Development of the Support Needs After ICU (SNAC) questionnaire

B O'Neill, Mark A Linden, Pam Ramsay, Alia Darweish Medniuk , Joanne Outtrim, Judy King, Bronagh Blackwood

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2 Citations (Scopus)
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AIMS: To develop a questionnaire to identify Intensive Care survivor needs at key transitions during the recovery process, and assess its validity and reliability in a group of ICU survivors.

METHODS: Development of the Support Needs After ICU (SNAC) questionnaire was based on a systematic scoping review, and analysis of patient interviews (n = 22). Face and content validity were assessed by service users (n = 12) and an expert panel of healthcare professionals (n = 6). A pilot survey among 200 ICU survivors assessed recruitment at one of five different stages after ICU discharge [(1) in hospital, (2) < 6 weeks, (3) 7 weeks to 6 months, (4) 7 to 12 months, or (5) 12 to 24 months post-hospital discharge]; to assess reliability of the SNAC questionnaire; and to conduct exploratory data analysis. Reliability was determined using Cronbach's alpha for internal consistency; intraclass correlation coefficients for test-retest reliability. We explored correlations with sociodemographic variables using Pearson's correlation coefficient; differences between questionnaire scores and patient demographics using one-way ANOVA.

RESULTS: The SNAC questionnaire consisted of 32 items that assessed five categories of support needs (informational, emotional, instrumental [e.g. practical physical help, provision of equipment or training], appraisal [e.g. clinician feedback on recovery] and spiritual needs). ICU survivors were recruited from Northern Ireland, England and Scotland. From a total of 375 questionnaires distributed, 202 (54%) were returned. The questionnaire had high internal consistency (0.97) and high test-retest reliability (r = 0.8) with subcategories ranging from 0.3 to 0.9.

CONCLUSIONS: The SNAC questionnaire appears to be a comprehensive, valid, and reliable questionnaire. Further research will enable more robust examination of its properties e.g. factor analysis, and establish its utility in identifying whether patients' support needs evolve over time.

RELEVANCE TO CLINICAL PRACTICE: The SNAC questionnaire has the potential to be used to identify ICU survivors' needs and inform post-hospital support services.

Original languageEnglish
Pages (from-to)410-418
Number of pages9
JournalNursing in Critical Care
Issue number3
Early online date13 Aug 2021
Publication statusPublished (in print/issue) - 7 May 2022

Bibliographical note

Funding Information:
Intensive Care Foundation Research Priority Award, UK Funding information

Funding Information:
This research was funded by Intensive Care Foundation Research Priority Award, UK. It was supported by Northern Ireland Clinical Research Network-Critical Care members [S O'Kane, A Campbell (PI Altnagelvin); E McKay, O O'Neill, P Johnston (PI Antrim); A O'Neill, K Ward, JMcCann, J McNamee (PI Royal Group of Hospitals); D McFarland, C Shevlin (PI Craigavon Hospital); S Hagan, J Trinder (PI Ulster Hospital)]. Also C McCulloch, D Hope, NHS Lothian; and A Ramesh and A Timpson, Southmead Hospital Bristol. Thank you to all patients who participated as well as the independent expert health care panel (N Ambler, B Connolly, R Graham, C Waldmann, J Rattray, Van Mellaerts).

Publisher Copyright:
© 2021 The Authors. Nursing in Critical Care published by John Wiley & Sons, Ltd on behalf of British Association of Critical Care Nurses.


  • ICU follow up
  • Questionnaire Design/Survey
  • Adult intensive care
  • ICU follow‐up
  • adult intensive care
  • questionnaire design/survey
  • ICU follow-up
  • Critical Care Nursing


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