The Stressful Memory Assessment Checklist for the Intensive Care Unit (SMAC-ICU): Development and Testing

Stressful or traumatic memories of an intensive care stay may lead to long-term psychological morbidity. Memory assessment is therefore essential to aid in the patients' recovery process. Acknowledging the large cohort of post ICU patients during the SARS-CoV-2 pandemic, a simple tool for the evaluation of ICU memories is needed. The aim of this study was, therefore, to develop and test the validity and reliability of a short stressful memory assessment checklist, including a distress intensity rating scale, for intensive care survivors. The consecutive sample consisted of 309 patients attending an intensive care follow-up consultation in Sweden. A methodological design was used consisting of four phases. The first three concerned construct and content validity and resulted in a 15-item checklist of potential stressful memories with a Likert-type scale including five response categories for distress intensity rating. To fill out the checklist, a median of 3 (2-3) minutes was needed. A test-retest approach yielded weighted kappa values between 0.419 and 0.821 for 12 of the single items and just below 0.4 for the remaining three. In conclusion, the stressful memory assessment checklist seems to be valid and reliable and can be used as a simple tool to evaluate the impact of stressful ICU memories.