: Translated questionnaire internal consistency. Individual and overall discomfort scores. Results: A total of 168 patients (58% men; mean age, 60.1 +/- 14.8 years; mean APACHE [Acute Physiology and Chronic Health Evaluation] II score, 13.8 +/- 5.6) completed the questionnaire. The translated questionnaire had good internal consistency (Cronbach's alpha, 0.82), and good content and construct validity (average inter-item correlation, 0.23). The mean overall discomfort score was 18.4 +/- 12.5, and discomfort scores did not differ between men and women or between types of ICUs (general ICU, cardiothoracic ICU or high dependency unit). On multivariate analysis, increasing age was an independent predictor of a low discomfort score (beta, -0.27; 95% CI, -0.42 to -0.12; P = 0.001). Conclusion: Patients admitted to our ICU reported low overall discomfort. There was an inverse relationship between age and perceived discomfort. The translated questionnaire for measuring discomfort performed well in our s