Development and validation of a questionnaire for quantitative assessment of perceived discomforts in critically ill patients.
OBJECTIVE
To develop and validate the IPREA (Inconforts des Patients de REAnimation) questionnaire for the assessment of discomfort perceived by patients related to their intensive care unit (ICU) stay.


METHODS
This was a two step-study comprising a phase of item generation conducted in one ICU and a phase of psychometric evaluation during a multicenter prospective cohort study in 14 ICUs. Patients were unselected consecutive adult surviving ICU patients. On the day of ICU discharge, a nurse asked patients to rate the severity of 16 discomfort sources, from 0 to 100. Ten percent of patients were randomly chosen to be questioned again to assess the reproducibility.


RESULTS
Of 1,380 eligible patients, 1,113 survived and 868 patients could be questioned. The highest scores were for sleep deprivation (35 ± 33), being restrained by tubing, wires, and cables (33 ± 30), pain (32 ± 30), and thirst (32 ± 34). No multidimensional structure was identified. The mean overall score of discomfort was 22 ± 14. Internal consistency was satisfactory using Cronbach's alpha coefficient (0.78). The test-retest reliability study found average measure intraclass correlations ranging from 0.70 to 0.92. The mean duration of the questionnaire administration was 10 ± 7 min.


CONCLUSIONS
The psychometric properties and acceptability of the IPREA questionnaire make it a potential instrument for measuring discomfort perceived by unselected ICU patients.
Kalfon
Pierre
P
Service de Réanimation Polyvalente, Hôpital Louis Pasteur, Hôpitaux de Chartres, 28018, Chartres Cedex, France. pkalfon@ch-chartres.fr.
Mimoz
Olivier
O
Département d'Anesthésie-Réanimation, Centre Hospitalier Universitaire (CHU) de Poitiers, Université de Poitiers and INSERM ERI-23, Poitiers, France.
Auquier
Pascal
P
Laboratoire de Santé publique, EA3279, Faculté de médecine, Marseille, France.
Loundou
Anderson
A
Unité d'Aide Méthodologique à la Recherche Clinique et Epidémiologique, Délégation Régionale à la Recherche Clinique, Assistance Publique-Hôpitaux de Marseille, Marseille, France.
Gauzit
Rémy
R
Département d'Anesthésie-Réanimation, Unité de Réanimation chirurgicale, CHU Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
Lepape
Alain
A
Département d'Anesthésie-Réanimation, Unité de Réanimation chirurgicale, CHU de Lyon Sud, Pierre-Bénite, France.
Laurens
Jean
J
Service de Réanimation Polyvalente, Polyclinique des Cèdres, Mérignac, France.
Garrigues
Bernard
B
Service de Réanimation Médico-Chirurgicale, Centre Hospitalier du pays d'Aix, Aix-en-Provence, France.
Pottecher
Thierry
T
Département d'Anesthésie-Réanimation, Réanimation Polyvalente, CHU Hautepierre, Strasbourg, France.
Mallédant
Yannick
Y
Département d'Anesthésie-Réanimation, Université de Rennes 1 and INSERM U 620, CHU Pontchaillou, Rennes, France.
D000328:Adult; D000368:Aged; D016638:Critical Illness; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D011594:Psychometrics; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires