Patients’ recollections of stressful experiences while receiving prolonged mechanical ventilation in an intensive care unit*

Rotondi, Armando J.; Chelluri, Lakshmipathi; Sirio, Carl A.; Mendelsohn, Aaron B.; Schulz, Richard; Belle, Steven H.; Im, Kyung Ah; Donahoe, Michael P.; Pinsky, Michael R.

doi:10.1097/00003246-200204000-00004

Cited by 516 publications

(356 citation statements)

References 19 publications

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“…First, the retrospective evaluation of PH may be associated with recall bias. However, considering that patients are more likely to remember experiences that were moderately to extremely bothersome during the acute phase of their disease [18] we believe that it is likely that their recall ability might be accurate, as most of our patients experienced a stressful situation: the stroke. Second, in the absence of data from a group of patients with stroke of other etiologies, one can not determine whether PH improvement was specific to SCAD or whether it was related to the experience of a stressful life event.…”

Section: Discussionmentioning

confidence: 99%

Primary headaches and painful spontaneous cervical artery dissection

et al. 2007

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The relation between primary headaches (PH) and pain related to spontaneous cervical artery dissection (SCAD) is still unclear, as well as the progress of PH after dissection. To investigate this relation, the characteristics of pain related to SCAD and changes in PH patterns after SCAD, we evaluated 54 consecutive patients. Thirty-five (65%) had previous PH. Painful SCAD occurred in 39 (72%). Frontal and parietal localizations were significantly associated with internal carotid artery dissection (p=0.013 and p=0.010, respectively), whereas occipital and nuchal pain, with vertebral artery dissection (p=0.047 and p<0.001, respectively). Previous PH did not influence the presence of pain at SCAD onset. Twenty-six (74%) patients with PH reported improvement in PH pattern after a mean follow-up of 32 months. These results suggest that mechanisms underlying PH do not modulate dissectionrelated pain. Disruption of perivascular afferents may be involved in improvement of PH patterns after SCAD.

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Section: Discussionmentioning

confidence: 99%

Primary headaches and painful spontaneous cervical artery dissection

et al. 2007

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“…Nighttime awakening and difficulty in falling asleep were reported by 40% and 35% of ICU patients respectively [7]. These sleep disturbances could persist after patients are discharged from the ICU [8].…”

Section: Introductionmentioning

confidence: 99%

New onset of insomnia in hospitalized patients in general medical wards: incidence, causes, and resolution rate

Raja

Waldhorn

et al. 2017

Journal of Community Hospital Internal Medicine Perspectives

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Background: Insomnia is common in hospitalized patients. However, no study has examined new onset of insomnia in patients without a prior history of insomnia. Objectives: Incidence of new onset of insomnia in inpatients, associated factors and resolution rate after 2 weeks. Method: This is a prospective observational study conducted at a community hospital. We used the Insomnia Severity Index questionnaire to screen for insomnia in all patients located in the general medical floors from day 3 to day 5 of their hospital stay. We excluded patients with a prior insomnia history. Results: Out of the 205 patients who met the inclusion criteria, 75 patients (36%) reported insomnia. Severe insomnia was present in 3% of patients. Difficulty in maintaining sleep is the most common symptom. Frequent staff disruptions due to blood draws and vital signs checks were reported by 68% as the cause of insomnia, followed by illness associated causes (64%) and sleep disruption due to noise and or brightness (23%). Patients with insomnia had more awakenings due to noise, brightness, and staff interruptions than those without insomnia (1.35 times vs. 0.9 times, p = 0.027). Patients with respiratory symptoms, cardiac monitoring, oxygen use, private rooms, and no sedative use did not have a higher insomnia risk. Patients with insomnia had significant lower satisfaction scores than patients without insomnia (4.53 vs. 4.05, p = 0.001) but did not have a different length of stay (6.18 vs. 6.19, p = 0.97). In 31% of patients with insomnia who were able to be contacted two weeks after discharge, 75% of them had insomnia resolution. Conclusion: New onset of insomnia occurred in 36% of hospitalized patients. Most common causes are staff disruption and disease symptoms. It was usually short-term and could decrease patients’ satisfaction score.

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“…A serious illness or injury, and treatment in the ICU, can be very stressful experiences (Granberg et al, 1998;Rotondi et al, 2002;Russell, 1999;Stein-Parbury and McKinley, 2000). A wide range of stressors, e.g.…”

Section: Introductionmentioning

confidence: 99%