Background
Methods
Development of the MIND questionnaire: qualitative phase
Component | Number of items | Item Description |
---|---|---|
Cognition | 2 | Orientation/Speech |
Feeding/swallowing | 1 | Feeding/swallowing |
Sleep | 5 | Sleep depth Sleep latency Awakenings Return to sleep Sleep quality |
Skin integrity | 1 | Skin integrity |
Oxygenation | 1 | Oxygenation |
Cough Strength | 1 | Cough Strength |
Secretion Management | 1 | Secretion Management |
Mobility | 2 | Sit to stand/ Stand to sit |
Upper limb strength /Lower limb strength | 2 | Upper limb strength Lower limb strength |
Ventilator Dependence | 1 | Ventilator Dependence |
Co-morbidities | 1 | Co-morbidities from the modified Charlson index list |
Validation of the MIND questionnaire: quantitative phase
Study subjects
Study design
Analysis
Results
Subject description
Time of assessment | Characteristics | Total (N = 128) | |
---|---|---|---|
Baseline | Age (years) – N = 128 | Mean (SD) | 65.0 (16.5) |
Min – Max | 18.0–89.0 | ||
Gender (%) – N = 128 | Male | 50.0 | |
Previous days of mechanical ventilation (days) – N = 111 | Mean (SD) | 78.1 (134.9) | |
Min – Max | 11.0–1025.0 | ||
Median | 46.0 | ||
Q1 – Q3 | 32.0–71.0 | ||
Primary diagnosis (%) – N = 128 | Post-Acute Lung Injury | 6.3 | |
COPD/Chronic Lung Disease | 34.4 | ||
Neuromuscular Disorders | 18.8 | ||
Post-Operative | 8.6 | ||
Cardiovascular Disorders | 9.4 | ||
Trauma (Spinal Cord and Head Injury) | 5.5 | ||
Cerebrovascular Disorders | 10.9 | ||
Other | 6.3 | ||
Use of (%) – N = 128 | Non-invasive ventilation | 6.3 | |
Invasive ventilation | 90.6 | ||
Tracheostomy collar | 3.1 | ||
MRC scale quadriceps (%) – N = 128 | 0–2 | 48.4 | |
3 | 20.3 | ||
4–5 | 28.9 | ||
Missing | 2.3 | ||
MRC scale biceps (%) – N = 128 | 0–2 | 35.9 | |
3 | 27.3 | ||
4–5 | 34.4 | ||
Missing | 2.3 | ||
SOFA score (%) – N = 128 | 0–2 | 83.6 | |
3–8 | 16.4 | ||
GCS score – N = 128 | 1–8 | 9.4 | |
9–12 | 13.3 | ||
13–15 | 77.3 | ||
DNS score – N = 128 | Mean (SD) | 20.4 (6.3) | |
Min – Max | 3.0–32.0 | ||
EQ-5D VAS – N = 110 | Mean (SD) | 47.5 (18.1) | |
Min – Max | 10.0–100.0 | ||
Day 30 | CGIC (%) – N = 128 | Much worse | 6.3 |
Worse | 6.3 | ||
Same status | 42.2 | ||
Better | 25.8 | ||
Much better | 11.7 | ||
Missing | 7.8 |
Validation of the MIND questionnaire
Component specification stage
Component | Initial Number of items | Items | Multi-item component scores | 11-component composite score | 2-component composite score | ||||
---|---|---|---|---|---|---|---|---|---|
Range of inter-item correlationsa | Cronbach’s αb | Weights for simple summation | Weights for weighted summationc | Weights for simple summation | Weights for weighted summationc | ||||
Overall | With item removed | ||||||||
Cognition | 2 | Orientation Speech | 0.70 | 0.82 | – | 1 | 3.4 | ||
Feeding/swallowing | 1 | Feeding/swallowing | 1 | 2.8 | 1 | 2.8 | |||
Sleep | 5 | Sleep depth Sleep latency Awakenings Return to sleep Quality of sleep | −0.16 – 0.78 | 0.72 | 0.61 0.90 0.57 0.58 0.56 | 1 | 3.7 | ||
Skin integrity | 1 | Skin integrity | 1 | 1.0 | |||||
Oxygenation | 1 | Oxygenation | 1 | −1.8 | |||||
Cough strength | 1 | Cough strength | 1 | 3.5 | 1 | 3.5 | |||
Secretion management | 1 | Secretion management | 1 | 0.9 | |||||
