The measurement properties of patient experience scales in the intensive care unit: A systematic review

Abstract

Background: As health care recipients, patients play an essential role in evaluating health care quality. Critical care patients have specific experiences that differ from those of regular patients. Existing instruments of patient experience to improve intensive care quality and their measurement properties should be defined. Aim: To review the existing tools for measuring patient experience in the intensive care unit (ICU) and evaluate their measurement properties. Study Design: This is a systematic review. The PubMed, CINAHL complete, Ovid: Embase, ProQuest Health and Medical complete and Cochrane Library databases were systematically screened from their inception to 9 November 2022. All the research that reported the development and measurement properties of instruments for ICU patient-perceived care was included. The COnsensus-based Standards for the selection of health Measurement Instruments risk of bias checklist (COSMIN-RoB-Checklist) was applied to assess the psychometric indicators of the included studies. Results: The search yielded 565 documents, of which 15 scales described in 17 studies met the inclusion requirements. Of the 15 scales, seven assessed ICU patient satisfaction and eight assessed patient experience. We categorized the items from existing scales into different elements based on the National Health Service (NHS) framework. The most frequently assessed elements are ‘Respect for patient-centred values, preferences and expressed needs’, ‘Information, communication and education’ and ‘Physical comfort’ (93.33%, 14/15), while ‘Transition and continuity’ (33.33%, 5/15) is the least frequently measured. There are no studies presenting all the criteria of measurement properties outlined by the COSMIN. In the scale development part, only eight of the items met the requirements of the pilot test. Among all the measurement properties, internal consistency (80%, 12/15) and structural validity (80%, 12/15) were the two most frequently measured attributes. The three most uncommon measurement properties were retest reliability (five, 33.33%), responsiveness (four, 26.67%) and measurement error (three, 20%). Conclusions: To enhance the quality of intensive care, it is essential to use professional scales to gather feedback from ICU patients. This systematic review examines existing tools and evaluates their measurement properties using the COSMIN-RoB-Checklist. Further research is needed to develop a strong patient experience framework and reliable psychometric properties. Relevance to Clinical Practice: Given the insufficient attention to critical care patients' experience, this review summarizes current patient experience scales in the intensive care unit and presents their measurement properties. This helps clinicians select more appropriate tools, develop better intensive care patient experience scales, enhance the understanding of intensive care quality and ultimately improve the excellence of work in ICUs.