Measurement of Sleep in Critically Ill Patients

2000 ◽  
Vol 8 (2) ◽  
pp. 131-144 ◽  
Author(s):  
Kathy C. Richards ◽  
Patricia S. O’Sullivan ◽  
Robin L. Phillips
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Gold Standard ◽  
Reliability And Validity ◽  
Internal Consistency Reliability ◽  
Efficiency Index ◽  
Single Factor ◽  
Analog Scale ◽  
Convenience Sample ◽  
Sleep Measurement

Research to evaluate interventions to promote sleep in critically ill patients has been restricted by the lack of brief, inexpensive outcome measures. This article describes the development and testing of an instrument to measure sleep in critically ill patients. A convenience sample of 70 alert, oriented, critically ill males was studied using polysomnography (PSG), the gold standard for sleep measurement, for one night. In the morning the patients completed the Richards-Campbell Sleep Questionnaire (RCSQ), a five-item visual analog scale. Internal consistency reliability of the RCSQ was .90 and principal components factor analysis revealed a single factor (Eigenvalue = 3.61, percent variance = 72.2). The RCSQ total score accounted for approximately 33% of the variance in the PSG indicator sleep efficiency index (p < .001). The data provide support for the reliability and validity of the RCSQ.

scholarly journals Reliability Study of the Sedation-Agitation Scale in an Intensive Care Unit

2021 ◽  
Author(s):  
◽  
Michelle Ryder-Lewis
Keyword(s):  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Medical Staff ◽  
Reliability And Validity ◽  
Validity And Reliability ◽  
Reliability Study ◽  
Kappa Score ◽  
Convenience Sample ◽  
Icu Patients

<p>The management of sedation in critically ill patients is a complex issue for Intensive Care Units (ICU) worldwide. Notable complications of sedation practices have been identified and efforts to modify these practices in ICUs have begun. While sedation-scoring tools have been introduced into clinical practice in intensive care few have been tested for validity and reliability. One tool which has reliability and validity established is the Sedation-Agitation Scale (SAS). This study is an extension of a previous study by Riker, Picard and Fraser (1999) to determine whether doctors and nurses rate patients similarly using the SAS in a natural ICU setting. It is essential to establish whether these different professionals provide consistent scores and have a mutual understanding of the SAS and its constituent levels. This will help ensure that clinical decisions relating to sedation-needs can be made appropriately and consistently. This quasi-experimental reliability study was set in a 12-bed tertiary general ICU in New Zealand. The SAS had recently been introduced into this unit and a convenience sample of 42 nursing and medical staff performed paired ratings on 69 randomly selected adult ICU patients over an eight week time frame. The mean patient age was 58 years, and 79% of patients were on continuous infusions of Propofol. Intubated patients made up 91% of the sample. 74% of patients were given the same SAS score by the doctor-nurse pair. The weighted kappa score for inter-rater agreement was 0.82 indicating very good agreement. Of the 26% of scores where there was a difference, the two readings were only one score apart. Most of the difference occurred around SAS scores of 1-2 and 3-4. Further analysis found no staff or patient variables to be statistically significant in impacting on the ratings. The SAS was found to be a reliable sedation-scoring tool in a general ICU when used by nurses and doctors of varying experience. The implementation of the SAS should improve the quality of sedation management in critically ill patients, facilitate communication between nurses and medical staff with regard to the effectiveness of sedation regimes, and assist with the development of optimal sedation and analgesia guidelines for ICU patients.</p>

scholarly journals Reliability Study of the Sedation-Agitation Scale in an Intensive Care Unit

2021 ◽  
Author(s):  
◽  
Michelle Ryder-Lewis
Keyword(s):  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Medical Staff ◽  
Reliability And Validity ◽  
Validity And Reliability ◽  
Reliability Study ◽  
Kappa Score ◽  
Convenience Sample ◽  
Icu Patients

