Intensive Care Experience Questionnaire Research Articles

Psychometric Properties of the Persian Version of the Intensive Care Experience Questionnaire (ICE-Q).

Background and Purpose: It is important to assess the experience of patients who have been admitted to an intensive care unit to provide the best treatment and nursing care possible. Therefore, a valid and reliable tool is necessary for measurement. This study aimed to determine the psychometric properties of the Persian version of the Intensive Care Experience Questionnaire (ICEQ) for open-heart surgery patients. Methods: The study was conducted in four steps: translation, face and content validity, confirmatory factor analysis, and reliability assessment. The adapted questionnaire was administered to 200 Iranian cardiac surgery patients who had received treatment in an intensive care unit within the past month. Results: In the final Persian version of ICEQ, there are 4 factors and 21 items. Following the translation and cultural adaptation process, the content validity was evaluated. Three items had content validity ratio < 0.6, so they were deleted. Scale-level content validity index/Average was 0.81 and more than 0.7 for each item on the scale. This scale was validated through confirmatory factor analysis using fit indicators (comparative fit index, normalized fit index, root mean square error of approximation, and chi-square). There was Cronbach's alpha of 0.71-0.85, and intraclass correlation coefficients were 0.82-0.93 for subscales. Conclusions: The Persian version of ICEQ showed appropriate psychometric properties. This scale may be useful to inform the development of effective interventions to improve subsequent outcomes for Iranian open-heart surgery patients.

The Relationship Between Patients' Overall ICU Experiences, Psychological Distress, and Sleep Quality Among Jordanian Burn Patients: A Cross-Sectional Study.

Objectives This study aimed to assess patients' experiences, psychological distress, and sleep quality among Jordanian burn patients. Method A cross-sectional, correlational design was used. A sample of 150 patients admitted to the burn-specific intensive care unit completed the study. Demographical data, Intensive Care Experience Questionnaire, and sleep ICU questionnaire were used for data collection. Descriptive and inferential statistics were used for analysis. Results Participants were found to have poor sleep quality and severe psychological distress. Sleep quality was negatively associated with awareness of ICU experience (r = -.190, P = .020) and psychological distress (r = -.190, P = .020) and positively associated with the recall of experience in ICU. Female participants had significantly greater ICU experience frightening and recall. Participants who experienced burn complications had significantly higher psychological distress. Discussion There is a need to offer an encouraging environment to burn patients to improve the psychological health and sleep quality in critical care units.

Measuring the intensive care experience of intensive care unit patients: A cross-sectional study in western China

BackgroundThe negative experiences of intensive care unit (ICU) patients seriously affect their quality of life and survival outcomes. Thus, it is of great significance to evaluate the monitoring experience of ICU patients for the clinical improvement of their experiences and promote interventions. ObjectivesThe objective of this study was to investigate patients' experiences of ICU and to understand the sources of patient experience and influencing factors. MethodsFrom November 2021 to September 2022, a cross-sectional survey was conducted with 600 inpatients from four grade A–III hospitals in western China. Data were collected using the Chinese version of the Intensive Care Experience Questionnaire. Results585 valid questionnaires were collected, the response rate was 97.5%. ICU patients in western China scored below-the-average for their intensive care experience. Family monthly income, occupation types, medical payment method, type of ICU, ICU admission plan, ICU admission times, mechanical ventilation use, fertility status, analgesia, sedation, and Acute Physiology and Chronic Health Evaluation II scores are important factors influencing ICU patients' intensive care experience. ConclusionsMedical staff need to pay attention to patient experience, improve the awareness of patient stressors and influencing factors, design nursing programs conducive to patient-positive experience, and promote interventions to further improve the long-term prognosis of patients. The results of this study can also be used as a set of nursing-sensitive indicators for evaluating nursing structure, process, and outcomes.

