Hospital Universitario de Getafe, Getafe, Madrid, España; CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, España.
Facultad de Medicina y Ciencias de la Salud, Universidad de Barcelona, Barcelona, España.
Enferm Intensiva (Engl Ed). 2020 Jul-Sep;31(3):131-146. doi: 10.1016/j.enfi.2019.10.001. Epub 2020 Mar 21.
To adapt the ICU Mobility Scale (IMS) to the area of intensive care units (ICU) in Spain and to evaluate the metric properties of the Spanish version of the IMS (IMS-Es).
Descriptive metric study developed in two phases. Phase 1, adaptation to Spanish of the IMS by a team of nurses and physiotherapists (translation, pilot, backtranslation and agreement). Phase 2, analysis of metric properties (convergent, divergent and predictive validity, interobserver reliability, sensitivity and minimum important difference) of the IMS-Es. Patient characteristics (Barthel, Charlson, BMI, sex), sedation/agitation level (RASS), ICU and hospital stays, survival, quality of life (SF-12), muscle weakness (MRC-SS) and mobility (IMS-Es) were recorded in the patients of the MOviPre national multicentre study.
After obtaining the IMS-Es, it was implemented in 645 patients from 80 Spanish ICUs between April and June 2017. Convergent validity: moderate correlation between IMS-Es and MRC-SS (r=.389; P<.001) and significant comparison between groups with and without ICU-acquired weakness (P<.001). Divergent validity: no correlation between IMS-Es and BMI [r (95%CI): -.112 (-.232 to .011)], weight [r (95%CI): -.098 (-.219 to .026)], Charlson [r (95%CI): -.122 (-.242 to .001)] and Barthel [r(95%CI): -.037 (-.160 to .087)] and no differences between sexes (P=.587) or BMI categories (P=.412). Predictive validity: moderate and significant correlations with post-ICU hospital stay [r (95%CI): -.442 (-.502 to -.377)] and physical component of SF-12 (PCS) [r (95%CI): .318 (.063 to .534)]; patients without active mobilisation in ICU increased risk of hospital mortality [OR (95%CI): 3.769 (1.428 to 9.947)]. Interobserver reliability: very good concordance between nurses [CCI (95%CI): .987 (.983 to .990)] and nurse-physiotherapist [CCI (95%CI): .963 (.948 to .974)]. Sensitivity to change: small effect on discharge from ICU (d=.273) and moderate effect at 3months after hospital discharge (d=.709). Minimal important difference: 2-point difference cut-off point, 91.1% sensitivity and 100.0% specificity.
The IMS-Es is useful, valid and reliable for implementation by ICU nurses and physiotherapists in assessing the mobility of critical patients.
将 ICU 活动量表（IMS）适应于西班牙的重症监护病房（ICU）领域，并评估西班牙版 IMS（IMS-Es）的度量特性。
描述性度量研究分为两个阶段进行。第 1 阶段，由护士和物理治疗师团队对 IMS 进行西班牙语翻译、试点、回译和达成一致（translation, pilot, backtranslation and agreement）。第 2 阶段，分析 IMS-Es 的度量特性（convergent, divergent and predictive validity, interobserver reliability, sensitivity and minimum important difference）。在 MOviPre 国家多中心研究中，记录了患者的特征（巴氏指数、Charlson 评分、BMI、性别）、镇静/躁动程度（RASS）、ICU 和住院时间、生存情况、生活质量（SF-12）、肌肉无力（MRC-SS）和移动能力（IMS-Es）。
获得 IMS-Es 后，于 2017 年 4 月至 6 月在西班牙 80 家 ICU 的 645 名患者中实施。收敛效度：IMS-Es 与 MRC-SS 呈中度相关（r=.389；P<.001），且有 ICU 获得性肌无力的患者与无肌无力患者之间的比较有显著差异（P<.001）。发散效度：IMS-Es 与 BMI [r（95%CI）：-.112（-.232 至.011）]、体重 [r（95%CI）：-.098（-.219 至.026）]、Charlson [r（95%CI）：-.122（-.242 至.001）]和巴氏指数 [r（95%CI）：-.037（-.160 至.087）]无相关性，且男女之间（P=.587）或 BMI 类别之间（P=.412）无差异。预测效度：与 ICU 后住院时间呈中度且显著相关 [r（95%CI）：-.442（-.502 至 -.377）]和 SF-12 的物理成分呈中度相关 [r（95%CI）：.318（.063 至.534）]；在 ICU 期间无主动活动的患者，其住院死亡率的风险增加[OR（95%CI）：3.769（1.428 至 9.947）]。观察者间可靠性：护士之间的一致性非常好[CCI（95%CI）：.987（.983 至.990）]，护士与物理治疗师之间的一致性也很好[CCI（95%CI）：.963（.948 至.974）]。对变化的敏感性：对 ICU 出院的影响较小（d=.273），对出院后 3 个月的影响较大（d=.709）。最小重要差异：2 分的差异作为截断点，灵敏度为 91.1%，特异性为 100.0%。
ICS-Es 可由 ICU 护士和物理治疗师用于评估重症患者的移动能力，是一种有用、有效且可靠的工具。
