Communication Difficulties and Psychoemotional Distress in Patients Receiving Mechanical Ventilation

2011 ◽  
Vol 20 (6) ◽  
pp. 470-479 ◽  
Author(s):  
Rabia Khalaila ◽  
Wajdi Zbidat ◽  
Kabaha Anwar ◽  
Abed Bayya ◽  
David M. Linton ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Psychological Distress ◽  
Endotracheal Tube ◽  
Structured Interview ◽  
Cross Sectional Study ◽  
Study Data ◽  
Cross Sectional ◽  
Stressful Experiences ◽  
Communication Methods

Background Difficulties in communication in intensive care patients receiving mechanical ventilation are a source of stressful experiences and psychoemotional distress. Objectives To examine the association between communication characteristics and psychoemotional distress among patients treated with mechanical ventilation in a medical intensive care unit and to identify factors that may be predictive of psychological outcomes. Methods A total of 65 critically ill patients, extubated within the preceding 72 hours, were included in this cross-sectional study. Data were collected by using a structured interview. Separate regression analysis of data on 3 psychoemotional outcomes (psychological distress, fear, and anger) were used for baseline variables, communication characteristics, and stressful experiences. Results Difficulty in communication was a positive predictor of patients’ psychological distress, and length of anesthesia was a negative predictor. Fear and anger were also positively related to difficulty in communication. In addition, the number of communication methods was negatively associated with feelings of fear and anger. Finally, the stressful experiences associated with the endotracheal tube were positively related to feelings of anger. Conclusions Patients treated with mechanical ventilation experience a moderate to extreme level of psychoemotional distress because they cannot speak and communicate their needs. Nurses should be aware of the patients’ need to communicate. Decreasing stressful experiences associated with the endotracheal tube and implementing more appropriate communication methods may reduce patients’ distress.

Nosocomial Sepsis and its Risk Factors: A Cross-Sectional Study in a Neonatal Intensive Care Unit

2019 ◽  
Vol 2 (1) ◽  
pp. 52-59
Author(s):  
Sunil Kumar Yadav ◽  
SP Yadav ◽  
P Kanodia ◽  
N K Bhatta ◽  
R R Singh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nosocomial Sepsis

Introduction: Nosocomial sepsis is a common and serious infection of neonates who are admitted in intensive care unit. They lead to significant morbidity and mortality in both developed and resource limited countries. The neonatal intensive care unit (NICU) is a suitable environment for disseminating the infections and, hence, needs preventive intervention. The study was carried out to determine the risk factors for nosocomial sepsis in neonatal intensive care unit. Material and Methods: This was a cross-sectional study conducted in a seven bedded teaching and referral hospital NICU. All neonates in NICU who did not have any sign of infection at admission and remained hospitalized for at least 48 hours were observed. Nosocomial sepsis was diagnosed according to the CDC criteria. Risk factors for nosocomial sepsis were analyzed with Chi-square test and Logistic regression model. P-value of <0.05 was considered significant. Results: Low birth weight (both preterm and IUGR) and mechanical ventilation were found to be related with nosocomial sepsis. Conclusions: Low birth weight and mechanical ventilation were the most important risk factors fornosocomial sepsis.

scholarly journals Clinical and paraclinical predictive factors for in-hospital mortality in adult patients with COVID-19

2021 ◽  
Author(s):  
Seyed Alireza Mousavi ◽  
Reyhaneh Sadat Mousavi-Roknabadi ◽  
Fateme Nemati ◽  
Somaye Pourteimoori ◽  
Arefeh Ghorbani ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Hospital Mortality ◽  
Ct Scan ◽  
Predictive Factors ◽  
Invasive Mechanical Ventilation ◽  
Cross Sectional Study ◽  
Study Data ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Non Invasive

