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

Rotondi, AJ and Chelluri, L and Sirio, C and Mendelsohn, A and Schulz, R and Belle, S and Im, K and Donahoe, M and Pinsky, MR (2002) Patients' recollections of stressful experiences while receiving prolonged mechanical ventilation in an intensive care unit. Critical Care Medicine, 30 (4). 746 - 752. ISSN 0090-3493

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Abstract

Objective: To describe stressful experiences of adult patients who received mechanical ventilation for ≥48 hrs in an intensive care unit. Design: Prospective cohort study. Setting: Four intensive care units within an East Coast tertiary-care university medical center. Patients: Patients were 150 adult intensive care unit patients receiving mechanical ventilation for ≥48 hrs. Intervention: None. Measurements and Main Results: As part of a study of the long-term outcomes of adult patients requiring prolonged mechanical ventilation, we used a 32-item questionnaire to collect data on patients' stressful experiences, both psychological (e.g., fearfulness, anxiety) and physical (e.g., pain, difficulty breathing), associated with the mechanical ventilation endotracheal tube and with being in an intensive care unit. Of 554 patients who met study criteria and survived prolonged mechanical ventilation, 150 consented and were oriented to person, place, and situation. Two thirds of these patients remembered the endotracheal tube and/or being in an intensive care unit. The median numbers of endotracheal tube and intensive care unit experiences remembered were 3 (of 7) and 9 (of 22), respectively. If a patient remembered an experience in the questionnaire, it was likely to be moderately to extremely bothersome. Some of the items that many patients found to be moderately to extremely bothersome were pain, fear, anxiety, lack of sleep, feeling tense, inability to speak/communicate, lack of control, nightmares, and loneliness. Stressful experiences associated with the endotracheal tube were strongly associated with subjects' experiencing spells of terror, feeling nervous when left alone, and poor sleeping patterns. Conclusions: Subjects were more likely to remember experiences that were moderately to extremely bothersome. This might be because the more bothersome experiences were easier to recall or because most of these experiences are common and significant stressors to many of these patients. In either case, these data indicate that these patients are subject to numerous stressful experiences, which many find quite bothersome. This suggests the potential for improved symptom management, which could contribute to a less stressful intensive care unit stay and improved patient outcomes.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Rotondi, AJ
Chelluri, L
Sirio, C
Mendelsohn, A
Schulz, Rschulz@pitt.eduSCHULZ
Belle, Sbelle@edc.pitt.eduSBELLE
Im, K
Donahoe, Mmpd@pitt.eduMPD
Pinsky, MRpinsky@pitt.eduPINSKY
Date: 1 January 2002
Date Type: Publication
Journal or Publication Title: Critical Care Medicine
Volume: 30
Number: 4
Page Range: 746 - 752
DOI or Unique Handle: 10.1097/00003246-200204000-00004
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
ISSN: 0090-3493
Article Type: Review
PubMed ID: 11940739
Date Deposited: 20 Mar 2012 15:55
Last Modified: 04 Feb 2019 19:55
URI: http://d-scholarship.pitt.edu/id/eprint/11484

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