scholarly journals 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

2021 ◽  
Vol 10 (17) ◽  
pp. 3928
Author(s):  
Henning Krampe ◽  
Claudia Denke ◽  
Jakob Gülden ◽  
Vivian-Marie Mauersberger ◽  
Lukas Ehlen ◽  
...  

The aim of this study was to synthesize quantitative research that identified ranking lists of the most severe stressors of patients in the intensive care unit, as perceived by patients, relatives, and health care professionals (HCP). We conducted a systematic literature search in PubMed, MEDLINE, EMBASE, PsycInfo, CINAHL, and Cochrane Library from 1989 to 15 May 2020. Data were analyzed with descriptive and semi-quantitative methods to yield summarizing ranking lists of the most severe stressors. We synthesized the results of 42 prospective cross-sectional observational studies from different international regions. All investigations had assessed patient ratings. Thirteen studies also measured HCP ratings, and four studies included ratings of relatives. Data indicated that patients rate the severity of stressors lower than HCPs and relatives do. Out of all ranking lists, we extracted 137 stressor items that were most frequently ranked among the most severe stressors. After allocation to four domains, a group of clinical ICU experts sorted these stressors with good to excellent agreement according to their stress levels. Our results may contribute to improve HCPs’ and relatives’ understanding of patients’ perceptions of stressors in the ICU. The synthesized stressor rankings can be used for the development of new assessment instruments of stressors.

2003 ◽  
Vol 22 (4) ◽  
pp. 39-45 ◽  
Author(s):  
Margo Charchuk ◽  
Christy Simpson

When a newborn is admitted to a neonatal intensive care unit the parents may experience a variety of emotions, including a heightened sense of loyalty to their child. While health care providers are working to meet the medical needs of their patients, parents need to find ways to fulfill this sense of loyalty and to express it via hope. Through sharing the experience of having a child in the NICU, I examine hope and loyalty as critical features of parents’ NICU experience, explaining why these emotions need to be acknowledged and encouraged by health care professionals.


2017 ◽  
Vol 33 (5) ◽  
pp. 279-287 ◽  
Author(s):  
Jim Q. Ho ◽  
Christopher D. Nguyen ◽  
Richard Lopes ◽  
Stephen C. Ezeji-Okoye ◽  
Ware G. Kuschner

Spiritual care is an important component of high-quality health care, especially for critically ill patients and their families. Despite evidence of benefits from spiritual care, physicians and other health-care providers commonly fail to assess and address their patients’ spiritual care needs in the intensive care unit (ICU). In addition, it is common that spiritual care resources that can improve both patient outcomes and family member experiences are underutilized. In this review, we provide an overview of spiritual care and its role in the ICU. We review evidence demonstrating the benefits of, and persistent unmet needs for, spiritual care services, as well as the current state of spiritual care delivery in the ICU setting. Furthermore, we outline tools and strategies intensivists and other critical care medicine health-care professionals can employ to support the spiritual well-being of patients and families, with a special focus on chaplaincy services.


1994 ◽  
Vol 5 (3) ◽  
pp. 289-295 ◽  
Author(s):  
Nancy E. Page ◽  
Nancy M. Boeing

Much controversy has arisen in the last few decades regarding parental and family visitation in the intensive care setting. The greatest needs of parents while their child is in an intensive care unit include: to be near their child, to receive honest information, and to believe their child is receiving the best care possible. The barriers that exist to the implementation of open visitation mostly are staff attitudes and misconceptions of parental needs. Open visitation has been found in some studies to make the health-care providers’ job easier, decrease parental anxiety, and increase a child’s cooperativeness with procedures. To provide family-centered care in the pediatric intensive care unit, the family must be involved in their child’s care from the day of admission. As health-care providers, the goal is to empower the family to be able to advocate and care for their child throughout and beyond the life crisis of a pediatric intensive care unit admission


Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 535
Author(s):  
Mariangela Valentina Puci ◽  
Guido Nosari ◽  
Federica Loi ◽  
Giulia Virginia Puci ◽  
Cristina Montomoli ◽  
...  

