title: ICU-RESPECT: An index to assess patient and family experiences of respect in the intensive care unit.
abstract: The purpose of the study is to develop a brief index of patient and family experiences of respect in the intensive care unit (ICU).
  
  
  
  We designed a questionnaire with 44 items representing 12 themes that emerged from prior in-depth interviews with ICU patients and families. After pilot testing, items with minimal variability were eliminated. The resulting 21-item questionnaire was administered to patients and families in 5 adult ICUs. Psychometric analyses were conducted.
  
  
  
  Fifty-seven questionnaires were completed. Factor analysis resulted in a unidimensional scale consisting of 10 items with an α of .85 and an Eigen value of 11.3. Factor loadings ranged from 0.54 to 0.84, and item-test correlations ranged from 0.47 to 0.71. The mean total score was 7.25 out of a maximum of 10. Scores were lower for surgical than medical or disease-specific ICUs.
  
  
  
  The "ICU-RESPECT" index demonstrates high reliability and concurrent validity in ICU patients and families. Future research should validate this index in other ICU settings, assess its predictive validity, and evaluate different methods for maximizing response rate. As hospitals address patient experience more broadly in response to national metrics, the index could identify particular behaviors or ICUs that would benefit from interventions to enhance respectful treatment.
authors.affiliation: Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205. Electronic address: ggeller@jhu.edu.
authors.forename: Gail
authors.initials: G
authors.lastname: Geller
authors.affiliation: Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205. Electronic address: ebranyo1@jhu.edu.
authors.forename: Emily D
authors.initials: ED
authors.lastname: Branyon
authors.affiliation: University of California, Institute for Health and Aging, San Francisco, CA 94118. Electronic address: lindsay.forbes@ucsf.edu.
authors.forename: Lindsay K
authors.initials: LK
authors.lastname: Forbes
authors.affiliation: Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205. Electronic address: rjtopazian@gmail.com.
authors.forename: Rachel J
authors.initials: RJ
authors.lastname: Topazian
authors.affiliation: Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205. Electronic address: bweir3@jhu.edu.
authors.forename: Brian W
authors.initials: BW
authors.lastname: Weir
authors.affiliation: Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205. Electronic address: jcarrese@jhmi.edu.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Carrese
authors.affiliation: Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205; Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD 21205. Electronic address: mcbeach@jhmi.edu.
authors.forename: Mary Catherine
authors.initials: MC
authors.lastname: Beach
authors.affiliation: Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205. Electronic address: jsugarman@jhu.edu.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Sugarman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care / Q000592:standards*; D005190:Family; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011594:Psychometrics; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult
keywords: Ethics; Human dignity; Intensive care units; Patient care; Professional-patient relationship; Psychometrics