Patientsʼ recollection of intensive care unit experience

Turner, J. S.; Briggs, Sandra J.; Springhorn, Helge; Potgieter, Peter D.

doi:10.1097/00003246-199009000-00012

Cited by 178 publications

(73 citation statements)

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“…Indeed, a survey of subjects following discharge from an ICU found that arterial puncture for ABG analysis was the most frequently reported unpleasant experience. 1 In this study, cryoanalgesia in the form of ice application for 3 min before arterial puncture significantly reduced procedure-related pain compared with a control procedure (ie, no ice). Cryoanalgesia reduced pain scores compared with the control in the naive subgroup, and there was a trend toward reduced pain in the experienced arterial puncture subgroup.…”

Section: Discussionmentioning

confidence: 62%

“…Arterial punctures can be quite painful for many patients and are a major source of morbidity in critically ill patients. 1 Randomized controlled trials (RCTs) of intradermal anesthetics have been shown to be effective in reducing ABGrelated pain [2][3][4] ; however, intradermal anesthetics are not widely used. 2 The underutilization of intradermal anesthetics is explained by the unsubstantiated belief that the intradermal injection causes as much pain as the arterial puncture and that the volume of fluid infused into the dermal layer may make it more difficult to palpate the SEE THE RELATED EDITORIAL ON PAGE 141 radial artery.…”

Section: Introductionmentioning

confidence: 99%

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Randomized Controlled Trial of Cryoanalgesia (Ice Bag) to Reduce Pain Associated With Arterial Puncture

Haynes

2014

Respir Care

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BACKGROUND: Arterial puncture can be a painful procedure for many patients. This study investigates whether precooling of a puncture site with ice can reduce the pain associated with arterial puncture. METHODS: This was a stratified randomized controlled trial of a convenience sample of out-patients with a physician order for an arterial blood gas (ABG) test. The intervention group had a plastic bag of ice applied to their wrists for 3 min before drawing an ABG sample from the radial artery. The control group had an ABG sample drawn from the radial artery without the application of ice. Pain from the arterial puncture was measured with a 100-mm visual analog scale. RESULTS: Subjects pretreated with ice reported less pain from arterial puncture compared with subjects in the control group (mean visual analog scale 13.8 ؎ 16.9 vs 25 ؎ 23 mm, P ‫؍‬ .01; median visual analog scale 7 mm, interquartile range (IQR) 1.5-19 vs 20 mm, IQR 4.5-38.5 mm, P ‫؍‬ .01). Stratified analysis showed that visual analog scale pain scores were lower in the naive group when ice was applied (naive ice vs naive control: mean visual analog scale 11 ؎ 14.3 vs 26.5 ؎ 25 mm, P ‫؍‬ .02; median visual analog scale 5 mm, IQR 2-14.5 vs 20 mm, IQR 6.5-36 mm, P ‫؍‬ .02). Visual analog scale pain scores trended lower in the experienced group when ice was applied (experienced ice vs experienced control: mean visual analog scale 15.9 ؎ 18.9 vs 25.1 ؎ 22 mm, P ‫؍‬ .15; median visual analog scale 8 mm, IQR 0.5-26.5 vs 23 mm, IQR 3.5-40 mm, P ‫؍‬ .08). There was no difference in first-attempt success between groups (ice group: 85%, control group: 82.5%, P > .99). Only 3 subjects could not tolerate 3-min ice application. CONCLUSIONS: Ice application before arterial puncture is well tolerated and reduces procedure-related pain. (ClinicalTrials.gov NCT02065115).

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Section: Discussionmentioning

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Randomized Controlled Trial of Cryoanalgesia (Ice Bag) to Reduce Pain Associated With Arterial Puncture

Haynes

2014

Respir Care

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“…Araştırmamızı yürüt-tüğümüz kurumların yoğun bakım ünitelerinde çalışan sağlık profesyonellerinin, uygulanan işlemler ve hastaların durumları hakkında bilgi ve geri bildirim vermeleri bu bağlamda da hastaların yoğun bakıma yatışla-rı sırasında kötümser deneyimler yaşamadıkları şeklinde yorumlanabilir. Literatürde, yoğun bakım hastalarında görülen olumsuz deneyimlerin duyusal yoksunluk, duyusal yüklenme, ajitasyon, oryantasyon güçlüğü, deliryum, depresyon, uyum güçlüğü, uyku bozukluğu, regresyon, tedaviyi reddetme, anksiyete, yalnızlık, güçsüzlük ve bilinmezlik korkusu olarak tanımlanmaktadır (34)(35)(36).…”

