Nurses’ Attitudes, Practices, and Barriers to Assessing Symptoms of Discomfort in Mechanically Ventilated Patients: A Cross-Sectional Study
Introduction Critically ill patients experience various stressful symptoms of discomfort, including dyspnea, pain, and sleep disruption. Notably, ventilated patients have difficulty self-reporting discomfort symptoms. Nurses need to assess discomfort symptoms to alleviate them, but limited research...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2024-04-01
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| Series: | SAGE Open Nursing |
| Online Access: | https://doi.org/10.1177/23779608241245209 |
| _version_ | 1797216558179680256 |
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| author | Tomohiko Takahashi Yusuke Oyama Hideaki Sakuramoto Mitsuhiro Tamoto Tomoo Sato Yuko Nanjo Sayaka Hosoi Takeshi Unoki |
| author_facet | Tomohiko Takahashi Yusuke Oyama Hideaki Sakuramoto Mitsuhiro Tamoto Tomoo Sato Yuko Nanjo Sayaka Hosoi Takeshi Unoki |
| author_sort | Tomohiko Takahashi |
| collection | DOAJ |
| description | Introduction Critically ill patients experience various stressful symptoms of discomfort, including dyspnea, pain, and sleep disruption. Notably, ventilated patients have difficulty self-reporting discomfort symptoms. Nurses need to assess discomfort symptoms to alleviate them, but limited research exists on discomfort symptom assessment and management in critically ill patients. Objective To identify the practices, attitudes, and barriers among nurses related to the assessment of discomfort symptoms in mechanically ventilated patients. Methods Using a cross-sectional, descriptive study design, a web-based survey was conducted between May and June 2022 with critical care nurses sampled through Japanese academic societies and social networking services. The survey contained questions relative to the above-stated objective. Descriptive statistical analysis was performed without sample size calculation because of the descriptive and exploratory nature of this study. Results There were 267 respondents to the questionnaire. The discomfort symptoms that nurses perceived as important to assess were pain (median 100 [interquartile range, IQR 90–100]), insomnia (99 [80–100]), and dyspnea (96.5 [75–100]). Most participants (89.8%) routinely assessed pain in mechanically ventilated patients using a scale; however, other discomfort symptoms were assessed by less than 40% (dyspnea [28.4%], fatigue [8.1%], thirst [13.1%], insomnia [37.3%], and anxiety [13.6%]). Two major barriers to assessing discomfort symptoms were lack of assessment culture within the intensive care unit and lack of knowledge of the relevant evaluation scales. Conclusions Nurses were aware of the importance of using scales to assess the discomfort symptoms experienced by mechanically ventilated patients. However, except for pain, most nurses did not routinely use scales to assess discomfort symptoms. Barriers to routine discomfort symptom assessment included the lack of an assessment culture and the lack of knowledge of the assessment scales. Clinicians should be educated regarding the existence of validated rating scales and develop additional rating scales utilizable for minor discomforts in mechanically ventilated patients. |
| first_indexed | 2024-04-24T11:47:52Z |
| format | Article |
| id | doaj.art-4793f53ff686482e80aa561bdc730bfe |
| institution | Directory Open Access Journal |
| issn | 2377-9608 |
| language | English |
| last_indexed | 2024-04-24T11:47:52Z |
| publishDate | 2024-04-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | SAGE Open Nursing |
