The Validity and Reliability of the Indonesian Version of Post-Intensive Care Syndrome Questionnaire (PICSQ) for Intensive Care Unit Survivors

Authors

  • Peggy Sunarjo 1. Doctoral Program in Medical Sciences, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. 2. Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia.
  • Luh Karunia Wahyuni Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
  • Dita Aditianingsih Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
  • Retno Asti Werdhani Department of Community Medicine, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
  • Kristiana Siste Kurniasanti Department of Psychiatry, Faculty of Medicine, Universitas Indonesia - Dr.  Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
  • Wisnu Ananta Kusuma Department of Computer Science, Faculty of Mathematics and Natural Sciences, IPB University, Bogor, Indonesia
  • Anitta Florence Stans Paulus Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Universitas Indonesia- Persahabatan General Hospital, Jakarta, Indonesia
  • Mellisya Ramadhany Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
  • Widjajalaksmi Kusumaningsih Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia

Keywords:

Intensive Care Unit, Quality of Life, Surveys and Questionnaires, Factor Analysis, Statistical, Indonesia

Abstract

Background: Post-Intensive Care Syndrome (PICS) encompasses cognitive, motor, and mental impairments persisting for years in ICU survivors. Despite its significance, the prevalence of PICS in Indonesia remains uncertain due to limited research and a lack of validated measurement tools. This study aims to translate and validate the PICS Questionnaire for use among ICU survivors in Indonesia. Methods: The study followed a two-phase approach: translation and evaluation. The translation phase adhered to the 10-step process of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines. The analysis phase involved 184 subjects, using Confirmatory Factor Analysis (CFA) for validation and Cronbach's α and Intraclass Correlation Coefficient (ICC) for reliability testing. Results: The CFA reported factor loadings (λ >0.40) for each item in its relevant domain. Fit index values indicated a good-to-acceptable fit. Internal reliability was high for the mental, physical, and cognitive domains (0.812 vs. 0.779 vs. 0.855), with Cronbach's α of > 0.70. Test-retest reliability and ICC demonstrated dependable results (>0.70) for each domain. Conclusion: The translated and validated Indonesian PICS Questionnaire demonstrates good validity and reliability. This tool will enable healthcare professionals to assess PICS among ICU survivors in Indonesia and facilitate further research on its prevalence and impact on quality of life.

References

Padte S, Samala Venkata V, Mehta P, Tawfeeq S, Kashyap R, Surani S. 21st century critical care medicine: An overview. World J Crit Care Med. 2024 Mar 9;13(1):90176.

Lee M, Kang J, Jeong YJ. Risk factors for post–intensive care syndrome: A systematic review and meta-analysis. Aust Crit Care. 2020 May 1;33(3):287–94.

Fresenko LE, Rivera ZC, Parry SM, Mayer KP. Post-intensive care syndrome: Physical impairments and function. Crit Care Clin. 2025 Jan 1;41(1):1–20.

Colbenson GA, Johnson A, Wilson ME. Post-intensive care syndrome: impact, prevention, and management. Breathe Sheff Engl. 2019 June;15(2):98–101.

Hiser SL, Fatima A, Ali M, Needham DM. Post-intensive care syndrome (PICS): recent updates. J Intensive Care. 2023 May 23;11(1):23.

Su H, Fuentes AL, Chen H, et al. The financial impact of post-intensive care syndrome. Crit Care Clin. 2025 Jan;41(1):103–19.

Ramnarain D, Aupers E, den Oudsten B, Oldenbeuving A, de Vries J, Pouwels S. Post intensive care syndrome (PICS): an overview of the definition, etiology, risk factors, and possible counseling and treatment strategies. Expert Rev Neurother. 2021 Oct 3;21(10):1159–77.

Post-intensive care syndrome as a predictor of mortality in patients with critical illness: A cohort study | PLOS One [Internet]. [cited 2025 Sept 10]. Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0244564

Carel D, Pantet O, Ramelet AS, Berger MM. Post intensive care syndrome (PICS) physical, cognitive, and mental health outcomes 6-months to 7 years after a major burn injury: A cross-sectional study. Burns J Int Soc Burn Inj. 2023 Feb;49(1):26–33.