<p>The management of sedation in critically ill patients is a complex issue for Intensive Care Units (ICU) worldwide. Notable complications of sedation practices have been identified and efforts to modify these practices in ICUs have begun. While sedation-scoring tools have been introduced into clinical practice in intensive care few have been tested for validity and reliability. One tool which has reliability and validity established is the Sedation-Agitation Scale (SAS). This study is an extension of a previous study by Riker, Picard and Fraser (1999) to determine whether doctors and nurses rate patients similarly using the SAS in a natural ICU setting. It is essential to establish whether these different professionals provide consistent scores and have a mutual understanding of the SAS and its constituent levels. This will help ensure that clinical decisions relating to sedation-needs can be made appropriately and consistently. This quasi-experimental reliability study was set in a 12-bed tertiary general ICU in New Zealand. The SAS had recently been introduced into this unit and a convenience sample of 42 nursing and medical staff performed paired ratings on 69 randomly selected adult ICU patients over an eight week time frame. The mean patient age was 58 years, and 79% of patients were on continuous infusions of Propofol. Intubated patients made up 91% of the sample. 74% of patients were given the same SAS score by the doctor-nurse pair. The weighted kappa score for inter-rater agreement was 0.82 indicating very good agreement. Of the 26% of scores where there was a difference, the two readings were only one score apart. Most of the difference occurred around SAS scores of 1-2 and 3-4. Further analysis found no staff or patient variables to be statistically significant in impacting on the ratings. The SAS was found to be a reliable sedation-scoring tool in a general ICU when used by nurses and doctors of varying experience. The implementation of the SAS should improve the quality of sedation management in critically ill patients, facilitate communication between nurses and medical staff with regard to the effectiveness of sedation regimes, and assist with the development of optimal sedation and analgesia guidelines for ICU patients.</p>

scholarly journals Evaluation of bedbath in critically ill patients: impact of water temperature on the pulse oximetry variation

2010 ◽  
Vol 44 (4) ◽  
pp. 1039-1045 ◽  
Author(s):  
Aretha Pereira de Oliveira ◽  
Dalmo Valério Machado de Lima
Keyword(s):  
Water Temperature ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Age Groups ◽  
University Hospital ◽  
Convenience Sample ◽  
Level Ii ◽  
Before And After ◽  
Quasi Experimental ◽  
Water Temperature Data

This is a participant study, quasi-experimental, of a before and after type. A quantitative approach of biophysiological measures was used, represented by the saturation of oxygen measured by pulse oximeter (SpO2), and recorded on three occasions: before, during and after the bedbath in critically ill patients hospitalized at the ICU of a University Hospital in Brazil. Objective: to compare the SpO2 in various stages of the bath, with and without control of water temperature. Data collection was performed between December 2007 and April 2008 on a convenience sample consisting of 30 patients aged over 18 who had classification in TISS-28 from level II. Results show that water temperature control means a lower variation of SpO2 (p<0.05). No marked differences in variation of saturation between men and women or between age groups were established. In conclusion, heated and constant water temperature during the bedbath is able to minimize the fall of SpO2 that occurs while handling patients during procedures.

Pain experiences of traumatically injured patients in a critical care setting

2001 ◽  
Vol 10 (4) ◽  
pp. 252-259 ◽  
Author(s):  
JA Stanik-Hutt ◽  
KL Soeken ◽  
AE Belcher ◽  
DK Fontaine ◽  
AG Gift
Keyword(s):  
Critically Ill ◽  
Visual Analog Scale ◽  
Critically Ill Patients ◽  
Mcgill Pain Questionnaire ◽  
Analog Scale ◽  
Intensity Index ◽  
Present Pain Intensity ◽  
Level I ◽  
Pain Experiences ◽  
Pain At Rest