Intensive Care Experience of Critical Care Patients and Its Related Factors : A Secondary Analysis Study

Purpose : This study investigates the experiences of patients in intensive care units (ICUs), and the factors influencing these experiences.Method : We used a cross-sectional survey design to analyze previously collected cohort data from 891 patients who spent over 24 hours in 19 ICUs across four university hospitals in Busan, South Korea between June 2019 and July 2020. Within a week of ICU discharge, participants completed the Korean version of the Intensive Care Experience Questionnaire, covering four areas: “awareness of surroundings,” “frightening experiences,” “satisfaction with care,” and “recall of experiences.” We used multiple linear regression to identify factors associated with the ICU experience.Results : Low income (β = -.08, &lt;i&gt;p&lt;/i&gt; = .016), unplanned hospitalization (β = -.09, &lt;i&gt;p&lt;/i&gt; = .006), sedation (β = -.16, &lt;i&gt;p&lt;/i&gt; ＜ .001), and delirium (β = -.15, &lt;i&gt;p&lt;/i&gt; ＜ .001) reduce patients’ awareness of their surroundings. Frightening experiences are associated with being female (β = -.07, &lt;i&gt;p&lt;/i&gt; = .027), experiencing delirium (β = -.15, &lt;i&gt;p&lt;/i&gt; ＜ .001), and longer stays in the ICU (β = -.14, &lt;i&gt;p&lt;/i&gt; ＜ .001). Using sedatives decreases satisfaction with care (β = -.08, &lt;i&gt;p&lt;/i&gt; = .048). Living alone (β = -.08, &lt;i&gt;p&lt;/i&gt; = .013) and using painkillers (β = -.08, &lt;i&gt;p&lt;/i&gt; = .020) reduces recall of experiences.Conclusion : Negative ICU experiences are significantly associated with being female, living alone, lower income, unplanned admission, using sedatives and painkillers, delirium, and longer stays in the ICU. Thus, improving ICU experiences requires interventions that address modifiable factors, such as delirium, medication, and length of ICU stays.

Item analysis of the Korean version of the Intensive Care Experience Questionnaire: Using the Rasch Model based on Item Response Theory

Purpose : This study aimed to examine the item characteristics of the Korean version of the intensive care experience questionnaire (K-ICEQ) using the Rasch analysis model of the item response theory.Methods : In this methodological study, the validity of the scale was examined, and a secondary analysis was conducted using cohort data of patients who were discharged from the intensive care units (ICU). Data from 891 patients who responded to the K-ICEQ upon ICU discharge were analyzed. The WINSTEP program was used to analyze item characteristics, including item difficulty, fit indices, appropriateness scale, and separation reliability.Results : The difficulty level of all 26 items of the K-ICEQ was appropriate, and the fit indices of the 25 items, except for item 18, were good. The 5-point scale of the K-ICEQ was not appropriate in the three subscales. The item separation reliability was good in all subscales, but did not meet the criteria in terms of respondents.Conclusion : The results of examining the item characteristics of the K-ICEQ revealed a good degree of difficulty, fitness, and item separation reliability. To increase the validity of the K-ICEQ, we suggest the rearrangement of the overall item order, modification of the item description of the “recall of experience” subscale, and reduction of the scale response level.

Do Humor Styles of Patients Affect Their Intensive Care Experiences?

The study was conducted in order to examine the correlation between the humor styles of the patients and their intensive care experiences. This study was conducted in descriptive and correlational design. The population of the study consisted of the patients who were treated in the general surgery, neurosurgery, neurology, and organ transplantation intensive care units of a university hospital. Its sample consisted of 204 intensive care patients. The data were collected using the Personal Information Form prepared by the researchers, Humor Styles Questionnaire, and Intensive Care Experience Questionnaire. The descriptive statistics, independent samples t test, One Way ANOVA, post-hoc tests, Correlation analysis and Cronbach's Alpha reliability analysis test were used to assess the data. In the study, it was found that the intensive care patients mostly used the affiliative and aggressive humor style and they had a positive intensive care experience. Additionally, there were a positive significant weak correlation between the affiliative humor and the subscale of “satisfaction with care” of ICEQ and a negative significant weak correlation between the subscales of “frightening experiences” and “recall of experience”. As a result of the study, it was observed that the patients using the affiliative humor style had less pessimistic experience, remembered the intensive care experiences less, and were satisfied with the care provided the intensive care unit.

