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Development and validation of a questionnaire for quantitative assessment of perceived discomforts in critically ill patients

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Abstract

Purpose

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.

Conclusion

The psychometric properties and acceptability of the IPREA questionnaire make it a potential instrument for measuring discomfort perceived by unselected ICU patients.

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Acknowledgments

We thank all members of the nursing staff of each participating ICU for their strong involvement and motivation in the study.

Author information

Authors and Affiliations

  1. Service de Réanimation Polyvalente, Hôpital Louis Pasteur, Hôpitaux de Chartres, 28018, Chartres Cedex, France

    Pierre Kalfon

  2. Département d’Anesthésie-Réanimation, Centre Hospitalier Universitaire (CHU) de Poitiers, Université de Poitiers and INSERM ERI-23, Poitiers, France

    Olivier Mimoz

  3. Laboratoire de Santé publique, EA3279, Faculté de médecine, Marseille, France

    Pascal Auquier

  4. Unité d’Aide Méthodologique à la Recherche Clinique et Epidémiologique, Délégation Régionale à la Recherche Clinique, Assistance Publique-Hôpitaux de Marseille, Marseille, France

    Anderson Loundou

  5. Département d’Anesthésie-Réanimation, Unité de Réanimation chirurgicale, CHU Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France

    Rémy Gauzit

  6. Département d’Anesthésie-Réanimation, Unité de Réanimation chirurgicale, CHU de Lyon Sud, Pierre-Bénite, France

    Alain Lepape

  7. Service de Réanimation Polyvalente, Polyclinique des Cèdres, Mérignac, France

    Jean Laurens

  8. Service de Réanimation Médico-Chirurgicale, Centre Hospitalier du pays d’Aix, Aix-en-Provence, France

    Bernard Garrigues

  9. Département d’Anesthésie-Réanimation, Réanimation Polyvalente, CHU Hautepierre, Strasbourg, France

    Thierry Pottecher

  10. Département d’Anesthésie-Réanimation, Université de Rennes 1 and INSERM U 620, CHU Pontchaillou, Rennes, France

    Yannick Mallédant

Authors
  1. Pierre Kalfon
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  2. Olivier Mimoz
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  3. Pascal Auquier
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  4. Anderson Loundou
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  5. Rémy Gauzit
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  6. Alain Lepape
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  7. Jean Laurens
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  8. Bernard Garrigues
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  9. Thierry Pottecher
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  10. Yannick Mallédant
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Corresponding author

Correspondence to Pierre Kalfon.

Additional information

On behalf of the Comité Réanimation (Critical Care Committee) de la Société Française d’Anesthésie et de Réanimation.

Electronic supplementary material

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Appendix

Appendix

Hospital investigators of the IPREA group and trial centers

Phase 1 of item generation: ICU A and Critical Care Medicine Committee of the Société Française d’Anesthésie Réanimation (SFAR)

ICU A: Pierre Kalfon, MD (from October 1996 to December 2002); Hélène Schenk, RN, Virginie Lagueny, RN; Nadine Archambaud, RN, and the whole nursing staff, Frank Thomas, MD; Hervé Clavier, MD and Lilia Soufir, MD, Service de réanimation polyvalente, Hôpital des Diaconesses, Paris.

