Date of Award

2013-03-01

Degree Name

PhD Nursing

Dissertation Committee

Joseph F. Burkard, DNSc, RN, CRNA, Chairperson; Jane M. Georges, PhD, RN; Karen Skerret, PhD, RN

Keywords

Intensive Care Unit, mental health, nursing, patients, perception, stressors

Abstract

Purpose: The purposes of this study were to investigate intensive care patients' perceptions of stressors, to investigate the health care provider's perception of what constitutes a stressor from the patient's perspective, and to describe how health care providers manage their patients' stressors. This study is a replication of Cornock's (1998) study of stress. Background and significance: A person's mental state and stress level affect his or her overall wellbeing and recovery from illness and statistics suggest that stress actually causes 80% to 90% of illnesses (Sidman, 2011). Approximately 4.4 million patients require intensive care unit (ICU) treatment annually in the United States (National Quality Measures Clearinghouse. 2012). It is important to describe ICU patients' stressful experiences in order to provide feedback to health care providers and improve the quality of care (Justic, 2000). Methodology: Mixed methods design, comparative descriptive design for the quantitative section and phenomenological approach for the qualitative section. The sample included 70 ICU patients and 70 ICU health care providers. After consenting to participate in this study, a demographic form and a paper based tool, the Environmental Stressors graphic data form Questionnaire" (ESQ) (Cornock, 1998), were given to subjects. Questionnaires were filled out by subjects anonymously and returned to the researcher in the same setting. Findings: the top three most stressful items ranked by the patients included: "Being in pain", followed by "Not Being able to sleep" and "Financial worries"; on the other hand, health care providers perceived "Being in pain", followed by "Not being able to communicate", and "Not being in control of yourself' as the top three stressors perceived by their patients. Communication, pain management, encouraging the presence of family, and environmental control were the major strategies in health care providers' management of patients' stressors. Study implications: ICU staff can manipulate the ICU environment to be less stressful. The findings of this study could guide the development of ICU stressor control policy. Future research should focus on investigating the financial effects on ICU patients and their recovery from critical illness, there is a need to refine the health care reimbursement system accordingly.

Document Type

Dissertation: USD Users Only

Department

Nursing

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