The relationship between person-centred care and the intensive care unit experience of critically ill patients: A multicentre cross-sectional survey

BackgroundPerson-centred care has the potential to improve the patient experience in the intensive care unit (ICU). However, the relationship between person-centred care perceived by critically ill patients and their ICU experience has yet to be determined. ObjectivesThe aim of this study was to investigate the relationship between person-centred care and the ICU experience of critically ill patients. MethodsThis study was a multicentre, cross-sectional survey involving 19 ICUs of four university hospitals in Busan, Korea. The survey was conducted from June 2019 to July 2020, and 787 patients who had been admitted to the ICU for more than 24 hours participated. We measured person-centred care using the Person-Centered Critical Care Nursing perceived by Patient Questionnaire. Participants' ICU experience was measured by the Korean version of the Intensive Care Experience Questionnaire that consists of four subscales. We analysed the relationship between person-centred care and each area of the ICU experience using multivariate linear regression. ResultsPerson-centred care was associated with ‘awareness of surroundings’ (β = 0.29, p < .001), ‘frightening experiences’ (β = −0.31, p < .001), and ‘satisfaction with care’ (β = 0.54, p < .001). However, there was no significant association between person-centred care and ‘recall of experience’. ConclusionsWe observed that person-centred care was positively related to most of the ICU experiences of critically ill patients except for recall of experience. Further studies on developing person-centred nursing interventions are needed.

Cross-Cultural Validation of the Intensive Care Experience Questionnaire in Korean Critical Care Survivors

PurposeThe purpose of this study was to culturally adapt the Intensive Care Experience Questionnaire (ICEQ) for Korean patients and evaluate its validity and reliability. MethodsThis cross-sectional study comprised two phases. The first phase involved the cultural adaptation of the ICEQ. In the second phase, the psychometric properties of the adapted measure were evaluated. Cultural adaptation was conducted in accordance with the World Health Organization's process. The adapted questionnaire was administered to 200 Korean patients who had received treatment in an intensive care unit within the past six months. Model fit was assessed through confirmatory factor analysis, and convergent validity and discriminant validity of the items were assessed. Known-groups validity was evaluated using the t test and Cohen's effect size. Cronbach's α was used to examine internal consistency reliability. ResultsThe Korean version of the ICEQ (K-ICEQ) consists of 26 items and four subscales: Frightening Experiences, Awareness of Surroundings, Satisfaction with Care, and Recall of Experiences. The model fit indices, convergent validity, and discriminant validity of the K-ICEQ were all satisfactory. According to the results of the test of known-groups validity, intensive care unit (ICU) experience varied according to gender, planned ICU admission, mechanical ventilation, and restraints application. Cronbach's α of the K-ICEQ subscales ranged from .74 to .93. ConclusionThe validity and reliability of the K-ICEQ reflecting the characteristics of Korean ICU patients were satisfactory. The K-ICEQ can be used to evaluate the experience of Korean ICU patients and contribute to the development of interventions to improve the ICU experience.

Health-Related Quality of Life and Associated Factors in Intensive Care Unit Survivors 6 Months After Discharge.

Intensive care unit survivors often have diminished health-related quality of life. To describe health-related quality of life of former intensive care patients and identify associated factors 6 months after hospital discharge. Six months after discharge, 193 patients from an intensive care unit completed the Short Form-36 Health Survey; measures of sleep; Intensive Care Experience Questionnaire; Depression, Anxiety and Stress Scales; and Posttraumatic Stress Disorder Checklist. Norm-based scores were calculated for the Short Form-36. Bivariate associations with Short Form-36 scores were tested by using the Pearson correlation. Multiple linear regression was used to identify independent associations with health-related quality of life. All scores on the Short Form-36 (physical component summary, 41.8; mental component summary, 48.2) were less than population norms. Bivariate associations with health-related quality of life (P < .05) were scores on the Acute Physiology and Chronic Health Evaluation II, hospital length of stay, awareness of surroundings and frightening experiences, depression, anxiety, stress, posttraumatic symptoms, and sleep quality at 2 and 6 months. In linear regression, scores on the Acute Physiology and Chronic Health Evaluation II, hospital length of stay, and sleep quality at 6 months were independently associated with Short Form-36 physical summary scores (P < .001); depression and stress were independently associated with mental summary scores (P < .001). Sleep, depression, and stress are potential targets for interventions to improve health-related quality of life and improve recovery.