Comité Réanimation (Critical Care Medicine Committee) of the Société Française d’Anesthésie Réanimation (SFAR) (January 2003): Yannick Mallédant, MD, PhD, Département d’Anesthésie-Réanimation, CHU Pontchaillou, Rennes; Jean Mantz, MD, PhD, Service d’Anesthésie Réanimation, CHU Beaujon, Clichy; Claude Martin, MD, PhD, Département d’Anesthésie-Réanimation, CHU Nord, Marseille; Olivier Mimoz, MD, PhD, Département d’Anesthésie-Réanimation, CHU La Miletrie, Poitiers; Thierry Pottecher, MD, PHD, Service de réanimation polyvalente, CHU Hautepierre, Strasbourg; Benoit Vallet, Clinique d’Anesthésie et de Réanimation, Hôpital Claude Huriez, CHU de Lille; Pierre Courant, MD, Service de réanimation polyvalente, Centre Hospitalier, Avignon; Hervé Dupont, MD, PhD, Service d’Anesthésie-Réanimation, CHU Hôpital Nord, Amiens; Bernard Garrigues, Service de Réanimation médico-chirurgicale, Centre Hospitalier du pays d’Aix, Aix-en-Provence; Rémy Gauzit, MD, Département d’Anesthésie-Réanimation, Unité de Réanimation chirurgicale, CHU Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris; Laurent Jacob, MD, PhD, Département d’Anesthésie-Réanimation, Unité de réanimation chirurgicale, CHU Saint-Louis, Assistance Publique-Hôpitaux de Paris; Jean Laurens, MD, Service de réanimation polyvalente, Polyclinique des Cèdres, Mérignac; Jacques Kienlen, MD, Département d’Anesthésie-Réanimation, Hôpital Gui de Chauliac, CHU de Montpellier; Alain Lepape, MD, Département d’Anesthésie-Réanimation, Unité de Réanimation chirurgicale, CHU de Lyon Sud, Pierre-Bénite; Benoit Weber, MD, PhD, Département d’Anesthésie-Réanimation, Unité de réanimation chirurgicale, CHU Charles Nicolle, Rouen; Nicolas Bruder, MD, PhD, Département d’Anesthésie-Réanimation, Unité de Soins Intensifs Neurochirurgicaux, CHU La Timone, Marseille; Jacques Durand-Gasselin, MD, Service de réanimation polyvalente, Centre Hospitalier Intercommunal Font-Pré, Toulon; Didier Journois, Département d’Anesthésie-Réanimation, Unité de réanimation chirurgicale, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris; Didier Payen de la Garanderie, Département d’Anesthésie-Réanimation, Unité de réanimation chirurgicale, CHU Lariboisière, Assistance Publique-Hôpitaux de Paris; Jean-François Poussel, Service de réanimation polyvalente, Hôpital Bon Secours, Metz, Pierre Kalfon, Service de réanimation polyvalente, Hôpital des Diaconesses, Paris.

Phase 2 of psychometric validation (ICU 1 to 14)

Yannick Mallédant, MD, PhD, Thomas Signouret, MD, Département d’Anesthésie-Réanimation, CHU Pontchaillou, Rennes; Jean Mantz, MD, PhD, Service d’Anesthésie Réanimation, CHU Beaujon, Clichy; Claude Martin, MD, PhD, Département d’Anesthésie-Réanimation, CHU Nord, Marseille; Olivier Mimoz, MD, PhD, Département d’Anesthésie-Réanimation, Unité de réanimation chirurgicale, CHU La Miletrie, Poitiers; Thierry Pottecher, MD, PHD, Service de réanimation polyvalente, CHU Hautepierre, Strasbourg; Pierre Courant, MD, Service de réanimation polyvalente, Centre Hospitalier, Avignon; Hervé Dupont, MD, PhD, Service d’Anesthésie-Réanimation, CHU Hôpital Nord, Amiens; Patrick Arnodo, MD, Bernard Garrigues, Service de Réanimation médico-chirurgicale, Centre Hospitalier du pays d’Aix, Aix-en-Provence; Rémy Gauzit, MD, Département d’Anesthésie-Réanimation, Unité de Réanimation chirurgicale, CHU Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris; Laurent Jacob, MD, PhD, Département d’Anesthésie-Réanimation, Unité de réanimation chirurgicale, CHU Saint-Louis, Paris; Jean Laurens, MD, Service de réanimation polyvalente, Polyclinique des Cèdres, Mérignac; Alain Lepape, MD, Département d’Anesthésie-Réanimation, Unité de Réanimation chirurgicale, CHU de Lyon Sud, Pierre-Bénite; Jacques Durand-Gasselin, MD, Service de réanimation polyvalente, Centre Hospitalier Intercommunal Font-Pré, Toulon; Annabelle Tessiau, RN, Martine Perdereau, RN, Thomas Sauzeau, RN, Mouldi Hamrouni, MD, Pierre Kalfon, MD (from September 2003), Guy Monchamps, MD, and Abdelkhader Ouchenir, MD, Service de réanimation polyvalente, Hôpitaux de Chartres, Chartres; and the entire nursing staff of each participating center, all in France.

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Kalfon, P., Mimoz, O., Auquier, P. et al. Development and validation of a questionnaire for quantitative assessment of perceived discomforts in critically ill patients. Intensive Care Med 36, 1751–1758 (2010). https://doi.org/10.1007/s00134-010-1902-9

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