Gail Geller1, Emily D Branyon2, Lindsay K Forbes3, Rachel J Topazian4, Brian W Weir5, Joseph A Carrese6, Mary Catherine Beach7, Jeremy Sugarman8. 1. Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205. Electronic address: ggeller@jhu.edu. 2. Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205. Electronic address: ebranyo1@jhu.edu. 3. University of California, Institute for Health and Aging, San Francisco, CA 94118. Electronic address: lindsay.forbes@ucsf.edu. 4. Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205. Electronic address: rjtopazian@gmail.com. 5. Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205. Electronic address: bweir3@jhu.edu. 6. Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205. Electronic address: jcarrese@jhmi.edu. 7. Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205; Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD 21205. Electronic address: mcbeach@jhmi.edu. 8. Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205. Electronic address: jsugarman@jhu.edu.
Abstract
PURPOSE: The purpose of the study is to develop a brief index of patient and family experiences of respect in the intensive care unit (ICU). MATERIALS AND METHODS: We designed a questionnaire with 44 items representing 12 themes that emerged from prior in-depth interviews with ICU patients and families. After pilot testing, items with minimal variability were eliminated. The resulting 21-item questionnaire was administered to patients and families in 5 adult ICUs. Psychometric analyses were conducted. RESULTS: Fifty-seven questionnaires were completed. Factor analysis resulted in a unidimensional scale consisting of 10 items with an α of .85 and an Eigen value of 11.3. Factor loadings ranged from 0.54 to 0.84, and item-test correlations ranged from 0.47 to 0.71. The mean total score was 7.25 out of a maximum of 10. Scores were lower for surgical than medical or disease-specific ICUs. CONCLUSIONS: The "ICU-RESPECT" index demonstrates high reliability and concurrent validity in ICU patients and families. Future research should validate this index in other ICU settings, assess its predictive validity, and evaluate different methods for maximizing response rate. As hospitals address patient experience more broadly in response to national metrics, the index could identify particular behaviors or ICUs that would benefit from interventions to enhance respectful treatment.
PURPOSE: The purpose of the study is to develop a brief index of patient and family experiences of respect in the intensive care unit (ICU). MATERIALS AND METHODS: We designed a questionnaire with 44 items representing 12 themes that emerged from prior in-depth interviews with ICU patients and families. After pilot testing, items with minimal variability were eliminated. The resulting 21-item questionnaire was administered to patients and families in 5 adult ICUs. Psychometric analyses were conducted. RESULTS: Fifty-seven questionnaires were completed. Factor analysis resulted in a unidimensional scale consisting of 10 items with an α of .85 and an Eigen value of 11.3. Factor loadings ranged from 0.54 to 0.84, and item-test correlations ranged from 0.47 to 0.71. The mean total score was 7.25 out of a maximum of 10. Scores were lower for surgical than medical or disease-specific ICUs. CONCLUSIONS: The "ICU-RESPECT" index demonstrates high reliability and concurrent validity in ICU patients and families. Future research should validate this index in other ICU settings, assess its predictive validity, and evaluate different methods for maximizing response rate. As hospitals address patient experience more broadly in response to national metrics, the index could identify particular behaviors or ICUs that would benefit from interventions to enhance respectful treatment.
Authors: Anica C Law; Stephanie Roche; Alyse Reichheld; Patricia Folcarelli; Michael N Cocchi; Michael D Howell; Kenneth Sands; Jennifer P Stevens Journal: Jt Comm J Qual Patient Saf Date: 2018-08-28
Authors: Melissa J Basile; Eileen Rubin; Michael E Wilson; Jennifer Polo; Sonia N Jacome; Samuel M Brown; Gabriel Heras La Calle; Victor M Montori; Negin Hajizadeh Journal: Crit Care Explor Date: 2021-06-15