Abstract Background Since December 2019, a type of coronavirus has emerged in Wuhan, China, which has become the focus of global attention due to an epidemic of pneumonia of unknown cause, called COVID-19. This study aimed to investigate the factors affecting in-hospital mortality of patients with COVID-19 hospitalized in one of the main hospital in central Iran. Methods This retrospective cross-sectional study (February 2019-May 2020) was conducted on patients with confirmed diagnosis COVID-19, who were admitted in Yazd Shahid Sadoughi Hospital, in middle of Iran. The patients with uncompleted or missed medical files were excluded from the study. Data were extracted from the patients' medical files and then analyzed. The patients were categorized as survivors and non-survivors groups, and they were compared. Results Totally, 573 patients were enrolled, that 356 (62.2%) were male. The mean ± SD of age was 56.29 ± 17.53 years, and 93 (16.23%) were died. All the complications were more in non-survivors. Intensive care unit (ICU) admission was in 20.5% of the patients which was more in non-survivors (P < 0.001). The results of multivariate logistic regression test showed that plural effusion in lung computed tomography (CT) scan (OR = 0.055, P = 0.009), white blood cell (WBC) (OR = 1.417, P = 0.022), serum albumin (OR = 0.009, P < 0.001), non-invasive mechanical ventilation (OR = 34.315, P < 0.001), and acute respiratory distress syndrome (ARDS) (OR = 66.039, P = 0.001) were achieved as the predictive factors for in-hospital mortality were the predictive factors for in-hospital mortality. Conclusion In-hospital mortality in patients with COVID-19 was about 16%. Plural effusion in lung CT scan, WBC, albumin, non-invasive mechanical ventilation, and ARDS were obtained as the predictive factors for in-hospital mortality.

scholarly journals Boas práticas de Enfermagem a pacientes em uso de ventilação mecânica

2019 ◽  
Vol 14 ◽  
Author(s):  
Carolina Papa Pazos ◽  
Francisco Mayron Morais Soares ◽  
Luana Cordeiro Barroso ◽  
Gustavo Mitsuo Cavalcante de Sousa ◽  
Gabriel Ítalo Da Silva Rodrigues ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Social Science ◽  
Nursing Care ◽  
Care Center ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Terapia Intensiva ◽  
Quantitative Descriptive ◽  
Ventilation Method

Objetivo: identificar os cuidados de enfermagem a pacientes em uso de ventilação mecânica. Método: trata-se de um estudo quantitativo, descritivo e transversal, com pacientes em uso de ventilação mecânica internados no Centro de Terapia Intensiva, divididos entre cirúrgicos e clínicos. Utilizou-se, para a análise dos dados, o programa Statistic Package for Social Science (versão 20). Resultados: revela-se, quanto aos cuidados de enfermagem, que manter a cabeceira elevada a 30º foi o mais encontrado, em 77,9% dos casos, e checar posicionamento do TOT ou TQT foi o menos encontrado, atingindo 61,9% das prescrições. Conclusão: conclui-se que ainda é necessário que haja organização da equipe na implementação das intervenções prescritas para o paciente em uso de ventilação mecânica para que, assim, se diminuam o tempo de internação, as complicações e as infecções, e o desmame ocorra em um tempo menor. Descritores: Respiração artificial; Enfermagem; Cuidados de Enfermagem; Cuidados Críticos; Unidades de Terapia Intensiva; Enfermagem Prática.AbstractObjective: to identify nursing care for patients on mechanical ventilation. Method: this is a quantitative, descriptive and cross-sectional study with patients on mechanical ventilation admitted to the Intensive Care Center, divided into surgical and clinical. For data analysis, the Statistical Package for Social Science program (version 20) was used. Results: it is revealed, as for nursing care, that keeping the head up to 30º was the most found in 77.9% of cases, and checking TOT or TQT positioning was the least found, reaching 61.9% of the cases. prescriptions. Conclusion: it is concluded that there is still a need to organize the team in the implementation of the prescribed interventions for the patient using mechanical ventilation, thus reducing the length of stay, complications and infections, and weaning to occur. a shorter time. Descriptors: Respiration, Artificial; Nursing; Nursing Care; Critical Care; Intensive Care Units; Nursing, Practical.ResumenObjetivo: identificar los cuidados de enfermería para pacientes con ventilación mecánica. Método: este es un estudio cuantitativo, descriptivo y transversal con pacientes en ventilación mecánica ingresados en el Centro de Cuidados Intensivos, dividido en quirúrgico y clínico. Para el análisis de datos, se usó el programa Statistic Package for Social Science (versión 20). Resultados: se revela, en cuanto a la atención de enfermería, que mantener la cabeza a 30º fue lo más encontrado en el 77.9% de los casos, y verificar el posicionamiento del TOT o TQT fue el menos encontrado, llegando al 61.9% de los casos, de las prescripciones. Conclusión: se concluye que todavía es necesario organizar al equipo en la implementación de las intervenciones prescritas para el paciente utilizando ventilación mecánica, reduciendo así la duración de la estadía, las complicaciones e infecciones y el destete en un tiempo más corto. Descriptores: Respiración Artificial; Enfermería; Atención de Enfermería; Cuidados Críticos; Unidades de Cuidados Intensivos; Enfermería Práctica.

scholarly journals The Relationship Between PaO2/FiO2 and Delirium in Intensive Care: A Cross-Sectional Study

