Stressors in ICU: perception of the patient, relatives and health care team

Objective: To compare the evaluation of the stressors present in the intens ive care unit (ICU) from the point of view of the patient, relatives and th e multiprofessional team and to identify differences and similarities with regard to the perception of stressors in order to optimize patient care. Design: Cross-sectional analytical survey. Setting: General ICU of a private hospital. Patients and participants: From April 1(st) to June 30(th), 1996, 50 ICU pa tients during the first week of their ICU stay, 50 of their respective rela tives and 50 members of the professional team directly involved in the care of these patients. Measurements and results: The Intensive Care Unit Environmental Stressor Sc ale (ICUESS) was administered to all patients. The relatives and health car e professionals were asked to complete the ICUESS on the basis of their per ception of the patient's stressors. Being in pain, having tubes in the nose or mouth, being restrained by tubes and being unable to sleep were conside red by the patients, relatives and health care professionals as the main st ressors. The professional team evaluated the intensity of the stressors hig her than either the family or the patient. No statistical significance was detected between the intensity of the stressors as evaluated by the patient and the intensity evaluated by relatives and by the professional team. Conclusions: Being in pain, being unable to sleep and having tubes in the n ose and/or mouth were pointed out as the major stressors by the three group s. There was no statistically significant correlation between the total str ess scores of the patients and their relatives (r = 0.193), between the pat ients and the team (r = -0.002), or between the total scores of the team an d the relatives (r = -0.185). The results suggest that the views of the rel atives and the professional team concerning the stressors have some similar points compared to the evaluation made by the patient himself, although th e intensity of the evaluation for each group corresponds to its own percept ion.