Validation of the Multi-INdependence Dimensions (MIND) questionnaire for prolonged mechanically ventilated subjects

Abstract

Background Evaluating severity of illness of patients with prolonged mechanical ventilation (PMV) is important to adopt the best appropriate care management for each individual. Yet, no severity-of-illness scoring system has been specifically designed for this type of patients. The aim of this study was to develop and validate a new instrument, the Multi-INdependence Dimensions (MIND) questionnaire designed to comprehensively measure the severity of illness of patients under PMV. Methods The validation of the MIND questionnaire was performed during a longitudinal observational study conducted with PMV subjects in weaning facilities in three countries (Argentina, Colombia and Germany). The questionnaire validity was tested in 3 stages: 1) Specification of components, with description of item responses, inter-item and Cronbach alpha correlations; 2) Creation of the composite scores; 3) Measurement properties determination including test-retest reliability after 30 days, clinical validity (Medical Research Council (MRC) muscle strength score, Sepsis-related Organ Failure Assessment (SOFA), Glasgow Coma Scale (GCS), Dependence Nursing Scale and EuroQol-5 Dimension evaluated at inclusion), and ability to detect change. Results A total of 128 subjects participated in the validation study. Eleven component scores and four composite scores were created. MIND scores significantly correlated with MRC muscle strength, SOFA, DNS, GCS and EQ-5D, supporting the validity of the new scores. Intraclass Correlation Coefficient greater than 0.82 were observed for all composite scores, indicating good test-retest reliability. MIND scores were able to detect improvement in subject severity of illness. Conclusion The MIND questionnaire is a valid and reliable instrument for measuring comprehensively the multiple dimensions characterizing the severity of illness of PMV patients. Trial registration NCT02255058 . Electronic supplementary material The online version of this article (10.1186/s12890-019-0870-2) contains supplementary material, which is available to authorized users.

Joint Statement on the Role of Respiratory Rehabilitation in the COVID-19 Crisis: The Italian Position Paper

“…− Twice per day evaluation of respiratory clinical parameters (temperature, SpO 2 , SpO 2 /FiO 2 , cough, dyspnea, manual muscle test, isokinetic muscle test, and measurement of joint range of motion. − In weaned patients and those with prolonged weaning from mechanical ventilation and oxygen use, reconditioning interventions are indicated in order to improve the physical status and to correct the motor and cognitive effects of prolonged immobilization in the intensive care area [40][41][42][43][44][45][46][47][48]. − As the effect of muscle activity in infections related to viral agents is not known, exercises aiming [15] at a gradual load increase based on subjective symptoms are recommended to maintain a normal function.…”

Rehabilitation of Difficult-to-Wean, Tracheostomized Patients Admitted to Specialized Unit: Retrospective Analyses over 10-Years

“…Further, SAPS II was developed and validated in the critical care setting but not specifically in the population enrolled in the study (post-acute patients); thus, caution should be used when considering this score in this subset of patients [ 31 ]. Although other multi-factorial scores have been recently developed to better assess the physical morbidity of the general adult critical care population [ 32 , 33 ], the good performance of SAPS II in the intermediate care setting and its wide usage in the available literature [ 34 ] motivated our choice in assessing clinical severity of our population. Last, this study reflects the experience of a single regional weaning unit, and its results cannot be easily generalized to facilities with a different organization.…”