Instruments to measure post-intensive care syndrome: a scoping review

Background
There is an increased interest in the evaluation of post-intensive care syndrome among adult patients who survive critical illness. However, there is little consensus regarding measurement instruments in clinical practice.

Objectives
To investigate the characteristics of existing instruments used to measure this syndrome in adults.

Design and Methods
A scoping review following the Arksey and O'Malley framework and Joanna Briggs Institute guideline was conducted. Studies published between 2010 and 2021 were identified in Medline via EBSCO, CINAHL complete, EMBASE, Web of Science, AMED, and PsycINFO databases, along with grey literature were included. The search retrieved 4134 references; eligible studies were independently identified, extracted, and appraised using the Crowe Critical Appraisal Tool.

Results
Out of 4134 articles, 18 research articles underwent data extraction and analysis. Forty-one instruments were identified. Most studies (n = 14) employed two or more instruments, generating single domain-specific instruments that measured functioning within the physical (n = 10), cognitive (n = 7), psychological (n = 12), or social (n = 3) domains. Three studies detected post-intensive care syndrome (without reference to the social domain) using a single assessment tool. Instruments used to measure psychological disorders were relatively consistent within studies, with little attention being paid to the social domain.

Conclusion
While post-intensive care syndrome is recognized as a growing phenomenon among patients globally, and international practice recommendations suggest a range of instruments to measure it, evaluation of this syndrome remains inconsistent. Also, identified instruments did not comprehensively assess this syndrome and lacked data pertaining to their psychometric properties. A psychometrically robust instrument that measures all domains of post-intensive care syndrome in clinical practice is an urgent requirement.

Relevance to Clinical Practice
Prompt recognition of post-intensive care syndrome can facilitate prevention and management interventions. Urgent attention is needed to develop a valid, reliable, and practical instrument to measure this syndrome holistically.