[Assessment of mental symptoms in intensive care unit patients : Suggestion for a German version of the Intensive...

Intensive care unit (ICU) treatment may be associated with mental symptoms such as anxiety, depressed mood, hopelessness and nightmares in critically ill patients. While many physical symptoms can be detected via standardized measures, an instrument to assess mental symptoms is actually missing.

An existing validated screening tool to detect mental symptoms in critically ill patients, the Intensive Care Psychological Assessment Tool (IPAT), has been translated into German and tested in two surgical ICUs and an intermediate care unit.

In addition to the German translation of the IPAT, Stait-Trait-Anxiety-Inventory (STAI-SKD) and Hospital Anxiety and Depression Scale (HADS-D) were used to determine convergent validity. Within a survey period of 3 months, a total of 90 awake and fully oriented patients were included in the study.

Internal consistency of the German translation was lower than that of the original study. The initial factor structure was partially replicated. Convergent validity was demonstrated for depressive and anxiety symptoms, but not for the presence of delirium. Patients who completed the screening were frequently suffering from sleep disturbances, tension, anxiety and depressed mood. A total of 37% of the patients exceeded the cut-off and are considered at-risk patients for psychological sequelae.

With regard to test quality, the results of the German version are currently not satisfactory. This may be due to the small sample size and sample selectivity, which is also the largest limitation of the study. The instrument proved to be practicable if patients can complete it as an interview. The adaptation for external assessment seems to be useful to capture psychological stress in patients with impaired communication and perception.