The children's chelsea critical care physical assessment tool: Modification of a validated adult assessment tool using delphi method

Abstract

Aims & Objectives: Evidence is emerging regarding early mobility interventions for critically unwell children in the paediatric intensive care unit (PICU). Targeted early assessment and rehabilitation is vital to help minimise the effects of critical illness on short and long-term physical function. Currently there is a lack of clinically relevant outcome measures to evaluate physical function of children in PICU. The objective of this project is to modify an existing validated measure of physical morbidity in the adult critical care population; The Chelsea Critical Care Physical Assessment Tool (CPAx), for use in children in PICU. Methods Delphi consensus methods were used to examine content validity and adapt the CPAx for paediatrics. An expert group of 22 PICU; physiotherapists, occupational therapists and paediatric intensivists from 7 countries participated. Three iterations including feedback and content revisions occurred until consensus was achieved. Results There were 11 respondents in round 1 of the survey, 12 respondents in round 2, and 16 respondents in round 3, representing 16 different tertiary level PICUs. For round one of the survey, consensus(>90%) was achieved for 41 of the 60 items, round 2; 36 and round 3; 49. In round 3, 100% of items reached over 80% consensus. Modifications were made to 46 score definitions. Conclusions The cCPAx has been developed using a modified Delphi method and after 3 iterations a strong level of consensus exists, this demonstrates a convergence of expert opinions. A pilot reliability and validity study is currently underway. The cCPAx tool has application for clinical practice, research, and education.L6238159492018-09-13 <br />