Mobility | 2 | Sit to stand Stand to sit | 0.98 | 0.99 | – | 1 | 3.2 | ||
Upper limb and lower limb strength | 2 | Upper limb strength Lower limb strength | 0.89 | 0.94 | – | 1 | 2.8 | ||
Ventilator dependence | 1 | Ventilator dependence | 1 | 1.2 | |||||
Co-morbidities | 1 | Co-morbidities | 1 | 0.3 |
Component | Cognition | Feeding/ swallowing | Sleep | Skin integrity | Oxygenation | Cough strength | Secretion management | Mobility | Upper limb and lower limb strength | Ventilator dependence | Co-morbidities |
---|---|---|---|---|---|---|---|---|---|---|---|
Cognition | 1.00 | ||||||||||
Feeding/swallowing |
0.60
| 1.00 | |||||||||
Sleep | 0.09 | 0.17 | 1.00 | ||||||||
Skin integrity | −0.02 | 0.14 | 0.02 | 1.00 | |||||||
Oxygenation | 0.00 | −0.14 | 0.12 | − 0.03 | 1.00 | ||||||
Cough strength | 0.11 | − 0.02 | 0.07 | 0.01 | 0.07 | 1.00 | |||||
Secretion management | 0.06 | −0.03 | 0.15 | − 0.04 | 0.30 |
0.48
| 1.00 | ||||
Mobility |
0.47
|
0.68
| 0.11 | 0.26 | −0.12 | −0.01 | − 0.02 | 1.00 | |||
Upper limb and lower limb strength |
0.59
|
0.66
| 0.02 | 0.15 | −0.13 | 0.05 | −0.02 |
0.75
| 1.00 | ||
Ventilator dependence | 0.17 | 0.15 | 0.11 | 0.03 | 0.18 |
0.45
|
0.55
| 0.19 | 0.20 | 1.00 | |
Co-morbidities | 0.00 | −0.09 | 0.17 | −0.12 | 0.17 | 0.17 | 0.32 | −0.15 | −0.29 | 0.27 | 1.00 |
Composite score creation
Measurement properties of the composite scores
MIND score | Final Number of items | ICCa (N = 114) | Correlations with external measuresb | Comparison of changes in scores from baseline to day 30 – Mean change in score (ESc) | |||||
---|---|---|---|---|---|---|---|---|---|
DNS score (N = 128) | EQ-5D VAS (N = 110) | CGIC = worse (N = 16) | CGIC = stable (N = 54) | CGIC = better (N = 48) | p-value§ | ||||
Component | Cognition | 2 | 0.89 | − 0.50 | 0.31 | − 0.5 (− 0.4) | 0.1 (0.1) | 0.5 (0.3) | < 0.001 |
Feeding/swallowing | 1 | 0.83 | −0.57 | 0.34 | 0.1 (0.0) | 0.1 (0.0) | 1.0 (0.5) | < 0.001 | |
Sleep | 4 | 0.38 | −0.23 | 0.21 | 0.6 (0.5) | −0.2 (− 0.2) | 0.4 (0.4) | 0.011 | |
Skin integrity | 1 | 0.84 | −0.35 | 0.07 | −0.1 (− 0.0) | 0.1 (0.1) | 0.2 (0.1) | 0.519 | |
Oxygenation | 1 | 0.67 | −0.03 | − 0.13 | −0.3 (− 0.2) | 0.2 (0.2) | 0.5 (0.3) | 0.119 | |
Cough strength | 1 | 0.71 | −0.20 | 0.32 | −0.3 (− 0.2) | 0.0 (0.0) | 0.3 (0.1) | 0.415 | |
Secretion management | 1 | 0.70 | −0.27 | 0.06 | −0.3 (− 0.2) | −0.1 (− 0.1) | 0.8 (0.5) | < 0.001 | |
Mobility | 1 | 0.83 | −0.61 | 0.29 | −0.1 (− 0.1) | 0.2 (0.1) | 0.8 (0.5) | < 0.001 | |
Upper limb and lower limb strength | 2 | 0.92 | −0.46 | 0.25 | −0.2 (− 0.2) | 0.2 (0.1) | 0.4 (0.3) | 0.002 | |
Ventilator dependence | 1 | 0.51 | −0.50 | 0.10 | 0.2 (0.1) | 0.1 (0.1) | 1.6 (0.9) | < 0.001 | |
Co-morbidities | 1 | 0.83 | −0.16 | 0.03 | 0.1 (0.0) | 0.1 (0.0) | −0.3 (− 0.2) | 0.125 | |
11-component composite | Simple summation | 16 | 0.83 | −0.76 | 0.38 | −0.7 (− 0.1) | 0.7 (0.1) | 6.1 (0.7) | < 0.001 |
Weighted summation | 16 | 0.89 | −0.71 | 0.46 | −0.8 (− 0.1) | 0.5 (0.0) | 12.3 (0.6) | < 0.001 | |
2-component composite | Simple summation | 2 | 0.83 | −0.58 | 0.46 | −0.2 (− 0.1) | 0.1 (0.0) | 1.3 (0.5) | 0.001 |
Weighted summation | 2 | 0.82 | −0.56 | 0.47 | −0.7 (− 0.1) | 0.3 (0.0) | 3.8 (0.5) | 0.003 |