BACKGROUND: Little is known about the acute pain experiences of traumatically injured critically ill patients. OBJECTIVES: To describe pain experiences of traumatically injured adults during the first 72 hours of hospitalization. METHODS: Thirty multiply injured adults at a level I trauma center participated in the study. Pain was measured by using the McGill Pain Questionnaire and a visual analog scale. Subjects completed pain measures while at rest in a supine recumbent position and after a turn onto the side. RESULTS: The typical subject was 37 years old, had 4 major blunt trauma injuries, and had received the equivalent of 55.9 mg of morphine during the 24 hours before data collection. Mean at-rest scores were 26.5 on the pain-rating index, 2 on the present pain intensity index, and 34.6 on the visual analog scale. Immediately after the turn, mean scores on the visual analog scale increased from 25 to 48.1 (P = .002). Other pain scores after the turn did not differ significantly from at-rest values. Subjects who turned had lower scores on the visual analog scale at rest (P = .02) and less anxiety (P = .02) than did those who refused to turn. Ninety-six percent reported pain in the injured areas, and 36% reported pain related to biomedical devices. No relationship was found among reported pain and demographic, treatment, or clinical variables. CONCLUSIONS: Additional research is needed on pain at rest and during commonly performed procedures and on improved methods for pain relief in traumatically injured critically ill patients.

Differences in Glucose Values Obtained From Point-of-Care Glucose Meters and Laboratory Analysis in Critically Ill Patients

2009 ◽  
Vol 18 (1) ◽  
pp. 65-72 ◽  
Author(s):  
Anjannette Cook ◽  
Delyla Laughlin ◽  
Margery Moore ◽  
Doreen North ◽  
Kathleen Wilkins ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Point Of Care ◽  
Method Comparison ◽  
Venous Catheter ◽  
Laboratory Analysis ◽  
Hematocrit Level ◽  
Convenience Sample ◽  
Indwelling Catheters ◽  
The Difference

Background Blood for glucose analysis is often obtained interchangeably from indwelling catheters and fingersticks. Objectives To determine the level of agreement between glucose values obtained by laboratory analysis and with a point-of-care device for blood from 2 different sources: fingerstick and a central venous catheter. Methods A method-comparison design was used. Point-of-care values for blood from fingersticks and catheters were compared with laboratory values for blood from catheters in a convenience sample of 67 critically ill patients. The effects of hematocrit level and finger edema on differences in glucose values between the 2 methods were also evaluated. A t test was used to determine differences in glucose values obtained via the 2 methods. Differences and limits of agreement were also calculated. Results Laboratory glucose values for blood from a catheter differed significantly from point-of-care values for blood from the catheter (t1,66 = −9.18; P &lt; .001) and from a fingerstick (t1,66 = 6.53; P &lt; .001). Glucose values for the 2 methods differed by 20 mg/dL or more for 1 of 6 patients (15%) for catheter samples and for 1 of 5 (21%) for fingerstick samples. Point-of-care glucose values for fingerstick and catheter samples did not differ (P = .98). Hematocrit level significantly explained the difference in glucose values between the 2 methods for both catheter (R2 = 0.288; P &lt; .001) and fingerstick (R2 = 0.280; P = .02) samples. Conclusions Use of a commonly used point-of-care device when precise glucose values are needed may lead to faulty treatment decisions.

scholarly journals Accuracy of zero-heat-flux thermometry and bladder temperature measurement in critically ill patients

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Anselm Bräuer ◽  
Albulena Fazliu ◽  
Thorsten Perl ◽  
Daniel Heise ◽  
Konrad Meissner ◽  
...  
Keyword(s):  
Heat Flux ◽  
Critically Ill ◽  
Core Temperature ◽  
Critically Ill Patients ◽  
Gold Standard ◽  
Prospective Observational Study ◽  
Standard Of Care ◽  
Limits Of Agreement ◽  
Blood Temperature ◽  
Bladder Temperature

AbstractCore temperature (TCore) monitoring is essential in intensive care medicine. Bladder temperature is the standard of care in many institutions, but not possible in all patients. We therefore compared core temperature measured with a zero-heat flux thermometer (TZHF) and with a bladder catheter (TBladder) against blood temperature (TBlood) as a gold standard in 50 critically ill patients in a prospective, observational study. Every 30 min TBlood, TBladder and TZHF were documented simultaneously. Bland–Altman statistics were used for interpretation. 7018 pairs of measurements for the comparison of TBlood with TZHF and 7265 pairs of measurements for the comparison of TBlood with TBladder could be used. TBladder represented TBlood more accurate than TZHF. In the Bland Altman analyses the bias was smaller (0.05 °C vs. − 0.12 °C) and limits of agreement were narrower (0.64 °C to − 0.54 °C vs. 0.51 °C to – 0.76 °C), but not in clinically meaningful amounts. In conclusion the results for zero-heat-flux and bladder temperatures were virtually identical within about a tenth of a degree, although TZHF tended to underestimate TBlood. Therefore, either is suitable for clinical use.German Clinical Trials Register, DRKS00015482, Registered on 20th September 2018, http://apps.who.int/trialsearch/Trial2.aspx?TrialID=DRKS00015482.