The ongoing pandemic scenario, due to the coronavirus disease 2019 (COVID-19), has had a considerable impact on public health all over the world. Italy was one of the most affected countries, as the first European full-blown outbreak occurred there. The exposure of the Italian health care workers to COVID-19 may be an important risk factor for psychological distress. The aim of this cross-sectional study was to describe worries and risk perception of being infected among Italian Health Care Workers (HCWs) during the first wave of the pandemic. In total, 2078 HCWs participated in a web survey (78.8% were females). The highest percentage of respondents were physicians (40.75%) and nurses (32.15%), followed by medical (18.00%), health care support (4.50%) and administrative (4.60%) staff. In a score range between 0 (not worried) and 4 (very worried), our results showed that participants declared that they were worried about the Coronavirus infection with a median score of 3 (IQR 2-3) and for 59.19% the risk perception of being infected was very high. In addition, HCWs reported they suffered from sleep disturbances (63.43%). From the analysis of the psychological aspect, a possible divergence emerged between the perceived need for psychological support (83.85%) and the relative lack of this service among health care providers emerged (9.38%). Our findings highlight the importance of psychological and psychiatric support services not only during the COVID-19 pandemic, but also in other emerging infectious diseases (EIDs) scenarios. These services may be useful for health authorities and policymakers to ensure the psychological well-being of health care professionals and to promote precautionary behaviors among them.


2000 ◽  
Vol 19 (3) ◽  
pp. 13-21 ◽  
Author(s):  
Diane Holditch-Davis ◽  
Margaret Shandor Miles

The purpose of this article is to let mothers tell the stories of their neonatal intensive care unit (NICU) experiences and to determine how well these experiences fit the Preterm Parental Distress Model. Interviews were conducted with 31 mothers when their infants were six months of age corrected for prematurity and were analyzed using the conceptual model as a framework. The analysis verified the presence in the data of the six major sources of stress indicated in the Preterm Parental Distress Model: (1) pre-existing and concurrent personal and family factors, (2) prenatal and perinatal experiences, (3) infant illness, treatments, and appearance in the NICU, (4) concerns about the infant’s outcomes, (5) loss of the parental role, and (6) health care providers. The study indicates that health care providers, and especially nurses, can have a major role in reducing parental distress by maintaining ongoing communication with parents and providing competent care for their infants.


Author(s):  
Teresia Mbogori

Background: Hypertension is one of the main modifiable risk factors for cardiovascular disease morbidity and mortality. Pharmacological and lifestyle modification approaches are used in the treatment and management of hypertension. The purpose of this study was to identify lifestyle modification advice provided to the general population and to those diagnosed with hypertension by health care providers (HCP) in Kenya.Methods: A secondary data analysis of cross-sectional data collected among 4500 Kenyans participating in the 2015 Kenya stepwise approach to surveillance study was conducted. Questions related to the consumption of salt, sugar, fat, fruits and vegetables as well as physical activity and weight management were evaluated.Results: Among all the participants, only 12.5%, 20.7%, 12.2%, 10.7%, 10.3% and 11.6% were advised to either reduce salt intake, eat 5 or more servings of fruits and vegetables, reduce fat intake, reduce intake of sugary beverages, lose or maintain weight and start or do more physical activity respectively.  Of those diagnosed with HTN, 37% were advised to increase intake fruits and vegetables, 37%, 27% and 25% were advised to reduce, salt, fat and sugary beverages intake respectively, 21% and 22% were advised to start or do more physical activity and maintain a healthy body weight or lose weight respectively.Conclusions: Majority of Kenyans had not received dietary modification advice from HCP despite this being a policy recommendation in Kenya. Policy makers need to work closely with HCP to develop appropriate policy implementation strategies. 


