Development of a menu of recovery goals to facilitate goal setting after critical illness

Objective: To develop an expert-informed (including end users) recovery goal menu for adults recovering from critical illness applicable to the community/home setting.Research methodology/design: Stage 1 Item generation: iterative development of domains, sub-domains, and goals in consultation with former intensive care patients, family members and expert clinicians. Stage 2 Content validity assessment: cognitive interviews and the content validity index.Setting: Virtual consultation meetings facilitated by the research team at King's College London and Guy's and St Thomas' NHS Foundation Trust. Main outcome measures: Content validity as assessed by: the Item-Content Validity Index (I-CVI), Scale LevelContent Validity Index/Universal Agreement (S-CVI/UA) score, the Scale Level-Content Validity Index/ Average (S-CVI/Ave) score and Average Content Validity Ratio (CVR).Results: Item generation resulted in a goal menu comprising 4 domains, 22 sub-domains and 95 goals assigned as follows: Self-care: 9 sub-domains with 37 goals, Productivity: 7 sub-domains with 13 goals, Leisure: 3 subdomains with 25 goals, and Person domain 3 sub-domains with 20 goals. Cognitive interviews resulted in addition of 79 goals and modification of 7, addition of 4 new sub-domains and modification of 4, thus resulting in 4 domains, 26 sub-domains with a total of 174 goals. Twenty-four sub-domains (169 goals) were deemed relevant with Item-Content Validity Index (I-CVI) scores ranging from 0.72 to 1. Two sub-domains (5 goals) did not meet the 0.7 cut-off and were removed. The Scale Level-Content Validity Index/Universal Agreement (S-CVI/ UA) score was 0.46; the Scale Level-Content Validity Index/Average (S-CVI/Ave) 0.91. Average Content Validity Ratio (CVR) was 0.93.Conclusion: An expert informed recovery goal menu for former intensive care patients has been developed with excellent content validity. The final goal menu comprises 169 goals within 24 sub-domains grouped under 4 domains.Implications for Clinical Practice: This menu will help patients to set goals and increase our understanding of how individuals recover from critical illness.