Patient and nurse perceptions of stressors in the intensive care unit

Abstract

The objective of the study was to determine the perceptions of a group of patients on intensive care units' (ICUs) stressors and the perceptions of nurses on ICU patients' stressors in Turkey, and compare the differences in patients' and nurses' perception of the stressors in ICUs. In this descriptive study, 155 patients who were admitted to medical or surgical ICUs and 152 nurses who are employed in the same units of two training and research hospitals in Turkey were enrolled in this study. The ICU Environmental Stressor Scale (ICUESS) was used to determine intensive care stressors. According to total ICUESS mean scores, patients (91.41 ± 34.91) perceived significantly less stress than the ICU nurses (133.23 ± 32.20) perceived them to have. Both patients and nurses ranked 'fear of death' as the greatest stressor. Physiological stressors were identified as the most important stressors by both patients and nurses. Patients and nurses in medical ICUs were more affected by stressors than their counterparts in surgical ICUs. Patients with unplanned or emergency admissions perceived higher stress than that of patients with planned admissions. Several factors could help reduce these stressors, such as having familiar arrangements, humane ICU environment, individual patient assessments and appropriate nursing interventions.

The relationship between stressors and intensive care unit experiences

“…5,13,22 Studies have demonstrated that physical stressors lead to more stress than psychological stressors. 13,16 Results of the present study are consistent with the evidence in the literature that physical stressors are perceived as the most stressful conditions in ICUs.…”

“…The stressors that cause stress in ICU patients are categorized into three groups: physical, psychological, and environmental . Studies have demonstrated that physical stressors lead to more stress than psychological stressors . Results of the present study are consistent with the evidence in the literature that physical stressors are perceived as the most stressful conditions in ICUs.…”

“…Environmental stressors include being in an unfamiliar environment and noise resulting from people and other factors in the environment . In general, these stressors include the presence of a tube in the mouth or nose, pain, inability to sleep and speak, thirst, fear of death, longing for family, urinary and faecal incontinence, and alarm sounds . Patients' experiences with stressors may negatively affect their recovery and return to normal life processes.…”

“…7 In general, these stressors include the presence of a tube in the mouth or nose, pain, inability to sleep and speak, thirst, fear of death, longing for family, urinary and faecal incontinence, and alarm sounds. [8][9][10][11][12][13][14][15][16] Patients' experiences with stressors may negatively affect their recovery and return to normal life processes. The effect of stressors that patients are exposed to in ICUs and that are remembered later on may cause patients to have psychological problems such as anxiety, inability to concentrate, nightmares, difficulty sleeping, fear, and panic in their life after discharge.…”

Critical incidents connected to nurses’ leadership in Intensive Care Units

“…Because of the intense activities performed during shifts in intensive care units, which happen in a busy, stressful environment, thorough attention and care are demanded from all workers. This will eventually overload the entire team and directly and negatively impact patients' recovery (4) . In this sense, the role of leaders as motivators and mediators of relations in this environment becomes essentially important.…”