Other Titles
Measurement tools used in studies reporting multiple subjective post-intensive care syndrome (PICS) symptoms: Findings from a scoping review [Title Slide]
Abstract
Background: A growing number of intensive care unit (ICU) survivors experience a range of distressing physical, mental, or cognitive problems post discharge, known as post-intensive care syndrome (PICS)1. Increasing evidence suggests that PICS spans multiple domains2, 3; however, prior reviews have noted a reliance on measures of individual symptoms and objective impairments4-6. There is growing recognition of the need for measurement tools that comprehensively assess subjective PICS symptoms across multiple domains7.
Purpose: We conducted a scoping review of studies reporting two or more self-reported subjective symptoms of PICS. In the current analysis, we aimed to identify the measurement tools used and describe their characteristics including symptoms and domains assessed.
Methods: We searched PubMed, CINAHL, PsycINFO, and SCOPUS for articles published in English between January 2020 and December 2023. We included quantitative studies conducted in the United States reporting two or more self-reported symptoms within one year of ICU discharge in adult ICU survivors (≥18 years). Studies of families’, caregivers’, or pediatric patients’ symptom experiences were excluded unless adult survivors' symptoms were reported separately.
Results: Of the 1,278 articles screened, fifteen studies were included. Fourteen tools measuring self-reported subjective symptoms were identified. All studies used established tools, and three studies additionally employed investigator-developed tools. The number of tools per study ranged from one to five. Of the fourteen tools, only one, the Physical, Emotive, Autonomy, Communication, Economic, and Transcendent (PEACE) tool, measured symptoms across all domains. Of the remaining thirteen tools, eight measured individual symptoms and five measured multiple symptoms, all within a single domain - physical, mental, or cognitive. The most commonly measured domains and subjective symptoms were mental (depression, anxiety) and physical (pain, problems walking). The Hospital Anxiety and Depression Scale (HADS) was the most commonly used tool, appearing in eight studies.
Conclusions: The findings highlight a gap in tools available to measure subjective symptoms across multiple PICS domains, underscoring the need to develop a more comprehensive PICS assessment tool. A patient-report tool would enhance the understanding of subjective PICS symptoms and facilitate the design of effective, patient-centered nursing interventions for ICU survivors.
Notes
References:
1. Needham DM, Davidson J, Cohen H, Hopkins RO, Weinert C, Wunsch H, Zawistowski C, Bemis-Dougherty A, Berney SC, Bienvenu OJ, Brady SL, Brodsky MB, Denehy L, Elliott D, Flatley C, Harabin AL, Jones C, Louis D, Meltzer W, Muldoon SR, Palmer JB, Perme C, Robinson M, Schmidt DM, Scruth E, Spill GR, Storey CP, Render M, Votto J, Harvey MA. Improving long-term outcomes after discharge from intensive care unit: Report from a stakeholders' conference. Critical Care Medicine. 2012;40(2):502-9. doi: 10.1097/CCM.0b013e318232da75. PubMed PMID: 21946660.
2. Marra A, Pandharipande PP, Girard TD, Patel MB, Hughes CG, Jackson JC, Thompson JL, Chandrasekhar R, Ely EW, Brummel NE. Co-cccurrence of Post-Intensive Care Syndrome problems among 406 survivors of critical illness. Critical Care Medicine. 2018;46(9):1393-401. doi: 10.1097/ccm.0000000000003218. PubMed PMID: 29787415; PMCID: PMC6095801.
3. Kang J, Lee MH. Incidence rate and risk factors for post-intensive care syndrome subtypes among critical care survivors three months after discharge: A prospective cohort study. Intensive and Critical Care Nursing. 2024;81:103605. doi: https://doi.org/10.1016/j.iccn.2023.103605.
4. Pant U, Vyas K, Meghani S, Park T, Norris CM, Papathanassoglou E. Screening tools for post–intensive care syndrome and post-traumatic symptoms in intensive care unit survivors: A scoping review. Australian Critical Care. 2023;36(5):863-71. doi: https://doi.org/10.1016/j.aucc.2022.09.007.
5. Phillips EK, Monnin C, Gregora A, Smith K, S. H. Schultz A, O'Keefe-McCarthy S, Arora RC, Duhamel TA, Chudyk AM. A scoping review of incidence and assessment tools for post-intensive care syndrome following cardiac surgery. Intensive and Critical Care Nursing. 2024;83:103718. doi: https://doi.org/10.1016/j.iccn.2024.103718.
