Assessment of functional status in the ICU: instruments used in Brazilian settings

Luiza Martins Faria,Sayonara De Fátima Faria Barbosa

doi:10.1590/1980-5918.030.001.ar02

Luiza Martins Faria, Sayonara De Fátima Faria Barbosa

Open Access

https://doi.org/10.1590/1980-5918.030.001.ar02

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Abstract

Abstract Introduction: Physical function impairment is a significant concern for patients who survive their intensive care unit (ICU) stay, due to its impact on the patient’s independence and functional status. In this context, the choice of a suitable instrument for the assessing functional status is important, because an inappropriate assessment could lead to incorrect conclusions regarding patient prognosis, treatment benefits, and condition. Objective: To identify which functional assessment tools are used in Brazil to assess patients who are in ICU. Additionally, we investigated the translation, adaptation, and validation of these instruments for use in this population. Methods: We searched Pubmed, SCIELO, Lilacs, and Scopus in November 2015. No language or date restrictions were applied to the search. Results: Ten studies and seven instruments were identified. The most commonly used instruments were the Karnofsky Performance Status Scale Scores and the Functional Independence Measure. Conclusion: The instruments found in the review were neither specifically developed to assess the functional status of ICU patients, nor were they validated for use in this population in Brazil. Transcultural development or adaptation studies should be conducted, followed by a validation process.

Highlights

Physical function impairment is a signi icant concern for patients who survive their intensive care unit (ICU) stay, due to its impact on the patient's independence and functional status
For patients hospitalized in the intensive care unit (ICU), surviving the critical illness that led to hospitalization is only the beginning of a long and arduous journey of physical and psychological rehabilitation [4]
Given the impact of ICU admission on patients' functional status and the importance of quality assessment tools, this study aimed to identify which functional assessment tools are used in Brazil to assess patients who are in ICU, and to investigate the translation, adaptation, and validation of these instruments for use in this population

Summary

Introduction

Physical function impairment is a signi icant concern for patients who survive their intensive care unit (ICU) stay, due to its impact on the patient's independence and functional status. According to the International Classi ication of Functioning, Disability and Health (ICF), functioning should be considered in a biopsychosocial model and encompasses all body functions (physiological functions and body structure), activities (performance of a task or action by an individual), and participation (an individual's involvement in a real-life situation) [7] Within this context, a prolonged ICU stay negatively affects physical functioning because it leads to numerous consequences for the physical and psychological capacity of patients, in addition to the social and economic impacts to the individual and his/her family [8]. This has a negative in luence on the patients' quality of life and can persist for years after discharge from the ICU [5, 9, 10]

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