Tools for assessment of acute psychological distress in critical illness: A scoping review

Elizabeth Kusi-Appiah; Maria Karanikola; Usha Pant; Shaista Meghani; Megan Kennedy; Elizabeth Papathanassoglou

doi:10.1016/j.aucc.2020.12.003

Tools for assessment of acute psychological distress in critical illness: A scoping review

Aust Crit Care. 2021 Sep;34(5):460-472. doi: 10.1016/j.aucc.2020.12.003. Epub 2021 Feb 27.

Authors

Elizabeth Kusi-Appiah¹, Maria Karanikola², Usha Pant³, Shaista Meghani⁴, Megan Kennedy⁵, Elizabeth Papathanassoglou⁶

Affiliations

¹ Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, T6G 1C9, Canada. Electronic address: kusiappi@ualberta.ca.
² Cyprus University of Technology, Department of Nursing, 15 Vragadinou str-Limassol, 3041, Cyprus. Electronic address: maria.karanikola@cut.ac.cy.
³ Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, T6G 1C9, Canada. Electronic address: upant@ualberta.ca.
⁴ Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, T6G 1C9, Canada. Electronic address: shaista@ualberta.ca.
⁵ John W. Scott Health Sciences Librarian, University of Alberta Library, 2K3.28 Walter C. Mackenzie Health Sciences Centre, Edmonton, AB, T6G 2R7, Canada. Electronic address: mrkenned@ualberta.ca.
⁶ Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, T6G 1C9, Canada. Electronic address: papathan@ualberta.ca.

PMID: 33648818
DOI: 10.1016/j.aucc.2020.12.003

Abstract

Objectives: Patients' experience of psychological distress in the intensive care unit (ICU) is associated with adverse effects, reduced satisfaction, and delayed physical and psychological recovery. There are no specific guidelines for the assessment and management of acute psychological distress during hospitalisation in the ICU. We reviewed existing tools for the assessment of acute psychological distress in ICU patients, examined evidence on their metric properties, and identified potential gaps and methodological considerations.

Method: A scoping review based on literature searches (Cumulative Index to Nursing and Allied Health Literature, Medical Literature Analysis and Retrieval System Online, Excerpta Medica Database, PsycINFO, Scopus, Health and Psychosocial Instruments, Dissertations and Theses Global, and Google Scholar) and predefined eligibility criteria was conducted as per current scoping review guidelines.

Findings: Overall, 14 assessment tools were identified having been developed in diverse ICU settings. The identified tools assess mainly anxiety and depressive symptoms and ICU stressors, and investigators have reported various validity and reliability metrics. It was unclear whether available tools can be used in specific groups, such as noncommunicative patients and patients with delirium, brain trauma, stroke, sedation, and cognitive impairments.

Conclusion: Available tools have methodological limitations worth considering in future investigations. Given the high prevalence of psychiatric morbidity in ICU survivors, rigorously exploring the metric integrity of available tools used for anxiety, depressive, and psychological distress symptom assessment in the vulnerable ICU population is a practice and research priority.

Relevance to clinical practice: These results have implications for the selection and implementation of psychological distress assessment methods as a means for promoting meaningful patient-centred clinical outcomes and humanising ICU care experiences.

Keywords: Anxiety; Assessment; Critical care; Reliability; Scale; Stress; Tool; Validity.

Publication types

Review

MeSH terms

Critical Care
Critical Illness*
Humans
Intensive Care Units
Psychological Distress*
Reproducibility of Results