2020 ◽  
Author(s):  
Fang Gong ◽  
Yuhang Ai ◽  
Lina Zhang ◽  
Qianyi Peng ◽  
Quan Zhou ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Cross Sectional Study ◽  
Assessment Method ◽  
Arterial Oxygen ◽  
Apache Ii Score ◽  
Sectional Study ◽  
Cross Sectional ◽  
Non Linear ◽  
The Relationship

Abstract Background: Studies investigating the association of delirium with ratio of partial pressure of arterial oxygen to fraction of inspired oxygen (PaO2/FiO2) have been limited. The main purpose of the our study was to explore the relationship between PaO2/FiO2 and the risk of delirium in intensive care units (ICUs). Methods: This was a cross-sectional study that involved the collection of data from patients admitted to the Xiang Ya Hospital Cardiothoracic Surgical Care Unit and Comprehensive Intensive Care Unit from September 1st, 2016, to December 10th, 2016. Delirium was diagnosed by the simplified version of the Chinese Confusion Assessment Method for the ICU (CAM-ICU). The PaO2/FiO2 of each patient was recorded at the first 24 h after admission to the ICU. Results: There was a non-linear relationship between the PaO2/FiO2 and delirium, after adjusting for the following potential confounders: gender, age, hypertension, heart disease, history of a cerebral vascular accident, diabetes, smoking habits, drinking habits, chronic pulmonary dysfunction, blood pressure at admission, postoperative surgery, mechanical ventilation, mechanical ventilation time, PaCO2, sedation, APACHE II score, and SOFA score. We used a two-piecewise linear regression model to calculate the threshold of 247 mmHg. On the left side of the threshold, the odds ratio (OR) was 0.91 (95% CI [0.84, 0.98]), while the OR on the right side was 1.03 (95% CI [1.00, 1.06]).Conclusions: The relationship between PaO2/FiO2 and risk of delirium was non-linear. The PaO2/FiO2 was negatively associated with the risk of delirium when the PaO2/FiO2 was less than 247 mmHg. As a readily available laboratory indicator, PaO2/FiO2 has potential value in the clinical evaluation risk of delirium in ICU patients. Of course, our conclusions need further confirmation from other studies, especially large prospective studies.

Skilled attendance at delivery: profile of nursing staff in maternity units from Alfenas city, Minas Gerais, Brazil

2010 ◽  
Vol 4 (4) ◽  
pp. 1894
Author(s):  
Eliana Peres Rocha ◽  
Maria José Clapis ◽  
Christianne Alves Pereira Calheiros
Keyword(s):  
Professional Competence ◽  
Obstetric Care ◽  
Structured Interview ◽  
Cross Sectional Study ◽  
Minas Gerais ◽  
Study Data ◽  
World Health ◽  
Cross Sectional ◽  
Health Organization ◽  
Nursing Professionals

ABSTRACTObjective: to identify the profile of nursing professionals providing care to pregnant women in maternity Alfenas-MG. Method: this is about a descriptive cross sectional study from quantitative approach. All nursing professionals (24) who worked in the care of patients participated in this study. Data collection was performed during the period from June to September 2008 using a structured interview. This study was conducted according to ethical principles of research and approved by the Ethics in Research of Universidade Federal de Alfenas/MG, under protocol number3087.001016/2008-98. Results: there was a lack of midwife in the team, keeping workload of 49.17 hours/week, 91.6% being female. As the professional category, the prevailing mid-level professionals with informal training and monitoring at work those with greater experience in the area. Conclusion it is understood that these professionals are not qualified for the obstetric care according to criteria of World Health Organization (WHO), highlighting the need for qualification of this team that assists women in maternity Alfenas, Minas Gerais. Descriptors: nursing; obstetric nursing; delivery; professional competence; qualified attention. RESUMOObjetivo: identificar o perfil dos profissionais de enfermagem que atendem as parturientes em maternidades de Alfenas-MG. Método: estudo descritivo de corte transversal com abordagem metodológica quantitativa. Participaram deste estudo todos os profissionais de enfermagem (24) que atuam na assistência às parturientes. A coleta de dados foi realizada no período de junho a setembro de 2008, utilizando-se um roteiro de entrevista. Este estudo foi conduzido segundo os preceitos éticos da pesquisa e aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal de Alfenas/MG, sob o protocolo nº 23087.001016/2008-98. Resultados: verificou-se a ausência de enfermeira obstétrica na equipe, mantendo carga horária de trabalho de 49,17 horas/semana, sendo 91,6 % do sexo feminino . Quanto à categoria profissional, prevalecem os profissionais de nível médio com treinamento informal e acompanhamento durante o trabalho; os quais possuem maior experiência na área. Conclusão entende-se que esses profissionais não estão qualificados para o atendimento obstétrico segundo os critérios da Organização Mundial de Saúde (OMS), evidenciando-se a necessidade de qualificação dessa equipe que atende as mulheres nas maternidades de Alfenas, Minas Gerais. Descritores: enfermagem; enfermagem obstétrica; parto; competência profissional; equipe de enfermagem.RESUMENObjetivo: identificar el perfil de los profesionales de enfermería que atienden a mujeres embarazadas en la maternidad Alfenas-MG. Método: estudio descriptivo transversal de enfoque cuantitativo. Participaron en este estudio, todos los profesionales de enfermería (24) que trabajan en el cuidado de los pacientes. Los datos fueron recolectados durante el período de junio a septiembre de 2008 utilizando una entrevista estructurada. Este estudio se realizó de acuerdo con los principios éticos de la investigación y aprobado por la Ética en la Investigación de la Universidad Federal de Alfenas - MG, en el marco del Protocolo 23087.001016/2008-98. Resultados Hubo una falta de matrona en el equipo, manteniendo la carga de trabajo de 49,17 horas a la semana, el 91,6% de ser mujer. A medida que la categoría profesional, la vigente de nivel medio profesionales con la formación informal y la supervisión en el trabajo, quienes tienen mayor experiencia en el área. Conclusión: se entiende que estos profesionales no están calificados para la atención obstétrica de acuerdo con los criterios de la Organización Mundial de la Salud (OMS), destacando la necesidad de calificación de este equipo que ayuda a las mujeres en la maternidad Alfenas, Minas Gerais. Descriptores: enfermería; enfermería obstétrica; entrega; competencia profesional. 

