Mui Louise, Morgan Brenda, Chassé Michaël, Crawshaw Jacob, Martin Claudio M
Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
Critical Care Trauma Centre, London Health Sciences Centre, London, ON, Canada.
Can J Anaesth. 2025 Mar;72(3):473-480. doi: 10.1007/s12630-025-02919-1. Epub 2025 Mar 18.
The Brief Illness Perception Questionnaire (Brief-IPQ) is used to quantify a patient's understanding of their condition. In critical care settings, substitute decision makers (SDMs) are tasked with making decisions on behalf of patients, but it can be difficult to evaluate how they perceive the patient's illness. We developed the Illness Perception Questionnaire for Substitute Decision Makers (IPQ-SDM) by adapting the Brief-IPQ and testing it with SDMs of patients in critical care.
In a mixed methods study, we modified the Brief-IPQ for the context of SDMs of critically ill patients using qualitative feedback. We then approached SDMs of critically ill patients three days after intensive care unit (ICU) admission to complete the IPQ-SDM in a prospective observational study. We calculated summary statistics for the individual questions and the total score. We evaluated prespecified associations between individual questions as well as the total score with clinical data that were abstracted from the patient chart.
We received 44/50 (88%) complete responses with a mean (standard deviation [SD]) total score of 43 (11). Forty-six percent reported that they did not have any in-person visits due to the restrictions during the COVID-19 pandemic. The correlation of total score with the nine equivalents of nursing manpower score (NEMS) was 0.42 (P = 0.005) but it was not correlated (P = 0.07) with the multiple organ dysfunction score (MODS). The total mean (SD) score was higher (i.e., worse) for patients who died in hospital (48.2 [9.7], n = 13) than for those who were discharged alive (40.5 [10.2], n = 31, P = 0.03). Concern regarding the illness was correlated with MODS (Spearman correlation coefficient [ρ] = 0.39, P = 0.01) and NEMS (ρ = 0.29, P = 0.04).
We observed a modest level of correlation of the IPQ-SDM score with clinical measures in the adult ICU setting. Further research is needed before such a tool is broadly implemented.
简短疾病认知问卷（Brief-IPQ）用于量化患者对自身病情的理解。在重症监护环境中，替代决策者（SDM）负责代表患者做出决策，但评估他们对患者疾病的认知可能具有挑战性。我们通过改编Brief-IPQ并在重症监护患者的替代决策者中进行测试，开发了替代决策者疾病认知问卷（IPQ-SDM）。
在一项混合方法研究中，我们根据定性反馈对Brief-IPQ进行了修改，使其适用于重症患者的替代决策者。然后，在重症监护病房（ICU）入院三天后，我们让重症患者的替代决策者参与一项前瞻性观察研究，以完成IPQ-SDM。我们计算了各个问题和总分的汇总统计数据。我们评估了各个问题以及总分与从患者病历中提取的临床数据之间的预先设定的关联。
我们收到了44/50（88%）的完整回复，平均（标准差[SD]）总分为43（11）。46%的人报告说，由于COVID-19大流行期间的限制，他们没有进行任何面对面的探访。总分与护理人力评分（NEMS）的九个等效值的相关性为0.42（P = 0.005），但与多器官功能障碍评分（MODS）无相关性（P = 0.07）。在医院死亡的患者（48.2 [9.7]，n = 13）的总平均分（SD）高于存活出院的患者（40.5 [10.2]，n = 31，P = 0.03）。对疾病的担忧与MODS（斯皮尔曼相关系数[ρ] = 0.39，P = 0.01）和NEMS（ρ = 0.29，P = 0.04）相关。
我们观察到在成人ICU环境中，IPQ-SDM评分与临床指标之间存在适度的相关性。在广泛应用这种工具之前，还需要进一步的研究。
