Adams Anne Mette N, Chamberlain Diane, Brun Thorup Charlotte, Maiden Matthew J, Waite Cherie, Dafny Hila Ariela, Bruce Kay, Conroy Tiffany
College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.
Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia.
J Adv Nurs. 2025 Apr 25. doi: 10.1111/jan.17000.
Exploring the concept of patient agitation in the intensive care unit.
Patient agitation in the intensive care unit is of widespread concern and linked to negative outcomes for patients, staff, and family members. There is currently no consensus on what constitutes agitation in the intensive care context, hindering effective and tailored prevention and management.
Concept Analysis.
Walker and Avant's eight-step concept analysis approach.
A comprehensive search was carried out in the databases MEDLINE, PsychINFO and CINAHL. A total of 32 papers published between 1992 and 2023 were included, reviewed, and analysed to explore definitions, attributes, antecedents and consequences of patient agitation.
Patient agitation in the intensive care unit is characterised by excessive motor activity, emotional tension, cognitive impairment, and disruption of care, often accompanied by aggression and changes in vital signs. Antecedents encompass critical illness, pharmacological agents and other drugs, physical and emotional discomfort, patient-specific characteristics and uncaring staff behaviours. Consequences of agitation range from treatment interruptions and poor patient outcomes to the psychological impact on patients, families, and staff.
Agitation in the intensive care unit is a complex issue which significantly impacts patient treatment and clinical outcomes. For healthcare professionals, patient agitation can contribute to high workloads and job dissatisfaction. Due to the complex nature of agitation, clinicians must consider multifaceted strategies and not rely on medication alone. Further research is needed to fully understand patient agitation in the ICU. Such understanding will support the development of improved strategies for preventing and managing the behaviours.
A clearer understanding of patient agitation supports the development of tailored interventions that improve patient care, guide ICU training, and inform future research.
This concept analysis was developed with input from a patient representative.
探讨重症监护病房中患者躁动的概念。
重症监护病房中的患者躁动受到广泛关注，且与患者、医护人员及家属的不良后果相关。目前在重症监护环境下，对于何为躁动尚无共识，这阻碍了有效的针对性预防和管理。
概念分析。
采用沃克和阿万特的八步概念分析方法。
在MEDLINE、PsychINFO和CINAHL数据库中进行了全面检索。纳入、审查并分析了1992年至2023年间发表的共32篇论文，以探讨患者躁动的定义、属性、 antecedents和后果。
重症监护病房中的患者躁动表现为运动活动过度、情绪紧张、认知障碍以及护理中断，常伴有攻击行为和生命体征变化。antecedents包括危重病、药物和其他药物、身体和情绪不适、患者特定特征以及医护人员冷漠行为。躁动的后果包括治疗中断、患者预后不良以及对患者、家属和医护人员的心理影响。
重症监护病房中的躁动是一个复杂问题，对患者治疗和临床结果有重大影响。对于医护人员而言，患者躁动会导致工作量增加和工作满意度降低。由于躁动的性质复杂，临床医生必须考虑多方面策略，而不能仅依赖药物治疗。需要进一步研究以全面了解重症监护病房中的患者躁动。这种理解将有助于制定更好的预防和管理此类行为的策略。
对患者躁动有更清晰的理解有助于制定针对性干预措施，改善患者护理，指导重症监护病房培训，并为未来研究提供信息。
本概念分析是在患者代表的参与下制定的。
