The relationship between stressors and intensive care unit experiences

Abstract

Background Patients in intensive care units (ICUs) face many physical and psychological stressors because of the environment of these units and their own critical conditions and experience stress in various degrees. Each stressor may affect patients' experiences in ICUs differently. Aim and objectives This study aimed to examine the relationship between stressors and patients' experiences in an ICU. Methods This descriptive, cross‐sectional study was conducted between September 2014 and June 2015 in a university hospital and included 116 patients who were admitted to the general ICU for at least 24 hours. Data were collected using the Intensive Care Experience Scale and a questionnaire that included questions about socio‐demographic and disease‐related characteristics of patients and their stressors. Results The mean age of the patients was 57.81 ± 13.81 years, and the mean duration of ICU stay was 2.28 ± 3.88 days. There was a moderate positive relation between the stressors noise (r = .534; P < .01), thirst (r = .438; P < .01), loneliness (r = .410; P < .01), and pain (r = .404; P < .01) and the subscale frightening experiences. However, there was a moderate, negative relation between the stressors inability to speak (r = −.444; P < .01), surrounding speeches (r = −.458; P < .01), equipment noise (r = −.490; P < .01), and physical exercise (r = −.546; P < .01) and the subscale satisfaction with care. Conclusions The patients associated stressors with satisfaction and frightening experiences in the early period of their discharge from the ICU. As stressors increases, so do frightening experiences, and satisfaction with care is affected negatively. Relevance to clinical practice Currently, stressors to which patients discharged from ICU are exposed during their admission to wards are not evaluated in practice. This study is important in that it can help health professionals be aware of effects of stressors on patients in the early period of their discharge.

Perceived Severity of Stressors in the Intensive Care Unit: A Systematic Review and Semi-Quantitative Analysis of the Literature on the Perspectives of Patients, Health Care Providers and Relatives

“…A first inspection of studies from different decades may give preliminary insights that can inform further detailed analyses of this topic. Three studies from different decades enable a first comparison of stressor ranking lists: the pioneering study of Cochran & Ganong (1989) [3], the study of Biancofiore et al (2005), which had been published 16 years later [33], and the most recent study of Zengin et al (2020) [63] (for details, see Supplementary Table S1). On the one hand, each ranking list contains stressors among the 10 highest ranking items that are not included in the other lists.…”

“…The larger item number of these domains is also a result of the finding that the ranking lists of patients, HCPs and relatives contain more physical and mental health stressors than communication and environmental stressors (Table 2). However, we have to take into consideration that some studies showed moderate to large associations between perceived environmental and communication stressors on the one hand and mental distress on the other hand, even when the stress level of the environmental and communication stressors were relatively low [10,63]. Moreover, there is ample evidence that perceived communication stressors and objectively measured environmental stressors can cause subjective mental distress, and that a reduction of environmental and communicative stress level leads to an improvement in mental distress [11,50,54,65,67,71,72,79,80].…”

Thirst in patients admitted to intensive care units: an observational study

“…What does this paper contribute to the wider global clinical community? While thirst is one of the most intensely perceived symptoms, the second most prevalent symptom in ICUs [ 13 ], there is a lack in nursing research regarding its assessment, diagnosis, and interventions. There is a high prevalence of thirst among ICU patients (76.1% of subjects, median 5.37).…”

“…Identification of patients at risk and early intervention should be standard practice within ICUs [ 8 , 9 ]. The relevance of the topic does not emerge in medical and nursing literature, but the scientific debate needs to focus on thirst in ICU patients: in fact, while thirst is one of the most intensely perceived symptoms, the first [ 12 , 13 ] or the second [ 14 ] most prevalent symptom in ICUs, there is a lack in ICU nursing research regarding its assessment, correlation to patient deterioration, or to agitation state, diagnosis, and interventions. This is remarkable, as thirst is primarily identified by nurses within hospitals [ 3 ].…”

What's in this Special Issue

“…Understanding stressors experienced by critical care patients is also crucial. Zegnin and colleagues, in a cross‐sectional survey, examined the relationship between ICU‐experienced stressors in adults in an ICU in Turkey. Using the Intensive Care Experiences Scale and another scale they collected data on 116 adults who stayed more than 24 hours in an ICU.…”