scholarly journals Outcome of early bubble CPAP in children presenting at paediatric in-tensive care unit from 2016-2017

2017 ◽  
Vol 1 (1) ◽  
pp. 35
Author(s):  
Madia Kazmi
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Respiratory Distress ◽  
Ventilatory Support ◽  
Respiratory Illness ◽  
Cross Sectional Study ◽  
Paediatric Intensive Care ◽  
Cross Sectional ◽  
Bubble Cpap

The aim of this study is to analyze the introduction of early continuous positive  airway pressure(CPAP) for children admitted in PICU in correcting respiratory  distress with or without hypoxaemia and impending respiratory failure in order to improve respiratory function, avoid the need for mechanical ventilation and its  complications. Objective: To determine the outcome of early bubble CPAP in   children admitted in paediatric intensive care of Abbasi Shaheed hospital. Methods: This pilot study is being conducted in paediatric intensive care of paediatric unit 2 department at Abbasi Shaheed hospital Karachi. The study was conducted from march 2016 to December 2016. The study design was cross-sectional study and sample  technique was non probability(purposive).Total 70 patients of both genders having age ranging between 0-12years exhibiting clinical features of respiratory distress with hypoxaemia (SpO2 <92%) and impending respiratory failure initially received oxygen supplementation through bCPAP delivered via an underwater tube through nasal prongs. Data regarding outcome after receiving bCPAP and need for mechanical  ventilation was collected and analyzed. Results: Oxygen was initiated by bCPAP in 70 patients. Out of these, forty-one (58.5%) were male and twenty-nine (41.2%) were females. The age group ranges from 0- 12years. Forty-nine (70%) patients survived after bCPAP and shift to ward. Twenty-one (30%) were intubated for worsening  distress and hypoxaemia. Eight (11.4%) were removed from vent, put on bCPAP and survived. Ten (14.2%) expired on ventilatory support. Conclusion: According to our results early bubble CPAP supplementation helps in correcting respiratory illness and contributes to reduce the number of children requiring endotracheal tube intubation and mechanical ventilation. In addition to the benefits mentioned above, it is a simple device which can be made locally, very cheap and effective.

scholarly journals Features of residency training and psychological distress among residents in a Nigerian teaching hospital

2014 ◽  
Vol 20 (2) ◽  
pp. 5 ◽  
Author(s):  
Oluyomi Esan ◽  
Adewunmi Adeoye ◽  
Paul Onakoya ◽  
Olarewalu Opeodu ◽  
Kola Owonikoko ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Residency Training ◽  
Service Provision ◽  
Training Programme ◽  
Cross Sectional Study ◽  
Study Data ◽  
College Hospital ◽  
Cross Sectional ◽  
Research And Education ◽  
Ibadan Nigeria