6. Chu Y, Thompson DR, Eustace-Cook J, Timmins F. Instruments to measure post-intensive care syndrome: A scoping review. Nursing in Critical Care. 2023;28(4):484-98. doi: https://doi.org/10.1111/nicc.12885.
7. Mikkelsen ME, Still M, Anderson BJ, Bienvenu OJ, Brodsky MB, Brummel N, Butcher B, Clay AS, Felt H, Ferrante LE, Haines KJ, Harhay MO, Hope AA, Hopkins RO, Hosey M, Hough CTL, Jackson JC, Johnson A, Khan B, Lone NI, MacTavish P, McPeake J, Montgomery-Yates A, Needham DM, Netzer G, Schorr C, Skidmore B, Stollings JL, Umberger R, Andrews A, Iwashyna TJ, Sevin CM. Society of Critical Care Medicine's International Consensus Conference on Prediction and Identification of Long-Term Impairments After Critical Illness. Critical Care Medicine. 2020;48(11):1670-9. doi: 10.1097/ccm.0000000000004586. PubMed PMID: 32947467.
Sigma Membership
Beta Eta at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Sub-acute Care, Long-term Care, Instrument and Tool Development, Post-intensive Care Syndrome, PICS
Recommended Citation
Eo, Yoonsoo; Hawn, Rachel; Stevens, Jennifer; Pecanac, Kristen; and Kwekkeboom, Kristine, "Measurement Tools of Multiple Subjective Post-Intensive Care Syndrome Symptoms: A Scoping Review" (2025). International Nursing Research Congress (INRC). 115.
https://www.sigmarepository.org/inrc/2025/presentations_2025/115
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Measurement Tools of Multiple Subjective Post-Intensive Care Syndrome Symptoms: A Scoping Review
Seattle, Washington, USA
Background: A growing number of intensive care unit (ICU) survivors experience a range of distressing physical, mental, or cognitive problems post discharge, known as post-intensive care syndrome (PICS)1. Increasing evidence suggests that PICS spans multiple domains2, 3; however, prior reviews have noted a reliance on measures of individual symptoms and objective impairments4-6. There is growing recognition of the need for measurement tools that comprehensively assess subjective PICS symptoms across multiple domains7.
Purpose: We conducted a scoping review of studies reporting two or more self-reported subjective symptoms of PICS. In the current analysis, we aimed to identify the measurement tools used and describe their characteristics including symptoms and domains assessed.
Methods: We searched PubMed, CINAHL, PsycINFO, and SCOPUS for articles published in English between January 2020 and December 2023. We included quantitative studies conducted in the United States reporting two or more self-reported symptoms within one year of ICU discharge in adult ICU survivors (≥18 years). Studies of families’, caregivers’, or pediatric patients’ symptom experiences were excluded unless adult survivors' symptoms were reported separately.
Results: Of the 1,278 articles screened, fifteen studies were included. Fourteen tools measuring self-reported subjective symptoms were identified. All studies used established tools, and three studies additionally employed investigator-developed tools. The number of tools per study ranged from one to five. Of the fourteen tools, only one, the Physical, Emotive, Autonomy, Communication, Economic, and Transcendent (PEACE) tool, measured symptoms across all domains. Of the remaining thirteen tools, eight measured individual symptoms and five measured multiple symptoms, all within a single domain - physical, mental, or cognitive. The most commonly measured domains and subjective symptoms were mental (depression, anxiety) and physical (pain, problems walking). The Hospital Anxiety and Depression Scale (HADS) was the most commonly used tool, appearing in eight studies.
Conclusions: The findings highlight a gap in tools available to measure subjective symptoms across multiple PICS domains, underscoring the need to develop a more comprehensive PICS assessment tool. A patient-report tool would enhance the understanding of subjective PICS symptoms and facilitate the design of effective, patient-centered nursing interventions for ICU survivors.
Description
This scoping review mapped and summarized the measurement tools used in studies reporting multiple subjective PICS symptoms in ICU survivors. Only one tool measured symptoms across all PICS domains. The findings highlight the need for developing comprehensive tools to improve the understanding of subjective PICS symptoms and support patient-centered interventions.