Kang J, Jeong YJ, Hong J. Cut-off values of the post-intensive care syndrome questionnaire for the screening of unplanned hospital readmission within one year. J Korean Acad Nurs. 2020 Dec;50(6):787–98.

Goel T, Arunmozhi R. Navigating the urgency: A narrative review on the critical demand for robust outcome measures in post-intensive care syndrome (PICS). Intensive Care Res. 2024 Sept 1;4(3):180–91.

Kean S, Donaghy E, Bancroft A, Clegg G, Rodgers S. Theorising survivorship after intensive care: A systematic review of patient and family experiences. J Clin Nurs. 2021 Sept;30(17–18):2584–610.

Jeong YJ, Kang J. Development and validation of a questionnaire to measure post-intensive care syndrome. Intensive Crit Care Nurs. 2019 Dec;55:102756.

Yusuf A, Abidin AZ, Anwar S, Romlah. Tindakan sistem pendidikan meninjau permasalahan rendahnya kualitas pendidikan di Indonesia dan solusinya. JIIP. 2024 Mar;7(3).

Wang S, Jawed Y, Perkins A, et al. Healthy aging brain care monitor, caregiver version: Screening for post–intensive care syndrome. Am J Crit Care. 2022 Mar 1;31(2):137–44.

Boateng GO, Neilands TB, Frongillo EA, Melgar-Quiñonez HR, Young SL. Best practices for developing and validating scales for health, social, and behavioral research: A primer. Front Public Health. 2018 Jun 11;6:149. doi: 10.3389/fpubh.2018.00149. PMID: 29942800; PMCID: PMC6004510.

Thronicke A, Schille L, Adie K, Junghanss C, Oei SL, Johnson SK, Roos J, Schad F. Translation and cultural adaptation of the MYCaW® questionnaire into German: the iSWOP study protocol. medRxiv. 2025 Mar 17. doi:10.1101/2025.03.17.25324105.

Hair J, Anderson R, Babin B, Black W. Multivariate data analysis [Internet]. Pearson International; 2013 [cited 2025 Sept 10]. Available from: https://elibrary.pearson.de/book/99.150005/9781292035116

Cho G, Hwang H, Sarstedt M, Ringle CM. Cutoff criteria for overall model fit indexes in generalized structured component analysis. J Mark Anal. 2020 Dec 1;8(4):189–202.

Yuan C, Timmins F, Thompson DR. Post-intensive care syndrome: A concept analysis. Int J Nurs Stud. 2021 Feb 1;114:103814.

Ronflé R, Hermitant J, Conti-Zolin C, et al. Impact of self-perceived discomfort in critically ill patients on the occurrence of psychiatric symptoms in post-intensive care syndrome (PICS): A prospective observational study. PLOS ONE. 2025 June 6;20(6):e0324099.

Yanagi N, Kamiya K, Hamazaki N, et al. Post-intensive care syndrome as a predictor of mortality in patients with critical illness: A cohort study. PLOS ONE. 2021 Mar 10;16(3):e0244564.

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Published

2026-04-09

How to Cite

Sunarjo, P., Wahyuni, L. K., Aditianingsih, D., Werdhani, R. A., Siste Kurniasanti, K., Kusuma, W. A., Paulus, A. F. S., Ramadhany, M., & Kusumaningsih, W. (2026). The Validity and Reliability of the Indonesian Version of Post-Intensive Care Syndrome Questionnaire (PICSQ) for Intensive Care Unit Survivors. Acta Medica Indonesiana, 58(1), 32. Retrieved from https://mail.actamedindones.org/index.php/ijim/article/view/3087

Issue

Vol. 58 No. 1 (2026): Acta Medica Indonesiana

Section

ORIGINAL ARTICLE

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Copyright (c) 2026 Peggy Sunarjo, Luh Karunia Wahyuni, Dita Aditianingsih, Retno Asti Werdhani, Kristiana Siste Kurniasanti, Wisnu Ananta Kusuma, Anitta Florence Stans Paulus, Mellisya Ramadhany, Widjajalaksmi Kusumaningsih

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