Analysis of stressors for the patient in Intensive Care Unit - Critical Care Science (CCS)

BACKGROUND AND OBJECTIVES: The hospital environment, especially in Intensive Care Units (ICU), due to the complexity of the assistance, as well as the physical structure, the noise, the equipments and people’s movement, is considered as stress generator for the patients. The aim of this study was to identify and stratify the stressful factors for patients at an ICU, in the perspective of the own patient, relatives and health care professionals. METHODS: A cross-sectional study was carried out between June and November 2004 in a general ICU of a private hospital. The sample was composed of three groups: patients (G1), relatives (G2) and a member of the ICU health care team responsible for the included patient (G3). In order to identify and stratify the stressful factors, we used the Intensive Care Unit Environmental Stressor Scale (ICUESS). For each individual, a total stress score (TSS) was calculated from the sum of all the answers of the scale. RESULTS: Thirty individuals were included in each group. The mean age of the three groups was: 57.30 ± 17.61 years for G1; 41.43 ± 12.19 for G2; and 40.82 ± 20.20 for G3. The mean TSS was 62.63 ± 14.01 for the patients; 91.10 ± 30.91 for the relatives; and 99.30 ± 21.60 for the health care professionals. The patients’ mean TSS was statistically lower than mean TSS of relatives and professionals (p < 0.01). The most stressful factors for the patients were: seeing family and friends only a few minutes a day; having tubes in their nose and/or mouth; and having no control on oneself. CONCLUSIONS: The perception of the main stressful factors was different among the three groups. The identification of these factors is important to the implementation of changes that can make the humanization of the ICU environment easier.