Abstract
AimsTo develop a questionnaire to identify Intensive Care survivor needs at key transitions during the recovery process, and assess its validity and reliability in a group of ICU survivors.MethodsDevelopment of the Support Needs After ICU (SNAC) questionnaire was based on a systematic scoping review, and analysis of patient interviews (n = 22). Face and content validity were assessed by service users (n = 12) and an expert panel of healthcare professionals (n = 6). A pilot survey among 200 ICU survivors assessed recruitment at one of five different stages after ICU discharge [(1) in hospital, (2) < 6 weeks, (3) 7 weeks to 6 months, (4) 7 to 12 months, or (5) 12 to 24 months post‐hospital discharge]; to assess reliability of the SNAC questionnaire; and to conduct exploratory data analysis. Reliability was determined using Cronbach's alpha for internal consistency; intraclass correlation coefficients for test–retest reliability. We explored correlations with sociodemographic variables using Pearson's correlation coefficient; differences between questionnaire scores and patient demographics using one‐way ANOVA.ResultsThe SNAC questionnaire consisted of 32 items that assessed five categories of support needs (informational, emotional, instrumental [e.g. practical physical help, provision of equipment or training], appraisal [e.g. clinician feedback on recovery] and spiritual needs). ICU survivors were recruited from Northern Ireland, England and Scotland. From a total of 375 questionnaires distributed, 202 (54%) were returned. The questionnaire had high internal consistency (0.97) and high test–retest reliability (r = 0.8) with subcategories ranging from 0.3 to 0.9.ConclusionsThe SNAC questionnaire appears to be a comprehensive, valid, and reliable questionnaire. Further research will enable more robust examination of its properties e.g. factor analysis, and establish its utility in identifying whether patients' support needs evolve over time.Relevance to clinical practiceThe SNAC questionnaire has the potential to be used to identify ICU survivors' needs and inform post‐hospital support services.
Highlights
Development of the Support Needs After ICU (SNAC) questionnaire was based on a systematic scoping review, and analysis of patient interviews (n = 22)
Further research will enable more robust examination of its properties e.g. factor analysis, and establish its utility in identifying whether patients' support needs evolve over time
Future research using the SNAC questionnaire following the same group of patients across their recovery continuum would identify whether patients' support needs evolve over time
Summary
The need for support throughout the post-ICU recovery process has long been identified.[1,2,3,4] A key priority for the intensive care community is determining how and when to support ICU survivors and their families/carers.[5,6] Guidelines recommend that individualized assessment, rehabilitation, and multidisciplinary follow-up services should be provided,[7,8] but there is little consensus on the components, individualization, timing, mode of delivery (e.g. face to face, telephone or online), and duration of such services.[9,10,11,12,13,14] there are no standardized, validated tools to evaluate the extent to which these services, where they exist, meet patients' needs.
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