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“…Ülkemizde yapılan bir çalışmada, hastaların genellikle yoğun bakım ünitesinde çalışan hekim ve hemşirelere güvendiği, kendilerine yapılan açıklamaları yeterli buldukları, soru sorabildikleri, fizik ortamdan ve sağlık çalışanlarından memnun oldukları belirlenmiştir (30). Yapılan bir çalışmada hastaların %94'ünün (17), başka bir çalışmada da hastaların %93'ü yoğun bakım ünitesini arkadaşça, sakin ve rahatlatıcı bir ortam olarak tanımladıkları bildirilmiştir (36). Literatürde yoğun bakım ünitesin-de olumsuz deneyimler yaşayan hastaların yoğun bakım ünitesinde verilen bakım ile ilgili memnuniyetlerinin de daha düşük olduğu bildirilmiştir (20,37).…”

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Assessment of Experiences of Patients Discharged from Intensive Care Units

Adsay¹,

Dedeli²

2016

Yoğun Bakim Derg

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Objective: The purpose of this study was to assess the experiences of patients discharged from intensive care units. Material and Methods:This descriptive and cross-sectional study was conducted with 190 patients who were hospitalized in intensive care units for 24 h and over in a university hospital and a public hospital in Manisa, Turkey. Data were collected by a demographic questionnaire and the Intensive Care Experience Scale. Mean±standard deviation, percentage, Pearson correlation coefficient, and Kruskal-Wallis and MannWhitney U tests were used in the statistical analysis.Results: The mean age of the patients was 56.6±10.8 years, and 60% of the patients were males. It was found that the patients' awareness of the environment in the intensive care unit subscale score of the Intensive Care Experience Scale was significantly different depending on gender and the length of stay in the intensive care unit (p<0.05). It was found that the patients' satisfactions levels about care the in intensive care unit subscale score of the Intensive Care Experience Scale was significantly difference depending on the type of intensive care unit and the length of stay in the intensive care unit (p<0.05). Conclusion:The results of this study show that being aware of the environment in intensive care unit was dependent the length of stay in the intensive care unit and gender and that satisfaction levels about care in the intensive care unit were affected by the length of stay in the intensive care unit and the type of intensive care unit. (Yoğun Bakım Derg 2015; 6: 90- GirişYoğun bakım üniteleri primer olarak ciddi bir hastalığı olan, yaşamı tehdit altında olan ve sürekli yoğun bakım izlemi gerektiren veya yaşamı destekleyici tedaviye bağımlı olan hastaların yaşamını sürdürmek amacına yönelik hizmet veren birimlerdir. Bireyler yaşamı tehdit eden bir hastalık ya da sağlık durumlarında ortaya çıkan ani ve ciddi değişiklikler nedeniyle yoğun bakım ünitesine yatmaktadır (1, 2).Yoğun bakım üniteleri, en ciddi tıbbi ve cerrahi hastalığı olan hastalara mümkün olan en ileri teknoloji ile bakım sağlayan birimlerdir. Belki de bunun bir sonucu olarak, bu birimler hastaların hem fiziksel hem de psikososyal açıdan birçok stresörle karşılaştığı ortamlar olarak kabul edilmektedir. Yoğun bakım ünitelerindeki stresörler fiziksel (ventilatör kullanımı, aspirasyon, iğne, stikler vb.), fizyolojik (hareket kısıtlılığı, sık muayene veya dokunulma, konfüzyon, iletişim güçlüğü vb.) ve çevre-sel (sürekli ışık ve gürültü, konforsuz yataklar, hoş olmayan görüntü ve kokular vb.) olarak tanılanmaktadır. Bu stresörlere hastanın yanıtı tıbbi tanı, prognoz, kültür, sosyal destek, aile ilişkileri, yaş, cinsiyet, gelişim düzeyi, mental durum, baş etme mekanizmaları gibi bireysel farklılıklara bağlıdır. Bireyin kendisini ve diğer kişilerle olan ilişkilerini algılaması, spiritüel değerleri, sosyal rollerinde kişisel yeterliliği stres ve hastalığa yanıtının etkilemesinde büyük bir rol oynamaktadır. Fiziksel hastalıklar, travma, cerrahi girişimlerin stres etkisi b...

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“…Arterial puncture for blood gas (ABG) analysis is a common procedure in a variety of clinical settings, and although it is often performed in sedated patients on mechanical ventilation, it is also frequently performed on patients who are awake, and it can cause significant pain and discomfort. 2 Perhaps due to the often time-sensitive nature of ABG analysis, the use of effective analgesic techniques for this procedure are not routinely employed in many settings. 3 However, the lack of adequate analgesia can lead to unnecessary anxiety and morbidity and may also complicate successful completion of the procedure.…”

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confidence: 99%