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      Instruments to assess post-intensive care syndrome assessment: a scoping review and modified Delphi method study

      research-article
      1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 9 , 10 , 10 , 9 , 11 , 9 , 9 , 5 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 26 , , 31 , 1 , 32
      Critical Care
      BioMed Central
      Activities of daily living, Cognitive function, Mental illness, Physical function, Post-intensive care syndrome, Quality of life

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          Abstract

          Background

          The assessment of post-intensive care syndrome (PICS) is challenging due to the numerous types of instruments. We herein attempted to identify and propose recommendations for instruments to assess PICS in intensive care unit (ICU) survivors.

          Methods

          We conducted a scoping review to identify PICS follow-up studies at and after hospital discharge between 2014 and 2022. Assessment instruments used more than two times were included in the modified Delphi consensus process. A modified Delphi meeting was conducted three times by the PICS committee of the Japanese Society of Intensive Care Medicine, and each score was rated as not important (score: 1–3), important, but not critical (4–6), and critical (7–9). We included instruments with ≥ 70% of respondents rating critical and ≤ 15% of respondents rating not important.

          Results

          In total, 6972 records were identified in this scoping review, and 754 studies were included in the analysis. After data extraction, 107 PICS assessment instruments were identified. The modified Delphi meeting reached 20 PICS assessment instrument recommendations: (1) in the physical domain: the 6-min walk test, MRC score, and grip strength, (2) in cognition: MoCA, MMSE, and SMQ, (3) in mental health: HADS, IES-R, and PHQ-9, (4) in the activities of daily living: the Barthel Index, IADL, and FIM, (5) in quality of life: SF-36, SF-12, EQ-5D-5L, 3L, and VAS (6), in sleep and pain: PSQI and Brief Pain Inventory, respectively, and (7) in the PICS-family domain: SF-36, HADS, and IES-R.

          Conclusion

          Based on a scoping review and the modified Delphi method, 20 PICS assessment instruments are recommended to assess physical, cognitive, mental health, activities of daily living, quality of life, sleep, and pain in ICU survivors and their families.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s13054-023-04681-6.

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          Most cited references85

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          PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation

          Scoping reviews, a type of knowledge synthesis, follow a systematic approach to map evidence on a topic and identify main concepts, theories, sources, and knowledge gaps. Although more scoping reviews are being done, their methodological and reporting quality need improvement. This document presents the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist and explanation. The checklist was developed by a 24-member expert panel and 2 research leads following published guidance from the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network. The final checklist contains 20 essential reporting items and 2 optional items. The authors provide a rationale and an example of good reporting for each item. The intent of the PRISMA-ScR is to help readers (including researchers, publishers, commissioners, policymakers, health care providers, guideline developers, and patients or consumers) develop a greater understanding of relevant terminology, core concepts, and key items to report for scoping reviews.
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            Scoping studies: towards a methodological framework

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              The PHQ-9: validity of a brief depression severity measure.

              While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity. The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples. In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.
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                Author and article information

