Faculty of Health Sciences, School of Rehabilitation Science, 3710McMaster University, Institute of Applied Health Sciences, Hamilton, Ontario, Canada.
Department of Health Research Methods, Evidence, and Impact, 3710McMaster University, McMaster University Medical Center, Hamilton, Ontario, Canada.
J Intensive Care Med. 2020 Dec;35(12):1396-1404. doi: 10.1177/0885066618824534. Epub 2019 Jan 22.
Although many performance-based measures assess patients' physical function in intensive care unit (ICU) survivors, to our knowledge, there are no patient-reported ICU rehabilitation-specific measures assessing function. We developed the Patient-Reported Functional Scale-ICU (PRFS-ICU), which measures patients' perceptions of their ability to perform 6 activities (rolling, sitting edge of bed, sit-to-stand and bed-to-chair transfers, ambulation, and stair climbing). Each item is scored from 0 (unable) to 10 (able to perform at pre-ICU level) to a maximum of 60.
Estimate the feasibility, reliability, responsiveness, and validity of the PRFS-ICU.
This was a substudy of TryCYCLE, a single-center, prospective cohort examining the safety and feasibility of early in-bed cycling with mechanically ventilated patients (NCT01885442). To determine feasibility, we calculated the number of patients with at least 1 PRFS-ICU assessment during their hospital stay. To assess reliability, 2 raters blinded to each other's assessments administered the PRFS-ICU within 24-hours of each other. We calculated the intraclass correlation coefficient (ICC; 95% confidence interval [CI]), standard error of measurement (SEM, 95% CI), and minimal detectable change (MDC). To assess validity, we estimated convergent validity of the PRFS-ICU with the Functional Status Score for ICU (FSS-ICU), Medical Research Council Sum Score (MRC-SS), Physical Function Test for ICU (PFIT-s), Katz Index of Independence in Activities of Daily Living (Katz ADLs), and a pooled index using Pearson's correlation coefficient (, 95% CI).
Feasibility: 20 patients completed a PRFS-ICU assessment. Reliability and responsiveness: 16 patients contributed data. The ICC, SEM, and MDC were 0.91 (0.76, 0.97), 4.75 (3.51, 7.35), and 11.04 points, respectively. Validity: 19 patients contributed data and correlations were ( [95% CI]): FSS-ICU (0.40 [-0.14, 0.76]), MRC-SS (0.51 [0.02, 0.80]), PFIT-s (0.43 [-0.13, 0.78]), Katz ADLs (0.53 [0.10, 0.79]), and pooled index (0.48 [-0.14, 0.82]).
Our pilot work suggests the PRFS-ICU may be a useful tool to assess and monitor patients' perceptions of function over time.
尽管有许多基于表现的指标可以评估重症监护病房（ICU）幸存者的身体功能，但据我们所知，目前还没有专门针对 ICU 康复的患者报告的功能评估指标。我们开发了患者报告的 ICU 功能量表（PRFS-ICU），该量表评估患者对完成 6 项活动（翻身、坐床边、坐站和床椅转移、走动和爬楼梯）的能力的认知。每个项目的得分为 0（无法完成）至 10（能够达到 ICU 前的水平），最高分为 60 分。
评估 PRFS-ICU 的可行性、可靠性、反应性和有效性。
这是一项针对 TryCYCLE 的子研究，TryCYCLE 是一项单中心前瞻性队列研究，旨在检查机械通气患者早期床上自行车运动的安全性和可行性（NCT01885442）。为了确定可行性，我们计算了在住院期间至少有 1 次 PRFS-ICU 评估的患者人数。为了评估可靠性，2 名评估者在彼此评估后 24 小时内对 PRFS-ICU 进行了评估。我们计算了组内相关系数（ICC；95%置信区间 [CI]）、测量标准误差（SEM，95%CI）和最小可检测变化（MDC）。为了评估有效性，我们使用 Pearson 相关系数（r，95%CI）来估计 PRFS-ICU 与 ICU 功能状态评分（FSS-ICU）、医学研究理事会总评分（MRC-SS）、ICU 物理功能测试（PFIT-s）、Katz 日常生活活动独立性指数（Katz ADLs）和综合指数之间的收敛效度。
可行性：20 名患者完成了 PRFS-ICU 评估。可靠性和反应性：16 名患者提供了数据。ICC、SEM 和 MDC 分别为 0.91（0.76，0.97）、4.75（3.51，7.35）和 11.04 分。效度：19 名患者提供了数据，相关性为（[95%CI]）：FSS-ICU（0.40[-0.14，0.76]）、MRC-SS（0.51[0.02，0.80]）、PFIT-s（0.43[-0.13，0.78]）、Katz ADLs（0.53[0.10，0.79]）和综合指数（0.48[-0.14，0.82]）。
我们的初步研究表明，PRFS-ICU 可能是一种有用的工具，可以随着时间的推移评估和监测患者对功能的感知。
