Department of Postoperative and Intensive Care Nursing, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
Department of Public Health Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
Intensive Care Med. 2023 Nov;49(11):1370-1382. doi: 10.1007/s00134-023-07219-0. Epub 2023 Oct 9.
The purpose of this study is to describe the prevalence, intensity and distress of five symptoms in intensive care unit (ICU) patients and to investigate possible predictive factors associated with symptom intensity.
This is a prospective cohort study of ICU patients. A symptom questionnaire (i.e., Patient Symptom Survey) was used to describe the prevalence, intensity and distress of pain, thirst, anxiousness, tiredness, and shortness of breath over seven ICU days. Associations between symptom intensity and possible predictive factors were assessed using the general estimating equation (GEE) model.
Out of 603 eligible patients, 353 (Sample 2) were included in the present study. On the first ICU day, 195 patients (Sample 1) reported thirst as the most prevalent symptom (66%), with the highest mean intensity score (6.13, 95% confidence interval (CI) [5.7-6.56]). Thirst was the most prevalent (64%) and most intense (mean score 6.05, 95%CI [5.81-6.3]) symptom during seven days in the ICU. Anxiousness was the most distressful (mean score 5.24, 95%CI [4.32-6.15]) symptom on the first day and during seven days (mean score 5.46, 95%CI [4.95-5.98]). During seven days, analgesic administration and sepsis diagnosis were associated with increased thirst intensity. Older age and being mechanically ventilated were associated with decreased pain intensity, and analgesic administration was associated with increased pain intensity. Family visits and female gender were associated with increased intensity of anxiousness and shortness of breath, respectively.
Self-reporting ICU patients experienced a high and consistent symptom burden across seven days. Certain variables were associated with the degree of symptom intensity, but further research is required to better understand these associations.
本研究旨在描述重症监护病房(ICU)患者五种症状的发生率、强度和困扰程度,并探讨与症状强度相关的可能预测因素。
这是一项 ICU 患者的前瞻性队列研究。使用症状问卷(即患者症状调查)描述疼痛、口渴、焦虑、疲倦和呼吸困难在七个 ICU 天内的发生率、强度和困扰程度。使用一般估计方程(GEE)模型评估症状强度与可能预测因素之间的关联。
在 603 名符合条件的患者中,有 353 名(样本 2)纳入本研究。在 ICU 第一天,195 名患者(样本 1)报告口渴是最常见的症状(66%),强度评分最高(6.13,95%置信区间(CI)[5.7-6.56])。在 ICU 的七天中,口渴是最常见(64%)和最强烈(平均评分 6.05,95%CI [5.81-6.3])的症状。焦虑是第一天和七天中最困扰(平均评分 5.24,95%CI [4.32-6.15])的症状(平均评分 5.46,95%CI [4.95-5.98])。在七天内,镇痛药物的给予和脓毒症的诊断与口渴强度的增加有关。年龄较大和机械通气与疼痛强度的降低有关,而镇痛药物的给予与疼痛强度的增加有关。家庭探视和女性与焦虑和呼吸困难强度的增加有关。
自我报告的 ICU 患者在七天内经历了高度一致的症状负担。某些变量与症状强度有关,但需要进一步的研究来更好地理解这些关联。