Development and psychometric validation of the Patient-Reported Intensive Care Experience Measure (PRICEM) to...

The aim of the study is to design an instrument to measure intensive care unit (ICU) experience from patients' perspective and to evaluate its psychometric properties.

The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology was applied. Patients were recruited from four ICUs of a university hospital. The Patient-Reported Intensive Care Experience Measure (PRICEM) instrument draft was developed based on a systematic review and patient interviews. Content validity was tested with 16 experts, exploratory factor analysis (EFA) was tested with 200 responses and a new cohort of 219 responses was used to evaluate the final 30-item instrument by confirmatory factor analysis (CFA), criterion validity, and reliability measures.

The scale-level content validity index (S-CVI/Ave) was 0.96. EFA identified a five-factor structure explaining 77% of the variance, which was confirmed by the adequate results of CFA. Criterion validity was supported by positive correlations between most dimensions and overall satisfaction (Pearson's r = 0.3-0.7; p < 0.01). The instrument demonstrated excellent overall internal consistency (α = 0.872) and Cronbach's alpha of subscales ranging from 0.768 to 0.909. Test-retest reliability was adequate, with intraclass correlation coefficients (ICCs) between 0.597 and 0.966, and a low standard error of measurement (SEM = 0.093). The final 30-item PRICEM covers five domains: Communication and Emotional Support, Professionalism in Critical Care, ICU Care Environment, Transitional Care and Coordination, and Family Involvement, using a 5-point Likert scale assessing frequency of ICU care experiences.

PRICEM, developed to measure ICU patients' experiences, demonstrated satisfactory measurement properties. Further cross-cultural validation and multicenter refinement is warranted to enhance its applicability as a quality performance indicator in intensive care.

PRICEM enables clinicians to better understand individual experiences in the critical care environment. Implementing PRICEM may facilitate more patient-centered strategies, ultimately enhancing the quality of intensive care.