<p><strong>Background.</strong> Resident doctors at University College Hospital (UCH), Ibadan, Nigeria, made a series of complaints about inadequate con­sultant supervision, lack of structure in the training programme and excessive workload. These complaints led to an evaluation of residency training. </p><p><strong>Objective. </strong>To investigate perceptions of the residency training programme and levels of psychological distress among residents.</p><p><strong>Methods.</strong> All 250 resident doctors at UCH were invited to complete questionnaires about their residency training and general health as part of a cross-sectional study. Data were analysed using SPSS 16. </p><p><strong>Results.</strong> A total of 128 residents (51.2%) responded to the questionnaire. Of the respondents, 72% rated their consultant supervision as good and 82.6% rated support from nurses as good; 61.8% had &lt;5 hours of formal educational activities and 65.1% had &lt;5 hours of research or private study per week. There was evidence of psychological distress in 48.4% of the respondents, and there was a significant association between psychological distress and the intensity of work (<em>p</em>&lt;0.01). </p><p><strong>Conclusion.</strong> The residency training programme at UCH appears to prioritise service provision over research and education activities. Residents who report high workloads also have high levels of psychological distress. Tackling these issues could improve overall satisfaction with residency training and reduce complaints. </p><div> </div>

scholarly journals Characteristics of related infections health care in an intensive care unit of a hospital school goiânia-goiáscity

2019 ◽  
pp. 31570-31573
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Demographic Data ◽  
Invasive Mechanical Ventilation ◽  
Invasive Procedure ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Candida Sp ◽  
Bladder Catheterization

Objective: To describe the types of HAI in a public intensive care unit in the city of Goiânia. Method: a descriptive cross-sectional study conducted in an Intensive Care Unit between March and August 2012. A structured questionnaire was used, involving demographic data, hospitalization, risk factors and comorbidities. Results: 38 infections were identified in 26 patients. The HAI rate was 13%, pneumonia had the highest incidence 63%, followed by bloodstream infection with 13%, and surgical site 10%. Regarding the procedures, 92% of the patients were exposed to bladder catheterization, 65% used invasive mechanical ventilation and 61% underwent central venous catheterization. Pseudomonas aeruginosa was the most isolated microorganism, with an incidence of 29%, followed by Acinetobacterbaumannii, 25.8%, and Candida sp. 11%. Conclusion: Among all HAI, there was a predominance of mechanical ventilation-associated pneumonia (VAP), although bladder catheterization was the most common invasive procedure. It is believed that continuing education with all ICU staff combined with daily auditing can improve the results obtained.

scholarly journals Utilization of mechanical ventilators in low resource Faculty: a cross sectional study

2020 ◽  
Author(s):  
Tigist Bacha ◽  
Netsanet Tsegaye ◽  
Wagari Tuli
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Mortality Rate ◽  
Severity Score ◽  
Pediatric Intensive Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Multi Organ Dysfunction Syndrome

Abstract Background Few studies are available from Africa on the use of mechanical ventilation (MV) in the pediatric intensive care unit (PICU). Knowledge of the outcome of patients on MV is critical for better use of resources and clinical decision making. We aimed to see the outcome and pattern of patients treated in a pediatric intensive care unit in a teresery hospital, which is the first study to evaluate an Ethiopian PICU. Methods A cross-sectional study with retrospective data collection was employed. Data were abstracted from the patients’ medical records by trained health professionals. SPSS version 21 software was used for data entry and analysis. The reports were depicted descriptively using measures of central tendency, dispersion, and displayed through tables and graphs. Results There were 536 patients admitted during the study period. 202 (41.2%) incidence of mechanical ventilation (MV) rate 63.6% of the participants were males and 130 (59.1%) died. The most common indication for the initiation of MV was respiratory problems 46 (20.9%). we identified 30.59/1000 ventilator days developed complications.Ventilator-associated pneumonia accounted for 18.6% of the complications with 20.9/1000 ventilator days. Survival of medical cases was better than the surgical cases (including trauma); [AOR = 0.13, 95% CI(0.04–0.413)] and those who have MV for more than 3 days are 79% more likely to die than those of less than 3 days ventilated; (p = 0.003). Those who have multi-organ dysfunction syndrome die more likely than the other group of patients; [AOR = 0.181, 95% CI (0.08, 0.412)] and the patient who had high PIM II severity score had higher mortality rate; [AOR = 35, 95% CI (1.7, 11)]. Conclusions In the current study, the mortality rate of mechanically ventilated pediatric patients was high. Severity score, multi-organ dysfunction syndrome, length of stay, and being a surgical patient increased the risk of mortality. Adequate education of PICU staff on the use of mechanical ventilator and prevention of complications as well as the use of severity score is necessary.

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