{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T16:51:55Z","timestamp":1791305515649,"version":"4.3.1"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVES:<\/jats:title>\n                    <jats:p>Although greater than 50% of acute respiratory failure (ARF) survivors develop postintensive care syndrome, dignity-centered interventions\u2014shown to improve psychosocial and existential outcomes in other longitudinally impaired populations\u2014remain largely unexplored in ARF survivorship. We aimed to validate the Patient Dignity Inventory (PDI) among ARF survivors by evaluating internal consistency and generalizability and establishing a minimal clinically important difference (MCID).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DESIGN\/SETTING\/PATIENTS:<\/jats:title>\n                    <jats:p>Prospective cohort study (June 2022 to April 2023) of mechanically ventilated (\u226524\u2009h) adults in four University of Pennsylvania hospitals\u2019 ICUs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>INTERVENTIONS:<\/jats:title>\n                    <jats:p>None.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MEASUREMENTS AND MAIN RESULTS:<\/jats:title>\n                    <jats:p>\n                      Patients completed the PDI within 1 month of ICU discharge and at 3, 6, and 12 months. We assessed internal consistency using Cronbach\u2019s alpha (reliability of questions measuring the same construct; range 0\u20131) and exploratory factor analysis to identify dignity-related distress domains. We evaluated generalizability using multilevel mixed-effects modeling to estimate variance attributable to patients, questions, and timepoints, which informed phi coefficient calculation (score consistency; range 0\u20131). We calculated MCID by averaging anchor-based (EuroQol-5 Dimension MCID = 0.11 from baseline to 12 months) and distribution-based (average of\n                      <jats:sc>se<\/jats:sc>\n                      of the mean, 0.3 \u00d7\n                      <jats:sc>sd<\/jats:sc>\n                      , and 5% of baseline score range) estimates.\n                    <\/jats:p>\n                    <jats:p>Of 967 eligible patients, 103 patients (11%) enrolled at baseline, with 70% retention at 12 months. PDI demonstrated excellent internal consistency across timepoints (Cronbach\u2019s alpha = 0.94\u20130.96). Factor analysis identified 2\u20133 factors per timepoint, with physical, psychologic, and cognitive impairments predominating early, and existential and interpersonal concerns increasing longitudinally. Seventy-five percent of score variance was attributable to patient differences and 25% to timepoint, yielding phi = 0.93 (excellent consistency).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>The PDI is a valid, reliable instrument for assessing dignity among ARF survivors longitudinally, demonstrating excellent internal consistency and generalizability, providing a foundation for designing and evaluating dignity-centered interventions addressing ARF survivors\u2019 evolving needs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/ccm.0000000000007272","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T17:02:27Z","timestamp":1784653347000},"page":"2766-2772","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Psychometric Properties of the Patient Dignity Inventory in a Longitudinal Cohort of Acute Respiratory Failure Survivors"],"prefix":"10.1097","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2607-9581","authenticated-orcid":false,"given":"Lydia E.","family":"Federico","sequence":"first","affiliation":[{"name":"Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig","family":"Kwiatkowski","sequence":"additional","affiliation":[{"name":"Palliative and Advanced Illness Research (PAIR) Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Jessica","family":"Dine","sequence":"additional","affiliation":[{"name":"Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingying","family":"Lu","sequence":"additional","affiliation":[{"name":"Palliative and Advanced Illness Research (PAIR) Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taara V.","family":"Prasad","sequence":"additional","affiliation":[{"name":"Lewis Katz School of Medicine at Temple University, Philadelphia, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erich","family":"Dress","sequence":"additional","affiliation":[{"name":"Palliative and Advanced Illness Research (PAIR) Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Scott","sequence":"additional","affiliation":[{"name":"Palliative and Advanced Illness Research (PAIR) Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael O.","family":"Harhay","sequence":"additional","affiliation":[{"name":"Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA."},{"name":"Palliative and Advanced Illness Research (PAIR) Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA."},{"name":"Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel A.","family":"Hadler","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA."},{"name":"Emory Critical Care Center, Emory University School of Medicine, Atlanta, GA."},{"name":"Division of Geriatrics and Extended Care, Atlanta VA Medical Center, Decatur, GA."},{"name":"Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, GA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9373-5035","authenticated-orcid":false,"given":"Rachel","family":"Kohn","sequence":"additional","affiliation":[{"name":"Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA."},{"name":"Palliative and Advanced Illness Research (PAIR) Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA."},{"name":"Leonard Davis Institute of Health Economics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"R1-20261006","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1097\/CCM.0b013e318232da75","article-title":"Improving long-term outcomes after discharge from intensive care unit: Report from a stakeholders\u2019 conference.","volume":"40","author":"Needham","year":"2012","journal-title":"Crit Care Med"},{"key":"R2-20261006","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1056\/NEJMoa022450","article-title":"One-year outcomes in survivors of the acute respiratory distress syndrome.","volume":"348","author":"Herridge","year":"2003","journal-title":"N Engl J Med"},{"key":"R3-20261006","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1177\/10547738211036969","article-title":"Dignity and predictors of its change among inpatients in long-term care.","volume":"31","author":"Kisvetrov\u00e1","year":"2022","journal-title":"Clin Nurs Res"},{"key":"R4-20261006","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1089\/jpm.2012.0066","article-title":"The Patient Dignity Inventory: Applications in the oncology setting.","volume":"15","author":"Chochinov","year":"2012","journal-title":"J Palliat Med"},{"key":"R5-20261006","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1016\/j.jpainsymman.2007.12.018","article-title":"The patient dignity inventory: A novel way of measuring dignity-related distress in palliative care.","volume":"36","author":"Chochinov","year":"2008","journal-title":"J Pain Symptom Manage"},{"key":"R6-20261006","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/j.jpainsymman.2021.12.001","article-title":"The patient dignity inventory and dignity-related distress among the critically ill.","volume":"63","author":"Mergler","year":"2022","journal-title":"J Pain Symptom Manage"},{"key":"R7-20261006","doi-asserted-by":"crossref","first-page":"155","DOI":"10.4081\/monaldi.2012.121","article-title":"EuroQol-5D (EQ-5D): An instrument for measuring quality of life.","volume":"78","author":"Balestroni","year":"2015","journal-title":"Monaldi Arch Chest Dis"},{"key":"R9-20261006","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1164\/rccm.202409-1712RL","article-title":"Patient dignity in long-term recovery among survivors of acute respiratory failure: A prospective cohort study.","volume":"211","author":"Kohn","year":"2025","journal-title":"Am J Respir Crit Care Med"},{"key":"R10-20261006","doi-asserted-by":"crossref","first-page":"100185","DOI":"10.1016\/j.chstcc.2025.100185","article-title":"Needs of acute respiratory failure survivors throughout 1 year of recovery: A qualitative analysis using the timing it right framework.","volume":"3","author":"Silvestri","year":"2025","journal-title":"CHEST Crit Care"}],"container-title":["Critical Care Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1097\/CCM.0000000000007272","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T16:01:49Z","timestamp":1791302509000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1097\/CCM.0000000000007272"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,21]]},"references-count":9,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.1097\/ccm.0000000000007272","relation":{},"ISSN":["0090-3493","1530-0293"],"issn-type":[{"value":"0090-3493","type":"print"},{"value":"1530-0293","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,21]]}}}