scholarly journals Validation of the Copenhagen Psychosocial Questionnaire Version III and Establishment of Benchmarks for Psychosocial Risk Management in Sweden

2020 ◽  
Vol 17 (9) ◽  
pp. 3179 ◽  
Author(s):  
Hanne Berthelsen ◽  
Hugo Westerlund ◽  
Gunnar Bergström ◽  
Hermann Burr
Keyword(s):  
Risk Management ◽  
Construct Validity ◽  
Reliability And Validity ◽  
Internal Consistency Reliability ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Questionnaire Version ◽  
Scale Characteristics ◽  
Copenhagen Psychosocial Questionnaire ◽  
Managerial Employees

This study presents the Swedish standard version of the Copenhagen Psychosocial Questionnaire, COPSOQ III, and investigates its reliability and validity at individual and workplace levels with the aim of establishing benchmarks for the psychosocial work environment. Cross-sectional data from (1) a random sample of employees in Sweden aged 25–65 years (N = 2847) and (2) a convenience sample of non-managerial employees at 51 workplaces (N = 1818) were analysed. Internal consistency reliability was evaluated as well as the effects of sex, work sector and blue/white-collar work. Population benchmarks and mean scores for major occupational groups were computed based on weighted data. ICC(1) and ICC(2) estimates were computed to evaluate aggregation to the workplace level and Pearson inter-correlations to evaluate construct validity at individual and aggregated levels. The reliability and scale characteristics were satisfactory, with few exceptions, at both individual and workplace levels. The strength and direction of correlations supported the construct validity of the dimensions and the amount of variance explained by workplace justified aggregation to the workplace level. The present study thus supports the use of COPSOQ III for measurement at the workplace level and presents benchmarks for risk management as well as for research purposes.

scholarly journals Elicitation of stakeholder viewpoints about medical cannabis research for pain management in critically ill ventilated patients: A Q-methodology study

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248475
Author(s):  
Giulio DiDiodato ◽  
Samah Hassan ◽  
Kieran Cooley
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Q Methodology ◽  
Community Hospital ◽  
A Priori ◽  
Healthcare Providers ◽  
Second Phase ◽  
Medical Cannabis ◽  
Convenience Sample ◽  
Care Community

Objectives To determine acceptability of medical cannabis research in critically ill patients. Design Q-methodology survey. Setting Convenience sample of healthcare providers and the general public were recruited at an acute care community hospital in Ontario, Canada. Participants In the first phase, 63 respondents provided 197 unique viewpoints in response to a topic statement about medical cannabis use in critically ill patients. Twenty-five viewpoints were selected for the q-sample. In the second phase, 99 respondents ranked these viewpoints according to an a priori quasi normal distribution ranging from +4 (most agree) to -4 (least agree). Factor analysis was combined with comments provided by survey respondents to label and describe the extracted factors. Results The factor labels were hoping and caring (factor 1), pragmatic progress (factor 2), and cautious/conservative and protectionist (factor 3). Factor 1 describes a viewpoint of unequivocal support for medical cannabis research in this population with few caveats. Factor 2 describes a viewpoint of cautious support with a need to monitor for unintended adverse effects. Factor 3 describes a viewpoint of ensuring that current analgosedation techniques are optimized before exposing patients to another potentially harmful drug. Conclusions Using a q-methodology design, we were able to sample and describe the viewpoints that exist about medical cannabis research in critically ill patients. Three factors emerged that seemed to adequately describe the relative ranking of q-statements by the majority of respondents. Combining the distinguishing statements along with respondent comments allowed us to determine that the majority support medical cannabis research in critically ill patients.

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