Scales for Evaluating Self-Perceived Anxiety Levels in Patients Admitted to Intensive Care Units: A Review

Abstract

Objective To review studies of anxiety in critically ill patients admitted to an intensive care unit to describe the level of anxiety and synthesize the psychometric properties of the instruments used to measure anxiety. Methods The CUIDEN, IME, ISOC, CINAHL, MEDLINE, and PSYCINFO databases for 1995 to 2005 were searched. The search focused on 3 concepts: anxiety, intensive care, and mechanical ventilation for the English-language databases and ansiedad, cuidados intensivos, and ventilación mecánica for the Spanish-language databases. Information was extracted from 18 selected articles on the level of anxiety experienced by patients and the psychometric properties of the instruments used to measure anxiety. Results Moderate levels of anxiety were reported. Levels were higher in women than in men, and higher in patients undergoing positive pressure ventilation regardless of sex. Most multi-item instruments had high coefficients of internal consistency. The reliability of instruments with only a single item was not demonstrated, even though the instruments had moderate-to-high correlations with other measurements. Conclusion Midlength scales, such the anxiety subscale of the Brief Symptom Inventory or the shortened state version of the State-Trait Anxiety Inventory are best for measuring anxiety in critical care patients.

Reliability and Validity of Shortened State Trait Anxiety Inventory in Spanish Patients Receiving Mechanical Ventilation

“…Pediatric patients (<15 years old), A nxiety is one of the negative experiences that patients in intensive care units (ICUs) remember most. 1,2 ICU patients receiving invasive mechanical ventilation (IMV) show higher anxiety levels than do patients who are not receiving mechanical ventilation, 3 principally because of the discomfort associated with endotracheal intubation and the difficulties it poses for communication with health professionals. 1,4 Obstacles hindering anxiety assessments include poor use of assessment tools and lack of time.…”

Nurses' perceptions of unpleasant symptoms and signs in ventilated and sedated patients

“…This may indicate that they were more aware or better informed of the key variables in patients' discomfort than were the more experienced nurses. Mechanical ventilation can cause both dyspnoea and anxiety (Chlan 2003;Perpiñá-Galvañ and Richart-Martínez, 2009;Schmidt et al, 2011) and fear-induced anxiety can compromise respiratory function and contribute to prolonged mechanical ventilation (Chen et al, 2011). To reduce ventilation time caused by anxiety and avoid oversedation, it is essential for nurses to develop competence about ventilator settings and patient responses.…”

Nonpharmacological Interventions to Manage Common Symptoms in Patients Receiving Mechanical Ventilation

“…3,5,32 Closely related to anxiety is agitation. These symptoms can be due to numerous physiological and psychological perturbations, but they can also be associated with common ICU procedures such as weaning.…”

“…32 Patients receiving mechanical ventilation have already experienced stressful situations just by being critically ill. Some patients may have had severe dyspnea and feelings of air hunger before treatment with mechanical ventilation, and implementation of weaning trials may increase the workload of breathing again.…”