Patients' experience of being in intensive care units

PurposeThe aim of the study was to describe the Jordanian patients' experience during their stay in intensive care units (ICUs) and to explore factors that contribute to positive and negative experiences. Materials and methodsA descriptive, exploratory design was used. The study was conducted at 3 hospitals in Jordan. Patients were selected from surgical and medical ICUs within 72hours after transfer to the floor. Data were collected through structured interviews using the Intensive Care Experience Questionnaire with 98 patients. ResultsData showed high level of awareness among patients to surrounding persons (82.2%) and relatives (90.3%). Although 58% of patients perceived pain as a problem during their stay, patients' perception of the care as good as it should be was generally high (82%). Male and female patients differed significantly in their frightening experiences (t=−2.559, P=.01). ConclusionUnderstanding patients’ experiences in the ICU would increase nurses' awareness to patients’ stressors. It would help policy makers in designing structural and process-related care activities in a manner that promotes positive patient experiences, which would improve quality of care in general and specifically ICU patients’ outcome. The ICU environment was found to adversely affect patients in many aspects. In addition, most patients were able to recall their ICU experience.

Developing an electronic ICU specific minimum dataset by examining current team leader nursing handover content

Introduction: Health related quality of life (HRQOL) is often reported to be low in survivors of ICU. Factors associated with HRQOL need further investigation. Objective: To identify factors associated with former ICU patients’ HRQOL six months after hospital discharge. Methods: Patients (n=193) from three ICUs of a tertiary referral hospital completed the Short Form-36 (SF-36) HRQOL health survey six months after discharge, together with measures of sleep (ICU, ward, two and six months after discharge), Intensive Care Experience Questionnaire, Depression, Anxiety and Stress Scales, and Post-traumatic Stress Disorder Checklist. Clinical and demographic data were obtained from hospital records. Norm-based scores were calculated for the SF-36. Following descriptive statistics, bivariate tests of association with SF-36 scores were tested with Pearson’s r or Chi-square. Multiple linear regression was used to identify independent associations with HRQOL. Results: Respondents were 59.0±16.2 years old, 35% were female; main reasons for ICU admission were cardiovascular (43%) and neurological (22%). All scores on the SF-36 were below population norms; the Physical Component Summary was 41.8±11.7 and Mental Component Summary 48.2±11.0. Significant bivariate associations with HRQOL (p< .05) were APACHE II (r=−.187), hospital length of stay (r=−.330), ICEQ Awareness of surroundings (r= .170) and Frightening experiences (r=−.198), depression (r=−.289), anxiety (r=−.350), stress (r=−.215), post-traumatic symptoms (r=−.331) and sleep quality at two months (r=−.346) and six months (r=−.456). Linear regression showed that APACHE II, hospital length of stay and sleep quality at sixmonthswere independently associated with SF-36 Physical Summary (p< .0005); depression and stress were independently associated with Mental Summary scores (p< .0005). Conclusion: Severity of illness and hospital length of stay continue to bepredictors ofHRQOL sixmonths after hospital discharge.

“Not being able to talk was horrid”: A descriptive, correlational study of communication during mechanical ventilation

The purpose of this study was to describe the patient experience of communication during mechanical ventilation. This descriptive study is a secondary analysis of data collected to study the relationship between sedation and the MV patients' recall of the ICU. Interviews, conducted after extubation, included the Intensive Care Experience Questionnaire. Data were analysed with Spearman correlation coefficients (rs) and content analysis. Participants were recruited from a medical-surgical intensive care unit in the Midwest United States. Participants (n = 31) with a mean age of 65 ± 11.9 were on the ventilator a median of 5 days. Inability to communicate needs was associated with helplessness (rs = .43). While perceived lack of information received was associated with not feeling in control (rs = 41) and helplessness (rs = 41). Ineffective communication impacted negatively on satisfaction with care. Participants expressed frustration with failed communication and a lack of information received. They believed receipt of information helped them cope and desired a better system of communication during mechanical ventilation. Communication effectiveness impacts patients' sense of safety and well-being during mechanical ventilation. Greater emphasis needs to be placed on the development and integration of communication strategies into critical care nursing practice.

