Evaluating the level of comfort and stress of conscious ICU patients

Introduction

Compassionate and humane care was recently incorporated into standard intensive care units. Alleviation of stress and discomfort is now recognized as an important step during the treatment of critically ill patients. The impact and relevance of this issue have been largely discussed but not yet fully evaluated. The authors hypothesized that conscious patients might provide important information that can result in improved compassionate care in adult ICUs.

Materials and method

Between November 1995 and February 1997, 138 patients admitted in the ICU with total alertness and preserved cognitive function for at least 3 days were asked to answer a questionnaire elaborated by the multidisciplinary team. Questions focused on aspects related to well-being and comfort of the patients: ambient temperature, noise, satisfaction with health care providers, sleepiness, pain, time orientation, complaints, and psychological reactions.

Results

The temperature was considered fair by 60% of the patients, 18% felt hot and 22% cold; 85% of the patients considered general professional care satisfactory; 82% were bothered by loud noise; 46% did not sleep during the night; 45% refer pain; 11% were not time oriented; and 17% had at least one complaint. Anxiety (47%) and fear (35%) were the most common psychological reactions.

Conclusion

The data suggest that short and simple questionnaires applied periodically to conscious patients might identify factors of stress and discomfort during ICU stay. This is an efficient and relatively inexpensive tool to improve the quality of care provided by a multidisciplinary team.