| spelling | doaj.art-4793f53ff686482e80aa561bdc730bfe2024-04-09T09:03:55ZengSAGE PublishingSAGE Open Nursing2377-96082024-04-011010.1177/23779608241245209Nurses’ Attitudes, Practices, and Barriers to Assessing Symptoms of Discomfort in Mechanically Ventilated Patients: A Cross-Sectional StudyTomohiko Takahashi0Yusuke Oyama1Hideaki Sakuramoto2Mitsuhiro Tamoto3Tomoo Sato4Yuko Nanjo5Sayaka Hosoi6Takeshi Unoki7 Intensive Care Unit, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan , Nagasaki, Japan Department of Critical Care and Disaster Nursing, , Munakata, Fukuoka, Japan , Kyoto, Kyoto, Japan Acute Care Nursing Division, , Kobe, Hyogo, Japan Department of Fundamental Nursing, Faculty of Nursing, , Kahoku, Ishikawa, Japan Department of Coronary Care Unit, , Ibaraki, Japan Department of Acute and Critical Care Nursing, School of Nursing, , Sapporo, Hokkaido, JapanIntroduction Critically ill patients experience various stressful symptoms of discomfort, including dyspnea, pain, and sleep disruption. Notably, ventilated patients have difficulty self-reporting discomfort symptoms. Nurses need to assess discomfort symptoms to alleviate them, but limited research exists on discomfort symptom assessment and management in critically ill patients. Objective To identify the practices, attitudes, and barriers among nurses related to the assessment of discomfort symptoms in mechanically ventilated patients. Methods Using a cross-sectional, descriptive study design, a web-based survey was conducted between May and June 2022 with critical care nurses sampled through Japanese academic societies and social networking services. The survey contained questions relative to the above-stated objective. Descriptive statistical analysis was performed without sample size calculation because of the descriptive and exploratory nature of this study. Results There were 267 respondents to the questionnaire. The discomfort symptoms that nurses perceived as important to assess were pain (median 100 [interquartile range, IQR 90–100]), insomnia (99 [80–100]), and dyspnea (96.5 [75–100]). Most participants (89.8%) routinely assessed pain in mechanically ventilated patients using a scale; however, other discomfort symptoms were assessed by less than 40% (dyspnea [28.4%], fatigue [8.1%], thirst [13.1%], insomnia [37.3%], and anxiety [13.6%]). Two major barriers to assessing discomfort symptoms were lack of assessment culture within the intensive care unit and lack of knowledge of the relevant evaluation scales. Conclusions Nurses were aware of the importance of using scales to assess the discomfort symptoms experienced by mechanically ventilated patients. However, except for pain, most nurses did not routinely use scales to assess discomfort symptoms. Barriers to routine discomfort symptom assessment included the lack of an assessment culture and the lack of knowledge of the assessment scales. Clinicians should be educated regarding the existence of validated rating scales and develop additional rating scales utilizable for minor discomforts in mechanically ventilated patients.https://doi.org/10.1177/23779608241245209 |
| spellingShingle | Tomohiko Takahashi Yusuke Oyama Hideaki Sakuramoto Mitsuhiro Tamoto Tomoo Sato Yuko Nanjo Sayaka Hosoi Takeshi Unoki Nurses’ Attitudes, Practices, and Barriers to Assessing Symptoms of Discomfort in Mechanically Ventilated Patients: A Cross-Sectional Study SAGE Open Nursing |
| title | Nurses’ Attitudes, Practices, and Barriers to Assessing Symptoms of Discomfort in Mechanically Ventilated Patients:
A Cross-Sectional Study |
| title_full | Nurses’ Attitudes, Practices, and Barriers to Assessing Symptoms of Discomfort in Mechanically Ventilated Patients:
A Cross-Sectional Study |
| title_fullStr | Nurses’ Attitudes, Practices, and Barriers to Assessing Symptoms of Discomfort in Mechanically Ventilated Patients:
A Cross-Sectional Study |
| title_full_unstemmed | Nurses’ Attitudes, Practices, and Barriers to Assessing Symptoms of Discomfort in Mechanically Ventilated Patients:
A Cross-Sectional Study |
| title_short | Nurses’ Attitudes, Practices, and Barriers to Assessing Symptoms of Discomfort in Mechanically Ventilated Patients:
A Cross-Sectional Study |
| title_sort | nurses attitudes practices and barriers to assessing symptoms of discomfort in mechanically ventilated patients a cross sectional study |
| url | https://doi.org/10.1177/23779608241245209 |
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