Assessment instruments for post–intensive care syndrome: a COSMIN-based scoping review

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.