2013 ◽  
Vol 7 (8) ◽  
pp. 365 ◽  
Author(s):  
Max Joseph Herman ◽  
Rini Sasanti Handayani ◽  
Selma Arsit Siahaan

Undang-undang Republik Indonesia No. 36 tahun 2009 tentang kesehatan dan peraturan pemerintah No. 51 tahun 2009 menyatakan bahwa tenaga kesehatan harus mempunyai kualifikasi minimum yang ditetapkan oleh pemerintah. Studi kualitatif secara potong lintang pada tahun 2010 untuk mengidentifikasi kualifikasi apoteker rumah sakit dalam memenuhi persyaratan tersebut di Bandung, Yogyakarta dan Surabaya. Data dikumpulkan dengan wawancara mendalam terhadap 10 orang apoteker dari enam rumah sakit dan empat orang direktur/wakil direktur rumah sakit, masing-masing satu orang apoteker dari enam perguruan tinggi farmasi, tiga pengurus Ikatan Apoteker Indonesia, tiga dinas kesehatan provinsi dan kabupaten/kota. Observasi praktek kefarmasian dengan menggunakan daftar tilik dilakukan pada tiap rumah sakit dan data sekunder terkait dokumentasi pemantauan dan evaluasi obat, kepuasan pasien, standar operasional prosedur dan kurikulum perguruan tinggi farmasi juga dikumpulkan. Analisis dilakukan dengan metode triangulasi dan hasil menunjukkan bahwa pengelolaan obat dalam hal pengadaan, distribusi dan penyimpanan dilaksanakan dengan baik oleh apoteker rumah sakit. Praktek farmasi klinik dan keselamatan pasien masih sangat terbatas karena alasan sumber daya manusia dan dokumentasi yang memadai. Informasi obat dan konseling kadang dilakukan tanpa fasilitas yang cukup dan apoteker juga terlibat dalam berbagai tim di rumah sakit seperti penanggulangan infeksi nosokomial dan komite farmasi dan terapi.The Indonesian Health Law No. 36 in 2009 and the Government Regulation No. 51 in 2009 state that health-care providers, including pharmacist, shall have minimum qualification set by the government. A qualitative cross sectional was conducted to to identify hospital pharmacist qualification as health care professionals in meeting the requirements was done in 2010 in Bandung, Yogyakarta and Surabaya. Data were collected through indepth interviews with pharmacists involving ten hospital pharmacists and four hos- pital directors/vice directors, six pharmacy colleges, three regional pharmacist associations, three provincial health offices and district health offices and observation of pharmacy practices using check list in each hospital was also conducted. Secondary data concerning documentation of drug monitoring and evaluation, patient satisfaction, standard operating procedure and pharmacy college curricula were collected too. Qualitative analysis was done descriptively using triangulation method. The study shows that drug procurement, distribution and storage, was well-managed by pharmacist. Practice in clinical pharmacy and patient safety was still limited for the reason of human resources and appropriate documentation. Drug information and counseling was sometimes conducted without adequate facilities and pharmacist was involved in various hospital teams like nosocomial infection control and pharmacy and therapy committee.


2020 ◽  
Vol 34 (4) ◽  
pp. 196-198
Author(s):  
Pardeep Dhingra

Background: Having a newborn baby admitted in the neonatal intensive care unit (NICU) can be a stressful experience for the parents. Objectives: This study was planned to know the following: 1. The concerns of parents whose babies were admitted in NICU 2. Parental satisfaction level about the services provided 3. Assessment of parents for their understanding and knowledge at discharge Study Design: Semiqualitative interview. Participants: Parents of 100 (56 M, 44 F) neonates. Intervention: We subjected them to a semiqualitative interview on the day of discharge of their newborn infant. Questionnaire consisted of parent’s understanding regarding NICU and health care providers, their perspective about the possible cause of illness in their baby along with competence and communication skills of health care providers. Parental satisfaction about the services was assessed by the short assessment of patient satisfaction (SAPS). They were assessed for their anxiety and depression levels by hospital anxiety and depression scale (HADS). They were assessed for their knowledge about care of baby at home after discharge by patient knowledge questionnaire (PKQ). Results: Parents of 44% babies had no prior idea about NICU and why babies need to be admitted. In total, 48% mothers and 36% fathers had clinically significant anxiety levels as assessed by HADS. Many parents complained about lack of communication about their babies illness, its cause, duration of treatment, and prognosis. Both parents scored the caregivers on borderline scores on the SAPS. At discharge only 13% knew the correct dose and duration of medicines prescribed. PKQ scores varied from 5 to 20. Almost all parents emphasized the need for more space, resting place for mothers, and better communication by doctors. Conclusions: This study reveals a significant communication gap between health care providers and parents. Concerns of parents have to be addressed to have their full participation in newborn care.


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