Symptom assessment in non-vocal or cognitively impaired ICU patients: Implications for practice and future research

Ji Yeon Choi, Margaret L. Campbell, Céline Gélinas, Mary Beth Happ, Judith Tate, Linda Chlan

Research output: Contribution to journalReview articlepeer-review

8 Scopus citations


Background Symptom assessment in critically ill patients is challenging because many cannot provide a self-report. Objectives To describe the state of the science on symptom communication and the assessment of selected physical symptoms in non-vocal ICU patients. Methods This paper summarizes a 2014 American Thoracic Society Annual International Conference symposium presenting current evidence on symptom communication, delirium, and the assessment of common physical symptoms (i.e., dyspnea, pain, weakness, and fatigue) experienced by non-vocal ICU patients. Results Symptom assessment begins with accurate assessment, which includes an evaluation of delirium, and assistance in symptom communication. Simple self-report measures (e.g., 0–10 numeric rating scale), observational measures (e.g., Respiratory Distress Observation Scale and Critical-Care Pain Observation Tool), or objective measures (e.g., manual muscle testing and hand dynamometry) have demonstrated utility among this population. Conclusion Optimizing symptom assessment with valid and reliable instruments with minimum patient burden is necessary to advance clinical practice and research in this field.

Original languageEnglish (US)
Pages (from-to)239-245
Number of pages7
JournalHeart and Lung: Journal of Acute and Critical Care
Issue number4
StatePublished - Jul 2017


  • Communication
  • Delirium
  • Dyspnea
  • Fatigue
  • ICU
  • Pain
  • Symptom assessment
  • Weakness

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine


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