Abstract
Background: No severity-of-illness scoring system has been specifically designed for patients under prolonged mechanical ventilation (PMV).
Objective: To validate the Multi-INdependence Dimensions (MIND) questionnaire, a comprehensive measure of health status of PMV patients.
Methods: The MIND questionnaire was composed of 11 components developed from a Delphi panel and existing measures. Key components were: cognition, feeding/swallowing, sleep, skin integrity, oxygenation, cough strength, secretion management, mobility, upper and lower limb strength, ventilator dependence and co-morbidities. The questionnaire was tested in patients admitted to 5 weaning facilities in 3 countries (Argentina, Colombia and Germany). MIND, Medical Research Council (MRC) muscle strength score, Sepsis-related Organ Failure Assessment (SOFA), Glasgow Coma Scale (GCS), Dependence Nursing Scale (DNS) and EuroQol-5 Dimension (EQ-5D) were evaluated at inclusion. MIND and clinician global impression of change (CGIC) were evaluated after one day and 30 days after inclusion.
Results: 128 patients (65 (SD=15.5) years) were included; 50% male; 34.4% COPD/Chronic Lung Disease, 18.8% Neuromuscular Disorders, 10.9% Cerebrovascular Disorders and 9.4% Cardiovascular Disorders. Four composite scores were created. All scores showed good test-retest reliability and correlated meaningfully with MRC score, SOFA, DNS, GCS and EQ-5D, supporting their validity. MIND scores were able to detect improvement in patient health status.
Conclusion: The MIND questionnaire is a valid and reliable instrument for measuring comprehensively the multiple dimensions characterizing the health status of PMV patients.
- Copyright ©the authors 2016
