Patients’ recollections of stressful experiences while receiving prolonged mechanical ventilation in an intensive care unit*
Top Cited Papers
- 1 April 2002
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Critical Care Medicine
- Vol. 30 (4), 746-752
- https://doi.org/10.1097/00003246-200204000-00004
Abstract
To describe stressful experiences of adult patients who received mechanical ventilation for ≥48 hrs in an intensive care unit. Prospective cohort study. Four intensive care units within an East Coast tertiary-care university medical center. Patients were 150 adult intensive care unit patients receiving mechanical ventilation for ≥48 hrs. None. As part of a study of the long-term outcomes of adult patients requiring prolonged mechanical ventilation, we used a 32-item questionnaire to collect data on patients’ stressful experiences, both psychological (e.g., fearfulness, anxiety) and physical (e.g., pain, difficulty breathing), associated with the mechanical ventilation endotracheal tube and with being in an intensive care unit. Of 554 patients who met study criteria and survived prolonged mechanical ventilation, 150 consented and were oriented to person, place, and situation. Two thirds of these patients remembered the endotracheal tube and/or being in an intensive care unit. The median numbers of endotracheal tube and intensive care unit experiences remembered were 3 (of 7) and 9 (of 22), respectively. If a patient remembered an experience in the questionnaire, it was likely to be moderately to extremely bothersome. Some of the items that many patients found to be moderately to extremely bothersome were pain, fear, anxiety, lack of sleep, feeling tense, inability to speak/communicate, lack of control, nightmares, and loneliness. Stressful experiences associated with the endotracheal tube were strongly associated with subjects’ experiencing spells of terror, feeling nervous when left alone, and poor sleeping patterns. Subjects were more likely to remember experiences that were moderately to extremely bothersome. This might be because the more bothersome experiences were easier to recall or because most of these experiences are common and significant stressors to many of these patients. In either case, these data indicate that these patients are subject to numerous stressful experiences, which many find quite bothersome. This suggests the potential for improved symptom management, which could contribute to a less stressful intensive care unit stay and improved patient outcomes.Keywords
This publication has 16 references indexed in Scilit:
- Hospital noise pollution: an environmental stress model to guide research and clinical interventionsJournal of Advanced Nursing, 2000
- Impact of Psychological Factors on the Pathogenesis of Cardiovascular Disease and Implications for TherapyCirculation, 1999
- An exploratory study of patients' perceptions, memories and experiences of an intensive care unitJournal of Advanced Nursing, 1999
- THE EXPERIENCE AND CARING NEEDS OF CRITICALLY ILL MECHANICALLY VENTILATED PATIENTSCritical Care Medicine, 1999
- Factors related to the emotional responses of intubated patients to being unable to speakHeart & Lung, 1998
- Health-related quality of life and posttraumatic stress disorder in survivors of the acute respiratory distress syndromeCritical Care Medicine, 1998
- Pain and distress among elderly intensive care unit patients: Comparison of patients' experiences and nurses' assessmentsHeart & Lung, 1998
- Sleep in the Intensive Care UnitChest, 1995
- Theoretical Considerations for Research on Environmental Stress and HealthImage: the Journal of Nursing Scholarship, 1994
- Assessment of patientsʼ experience of discomforts during respirator therapyCritical Care Medicine, 1989