Intensive Care Medicine

, Volume 36, Issue 10, pp 1751–1758 | Cite as

Development and validation of a questionnaire for quantitative assessment of perceived discomforts in critically ill patients

  • Pierre KalfonEmail author
  • Olivier Mimoz
  • Pascal Auquier
  • Anderson Loundou
  • Rémy Gauzit
  • Alain Lepape
  • Jean Laurens
  • Bernard Garrigues
  • Thierry Pottecher
  • Yannick Mallédant



To develop and validate the IPREA (Inconforts des Patients de REAnimation) questionnaire for the assessment of discomfort perceived by patients related to their intensive care unit (ICU) stay.


This was a two step-study comprising a phase of item generation conducted in one ICU and a phase of psychometric evaluation during a multicenter prospective cohort study in 14 ICUs. Patients were unselected consecutive adult surviving ICU patients. On the day of ICU discharge, a nurse asked patients to rate the severity of 16 discomfort sources, from 0 to 100. Ten percent of patients were randomly chosen to be questioned again to assess the reproducibility.


Of 1,380 eligible patients, 1,113 survived and 868 patients could be questioned. The highest scores were for sleep deprivation (35 ± 33), being restrained by tubing, wires, and cables (33 ± 30), pain (32 ± 30), and thirst (32 ± 34). No multidimensional structure was identified. The mean overall score of discomfort was 22 ± 14. Internal consistency was satisfactory using Cronbach’s alpha coefficient (0.78). The test–retest reliability study found average measure intraclass correlations ranging from 0.70 to 0.92. The mean duration of the questionnaire administration was 10 ± 7 min.


The psychometric properties and acceptability of the IPREA questionnaire make it a potential instrument for measuring discomfort perceived by unselected ICU patients.


Critical care Discomfort Outcome Visual analog scale Sleep deprivation Pain Thirst Anxiety Noise 



We thank all members of the nursing staff of each participating ICU for their strong involvement and motivation in the study.

Supplementary material

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Copyright information

© Copyright jointly held by Springer and ESICM 2010

Authors and Affiliations

  • Pierre Kalfon
    • 1
    Email author
  • Olivier Mimoz
    • 2
  • Pascal Auquier
    • 3
  • Anderson Loundou
    • 4
  • Rémy Gauzit
    • 5
  • Alain Lepape
    • 6
  • Jean Laurens
    • 7
  • Bernard Garrigues
    • 8
  • Thierry Pottecher
    • 9
  • Yannick Mallédant
    • 10
  1. 1.Service de Réanimation PolyvalenteHôpital Louis Pasteur, Hôpitaux de ChartresChartres CedexFrance
  2. 2.Département d’Anesthésie-Réanimation, Centre Hospitalier Universitaire (CHU) de PoitiersUniversité de Poitiers and INSERM ERI-23PoitiersFrance
  3. 3.Laboratoire de Santé publique, EA3279Faculté de médecineMarseilleFrance
  4. 4.Unité d’Aide Méthodologique à la Recherche Clinique et Epidémiologique, Délégation Régionale à la Recherche CliniqueAssistance Publique-Hôpitaux de MarseilleMarseilleFrance
  5. 5.Département d’Anesthésie-RéanimationUnité de Réanimation chirurgicale, CHU Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris (AP-HP)ParisFrance
  6. 6.Département d’Anesthésie-Réanimation, Unité de Réanimation chirurgicaleCHU de Lyon SudPierre-BéniteFrance
  7. 7.Service de Réanimation PolyvalentePolyclinique des CèdresMérignacFrance
  8. 8.Service de Réanimation Médico-ChirurgicaleCentre Hospitalier du pays d’AixAix-en-ProvenceFrance
  9. 9.Département d’Anesthésie-Réanimation, Réanimation PolyvalenteCHU HautepierreStrasbourgFrance
  10. 10.Département d’Anesthésie-RéanimationUniversité de Rennes 1 and INSERM U 620, CHU PontchaillouRennesFrance

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