Well-being and sense of security of intubated patients in intensive care units: a patient co-constructed dedicated scale

TL;DR

This paper introduces a new scale to assess the well-being and sense of safety of intubated ICU patients, co-developed with patients and professionals.

Contribution

A novel patient-co-constructed scale for real-time assessment of ICU patient well-being and safety.

Findings

A 4-item scale (Comfort, Safety, Information, Trust) was developed and validated for bedside use.

The scale demonstrated improved reliability and coherence after psychometric analysis.

Focus groups emphasized the importance of communication and human support in ICU settings.

Abstract

Intensive care unit (ICU) patients endure significant stress due to their critical condition, communication difficulties, and the hostile environment. Despite efforts to humanize ICUs, there is a lack of real-time assessment tools for patient well-being and sense of safety. The aim of this project was to develop a scale assessing the feeling of well-being and safety in real time among intubated patients.

A systematic review was performed to identify study outcomes evaluating well-being and sense of security. Results were used to organize focus groups and explore patients’ experiences during their ICU stay. The scale was then developed via Delphi methodology by a patient-professional group. The scale was validated through patient interviews for face validity and implementation in a multicentric French cohort. Lastly, the scale was translated in English.

The systematic review included 137 articles. Focus groups (23 former patients and 5 relatives) highlighted communication challenges and the need for human support. Scale construction resulted in an initial 6-item pragmatic bedside tool. Face validation showed that the constructed scale was acceptable and led to refining the scale by changing item evaluation formats to a 4-stage Likert scale. Cohort validation, comprising 305 scale administrations (84 patients), indicated overall satisfaction and adequate completion rates. Psychometric analysis led to the removal of two items. A simplified 4-item scale (Comfort, Safety, Information, Trust) demonstrated improved reliability and coherence.

The final scale provides a practical measure of patient well-being in ICUs and is usable in real time at the bedside.

The online version contains supplementary material available at 10.1186/s13054-026-05923-z.

A simple, quick, and effective scale to assess, in real-time at the bedside, the well-being and sense of safety of intubated patients and all patients hospitalized in intensive care units, was co-constructed with former patients, relatives, and healthcare professionals.

The online version contains supplementary material available at 10.1186/s13054-026-05923-z.

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