Purpose
Post–intensive care syndrome (PICS) has traditionally been conceptualized as comprising physical, cognitive, and psychological impairments. However, emerging evidence highlights additional domains, including fatigue, sleep disturbance, pain, social participation, and self-management. This COSMIN-based scoping review aimed to map available PICS assessment instruments, evaluate their psychometric and methodological quality, and propose future directions for the development of comprehensive multidomain tools.
Methods
Following the COSMIN guideline, JBI methodology, and the PRISMA-ScR framework, we systematically searched PubMed, Embase, the Cochrane Library, CINAHL, and RISS for studies published between January 2012 and June 2024. Two reviewers independently screened studies and extracted data. Psychometric properties, including content validity, structural validity, internal consistency, reliability, measurement error, and responsiveness, were evaluated according to COSMIN criteria.
Results
Twenty-eight studies describing 20 PICS-related instruments were identified. Single-domain measures were used more frequently than multidomain instruments. Multidomain tools demonstrated acceptable internal consistency; however, evidence for confirmatory factor analysis, measurement invariance, test-retest reliability, and measurement error was limited. Several patient-experienced domains, including fatigue, sleep disturbance, pain, and social participation, were only partially represented across instruments, thereby limiting the comprehensive assessment of recovery trajectories.
Conclusion
Despite growing recognition of PICS, the use of validated assessment tools in clinical practice remains inconsistent, and existing instruments do not adequately capture the full spectrum of physical, cognitive, psychological, and social outcomes. Evidence supporting their psychometric robustness is also limited. A patient-centered, multidomain instrument with strong methodological foundations is urgently needed to enable accurate monitoring, guide timely interventions, and improve long-term outcomes among intensive care unit survivors.

Purpose
This study aimed to investigate the incidence rate, types and risk factors for delirium in patients admitted to the surgical Step-Down Unit (SDU).
Methods
This study was a retrospective study of the electronic medical records of patients admitted to a surgical SDU from February 2020 to July 2020. The delirium assessment was conducted using the short Confusion Assessment Method (a tool that allows quick and easy screening of delirium) and the incidence and risk factors for delirium were determined.
Results
Among a total of 227 patients in the study, the incidence rate of delirium was 35 cases (16.7%). It predominantly occurred on the first day (n = 16, 45.7%) and the second day of admission (n = 15, 42.8%). The peak occurrence of delirium was between 14:00 and 22:00 (n = 30, 85.7%). The most common type of delirium was hypoactive (n = 19, 54.3%). The results of multiple logistic regression analysis indicated that the factors influencing the occurrence of delirium in the surgical step down unit (SDU) were age, hypertension, stroke, white blood cell count, and the use of restraints.
Conclusion
Considering the characteristics of high-risk groups for delirium in the surgical SDU, it is necessary to establish nursing practice guidelines to minimize delirium.

Citations

• A Systems Biology Approach to Understanding Delirium Pathophysiology and Identifying Natural Compounds for Potential Therapeutic Purposes
  Babak Sokouti
  OBM Neurobiology.2025; 09(01): 1.     CrossRef