Development and preliminary validation of the post-intensive care syndrome-family assessment scale

Post-Intensive Care Syndrome-Family (PICS-F) is a condition that often develops in family caregivers of ICU patients and severely impacts their quality of life. Currently, there is a lack of comprehensive assessment tools suitable for the Chinese cultural context.

To develop and validate a culturally appropriate scale for assessing PICS-F in family members of ICU patients within the Chinese context.

This study adopted an exploratory sequential mixed-methods design. The scale was developed based on a preliminary qualitative study and guided by the Theory of being devastated by the critical illness journey in the family. An initial pool of 42 items was generated. Content validity was evaluated through expert consultation. A pilot survey was conducted. A cross-sectional survey was then performed with 447 family members. Reliability and validity were assessed using item analysis, exploratory factor analysis, confirmatory factor analysis, and Cronbach's α coefficient.

Content validity indices were adequate (item-level content validity index (I-CVI): 0.80-1.00; scale-level content validity index/average (S-CVI/Ave) = 0.98). The final PICS-F Assessment Scale contains 19 items across three dimensions: Psychological Trauma and Distress (8 items), Social and Family Functioning Impairment (8 items), and Deteriorating Physical Health (3 items). Exploratory Factor Analysis (EFA) supported the three-factor structure, accounting for 56.98% of the total variance. Confirmatory Factor Analysis (CFA) indicated adequate model fit [χ ²/d f = 2.268, root-mean-square error of approximation (RMSEA) = 0.075, comparative fit index (CFI) = 0.934, Tucker-Lewis index (TLI) = 0.924, Standardized Root Mean Square Residual (SRMR) = 0.064]. The scale demonstrated high internal consistency (Cronbach's α = 0.918 for the total scale; subscales: 0.919, 0.903, 0.851).

The scale provides a practical tool for early screening and assessment of PICS-F in clinical settings, facilitating timely and targeted support for at-risk family caregivers.

The PICS-F Assessment Scale demonstrated promising preliminary psychometric properties for holistically assessing the impact of critical illness on family members, demonstrating good internal consistency reliability, content validity, and construct validity. Further validation with larger samples and criterion-related measures is needed.