Date of Award

2022-08-31

Degree Name

PhD Nursing

Dissertation Committee

Ann M. Mayo, DNSc, RN, FAAN, Chairperson Caroline Etland, PhD, RN, CNS, ACHPN, Member Kathleen M. Stacy, PhD, RN, APRN-CNS, CCNS, FCNS, Member

Keywords

discomfort, ICU discomfort, stressors, unmet needs, patient satisfaction

Abstract

Background: Discomfort has a significant effect on patient health and well-being; however, the symptoms are often difficult to address in ICU. Most patients in ICU are unable to communicate, making it difficult for physicians and nurses to distinguish between pain and discomfort. For example, artificial airways and assisted ventilation prevent patients from communicating. Patients may also have difficulty communicating due to delirium, fatigue, sedation, or neurological disease. Rationale: Discomfort has a considerable influence on patient health outcomes and well-being if not identified and addressed. Researchers have not explicitly explored discomfort apart from pain, which underscores the importance of studying the effects of discomfort experienced in intensive care. Purpose: The purpose of this study was to describe select sociodemographic characteristics and other factors associated with the perception of ICU discomfort among adults 18 years and older after they were transferred to a progressive care, medical or surgical hospital unit. Design: A descriptive correlational cross-sectional design was used for this study. A convenience sample of 101 patients was recruited from a tertiary-level acute care hospital located in southern California. Results: Two variables were significantly related to ICU discomfort. Specifically, ICU length of stay and anxiety. There was a significant medium positive correlation between ICU length of stay and ICU discomfort (r = .457, p < .001) and a strong positive correlation between anxiety and ICU discomfort (r = .674, p < .001). As the average participant’s anxiety increased so did their ICU discomfort. For each day in ICU, the perceived ICU discomfort score increased by 0.96 units (95% CI = 0.13, 1.79), and for each unit increase in anxiety score, perceived ICU discomfort score increased by 0.50 units (95% CI = 0.36, 0.64). Implications for Nursing: Preventing sources of discomfort may help improve patient satisfaction, shorten hospital stays, and lead to higher cost-benefit ratios. Early recognition of the causes of discomfort may help health care professionals implement timely, person-centered interventions to eliminate the sources of discomfort and potentially improve patient satisfaction.

Document Type

Dissertation: Open Access

Department

Nursing

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