                Contributors
                mamashockpapashock@yahoo.co.jp
                Journal
                Crit Care
                Critical Care
                BioMed Central (London )
                1364-8535
                1466-609X
                7 November 2023
                7 November 2023
                2023
                : 27
                : 430
                Affiliations
                [1 ]Division of Disaster and Emergency Medicine, Department of Surgery Related, Kobe University Graduate School of Medicine, ( https://ror.org/03tgsfw79) 7-5-2 Kusunoki, Chuo-ward, Kobe, 650-0017 Japan
                [2 ]Critical Care Research Group, The Prince Charles Hospital, ( https://ror.org/02cetwy62) Brisbane, QLD 4032 Australia
                [3 ]Institute for Molecular Bioscience, The University of Queensland, ( https://ror.org/00rqy9422) Brisbane, QLD 4067 Australia
                [4 ]GRID grid.411724.5, ISNI 0000 0001 2156 9624, Non-Profit Organization ICU Collaboration Network (ICON), ; Tokyo, 113-0033 Japan
                [5 ]GRID grid.410775.0, ISNI 0000 0004 1762 2623, Department of Critical Care and Emergency Medicine, , Japanese Red Cross Maebashi Hospital, ; 389-1, Asakura-Machi, Maebashi-shi, Gunma, 371-0811 Japan
                [6 ]Berlin Institute of Health Center for Regenerative Therapies (BCRT), Charité – Universitätsmedizin Berlin, ( https://ror.org/001w7jn25) Augustenburger Platz 1, 13353 Berlin, Germany
                [7 ]Department of Rehabilitation Medicine, Osaka Police Hospital, ( https://ror.org/015x7ap02) 10-31 Kitayama, Tennouji, Osaka, 543-0035 Japan
                [8 ]Department of Rehabilitation Medicine, Okayama University Hospital, ( https://ror.org/019tepx80) 2-5-1 Shikata, Kitaku, Okayama, 700-8558 Japan
                [9 ]Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, ( https://ror.org/03t78wx29) 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551 Japan
                [10 ]Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, ( https://ror.org/038dg9e86) Hiroshima, 734-8551 Japan
                [11 ]Department of Pharmaceutical Services, Hiroshima University Hospital, ( https://ror.org/038dg9e86) Hiroshima, 734-8551 Japan
                [12 ]GRID grid.443092.8, ISNI 0000 0004 7433 9955, Department of Physical Therapy, , Toyohashi SOZO University School of Health Sciences, ; 20-1, Matsushita, Ushikawa, Toyohashi, 440-8511 Japan
                [13 ]Department of Nursing, Fujita Health University Hospital, ( https://ror.org/02r3zks97) 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192 Japan
                [14 ]Department of Emergency and Critical Care Medicine, Osaka Medical and Pharmaceutical University, ( https://ror.org/01y2kdt21) 2-7, Daigaku-machi, Takatsuki, Osaka 569-8686 Japan
                [15 ]Department of Emergency and Critical Care Medicine, St. Luke’s International Hospital, ( https://ror.org/002wydw38) 9-1, Akashi-cho, Chuo-ku, Tokyo, 104-8560 Japan
                [16 ]Department of Acute and Critical Care Nursing, School of Nursing, Sapporo City University, ( https://ror.org/000yk5876) Kita 11 Nishi 13, Chuo-ku, Sapporo, 060-0011 Japan
                [17 ]GRID grid.413984.3, Department of Intensive Care Medicine, , Iizuka Hospital, ; 3-83, Yoshio-machi, Iizuka, Fukuoka 820-8505 Japan
                [18 ]GRID grid.416810.a, ISNI 0000 0004 1772 3301, Department of Rehabilitation, , Japanese Red Cross Okayama Hospital, ; 2-1-1 Aoe, Kita-ward, Okayama, 700-8607 Japan
                [19 ]Department of Scientific Research, Japanese Society for Early Mobilization, 1-2-12, Kudan-kita, Chiyoda-ku, Tokyo, 102-0073 Japan
                [20 ]Clinic Sumita, 305-12, Minamiyamashinden, Ina-cho, Toyokawa, Aichi 441-0105 Japan
                [21 ]Department of Physical Therapy, Juntendo University, ( https://ror.org/01692sz90) 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
                [22 ]Department of Rehabilitation, Sapporo General Hospital, ( https://ror.org/0498kr054) Kita11-Nishi13, Chuou-ku, Sapporo, Hokkaido 060-8604 Japan
                [23 ]Department of Critical Care and Anesthesia, National Center for Child Health and Development, ( https://ror.org/03fvwxc59) 2-10-1 Okura, Setagaya, Tokyo, 157-8535 Japan
                [24 ]Department of Rehabilitation Medicine, Nagasaki University Hospital, ( https://ror.org/05kd3f793) 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
                [25 ]GRID grid.174567.6, ISNI 0000 0000 8902 2273, Department of Physical Therapy Science, , Nagasaki University Graduate School of Biomedical Sciences, ; 1-7-1 Sakamoto, Nagasaki, 852-8520 Japan
                [26 ]Department of Critical Care Medicine, Yokohama City University Hospital, ( https://ror.org/010hfy465) 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004 Japan
                [27 ]Department of Intensive Care Medicine, School of Medicine, Sapporo Medical University, ( https://ror.org/01h7cca57) South-1, West-16, Chuo-ku, Sapporo, Hokkaido 060-8543 Japan
                [28 ]Department of Emergency Medicine, Kakogawa Central City Hospital, 439 Kakogawacho Honmachi, Kakogawa-city, Hyogo 675-8611 Japan
                [29 ]Department of Intensive Care Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, ( https://ror.org/051k3eh31) 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510 Japan
                [30 ]Department of Emergency and Critical Care Medicine, Wakayama Medical University, ( https://ror.org/005qv5373) 811-1 Kimiidera, Wakayama, Wakayama, 641-8509 Japan
                [31 ]Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, ( https://ror.org/03gxkq182) Urayasu, 279-0021 Japan
                [32 ]Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, ( https://ror.org/046f6cx68) 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192 Japan
                Article
                4681
                10.1186/s13054-023-04681-6
                10629074
                37936249
                f232b411-80aa-4854-b457-618573c438f4
                © The Author(s) 2023

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 24 July 2023
                : 7 October 2023
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                Research
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                © BioMed Central Ltd., part of Springer Nature 2023

                Emergency medicine & Trauma
                activities of daily living,cognitive function,mental illness,physical function,post-intensive care syndrome,quality of life

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