# Quantifying the recollection of discomfort and emotional suffering during a stay in intensive care: development and validation of the EXPRIM questionnaire: EXPRIM: quantification of discomfort experienced during an ICU stay

## TL;DR

The paper introduces a new questionnaire called EXPRIM to measure discomfort and emotional suffering experienced by ICU patients after their stay.

## Contribution

The novel contribution is the development and validation of the EXPRIM questionnaire, which quantifies ICU-related discomfort and emotional suffering.

## Key findings

- EXPRIM demonstrated excellent psychometric properties, including high internal consistency and reliability.
- The questionnaire showed good correlations with other similar tools and strong content validity.
- EXPRIM is a promising tool for comparing ICU experiences across patients or populations.

## Abstract

Discomfort perceived by patients during an intensive care unit (ICU) stay may limit their function, well-being, and quality of life after their stay. This study creates a comprehensive questionnaire (EXPRIM) able to distinguish and quantify the recollection of discomfort and emotional suffering experienced during a stay in an ICU stay, and to assess its performance.

The measurement properties of the questionnaire were tested in a first sample of 50 patients recruited between February and July 2024 in a tertiary ICU, using internal consistency, test-retest reliability, standard error of measurement (SEM), and construct validity. Content validity was also tested, in a second sample of 20 patients and 10 ICU healthcare providers recruited between April and June 2024 in a regional ICU, using face-to-face qualitative interviews based on a semi-structured interview guide assessing comprehensibility, relevance and comprehensiveness of the instruction and items.

EXPRIM is a 30-item questionnaire developed in French and translated in English. Its total score ranges from 0 to 10, reflecting the weighting of discomfort versus suffering. The internal consistency was very good (Cronbach’s alpha coefficient 0.81). The intra- and inter-examinator reliabilities were excellent (Intraclass Coefficient Correlation = 0.875 and 0.858, respectively). SEM ranged from −0.071 to 0.035. Good correlations were found between EXPRIM and other questionnaires measuring similar concepts. There was good evidence of content validity to explore recollection of the ICU stay.

The EXPRIM questionnaire is a new tool with excellent psychometric properties to quantitatively assess the ICU experiences survivors recall after discharge. It is a promising tool to explore the extent of discomfort and emotional suffering during an ICU stay and to compare experiences between patients or populations.

The online version contains supplementary material available at 10.1186/s41687-026-01011-6.