Sleep during and after critical illness and psychological health in recovery

Introduction: Intensive care patients often report sleep disruption in ICU and during recovery from critical illness. Objectives: To assess patients’ self-reported sleep quality in ICU, on the hospital ward and 6 months after discharge, whether patients who experience sleep disruption in ICU experience problems sleeping during recovery and whether sleep disruption is associated with psychological recovery. Methods: Patients in ICU for ≥2 nights self-reported on their sleep prehospital (Insomnia Severity Index), in ICU and the ward (Richards Campbell Sleep Questionnaire) and 6 months after hospital discharge (Pittsburgh SleepQuality Index), and after discharge completed the Intensive Care Experience Questionnaire (ICEQ), the Depression, Anxiety and Stress Scales, the Posttraumatic Stress Checklist (PCL) and SF-36quality of life. Associations between sleep and outcomes were examined using bivariate and multiple linear regression analyses Results: Patients (n=222) were aged (mean± SD) 57.2±17.2 years, 35% female and had APACHE II scores of 25±5, ICU stays of 5±6 days and BMI 26±5. Poor sleep at 6 months was reported by 101 (57%), and by 38 patients (17%) at all timepoints. In multivariate analysis, prehospitalisation insomnia (p= .0005), sleep quality on theward (p= .006) plus anxiety (p= .002), andmental (p= .0005) and physical health (p=0005) were associated with sleep disruption in survivors 6 months after ICU treatment. Conclusions: Sleep is a significant issue for over half of survivors 6 months after ICU treatment. Poor sleep at 6 months was associated with prehospital insomnia, sleep quality on the hospital ward and anxiety, physical health and mental health at 6 months.

Effect of attachment styles of individuals discharged from an intensive care unit on intensive care experience

IntroductionThe present study was conducted as a cross-sectional type to examine the effect of attachment styles of individuals discharged from an intensive care unit (ICU) on intensive care experience and health status. MethodsThe population of the study included patients discharged from the ICU in a university hospital. The sample included 108 patients who were selected via simple random sampling method. Data were collected using a Demographic Information Questionnaire, Intensive Care Experience Questionnaire, the Relationship Scales Questionnaire, and Acute Physiology and Chronic Health Evaluation II system. In the analysis of data, frequency, percentage, mean, standard deviation, minimum and maximum values, and Mann-Whitney U, Kruskal-Wallis, Bonferroni-adjusted Mann-Whitney, and Spearman ρ correlation tests were used. ResultsA significant difference in the awareness of surroundings subscale for attachment styles was noted (χ2 = 10.820, P ≤ .01). Moreover, participants' attachment styles (fearful, preoccupied, and dismissing) and intensive care experience were significantly correlated. A significant correlation was found between participants' secure attachment style points and Acute Physiology and Chronic Health Evaluation II score during discharge from the ICU (r = 0.322, P = .001). ConclusionIndividuals' attachment styles should be taken into consideration when planning and implementing the nursing care and treatment of individuals hospitalized in an ICU.

Predictors of emotional outcomes of intensive care

Negative emotional outcomes (anxiety, depression and post-traumatic stress) have been identified in patients discharged from intensive care. The aims of this prospective, longitudinal study were to assess levels of and changes in emotional outcome after intensive care, and to explore how these relate to objective and subjective indicators of the intensive care experience. Emotional outcome was assessed using the Hospital Anxiety and Depression and Impact of Event Scales. Anxiety (p = 0.046) and depression (p = 0.001) were reduced subsequently, but not avoidance (p = 0.340) or intrusion (p = 0.419). Most objective (age, gender, length of ICU and hospital stay) and subjective indicators (as measured by the Intensive Care Experience Questionnaire) of the intensive care experience were related to negative emotional outcome. Subjective interpretation of the intensive care experience emerged as a consistent predictor of adverse emotional outcome, in both the short- and the long-term.