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Review
. 2021 Aug 31;10(17):3928.
doi: 10.3390/jcm10173928.

Perceived Severity of Stressors in the Intensive Care Unit: A Systematic Review and Semi-Quantitative Analysis of the Literature on the Perspectives of Patients, Health Care Providers and Relatives

Henning Krampe  1 , Claudia Denke  1 , Jakob Gülden  1 , Vivian-Marie Mauersberger  1 , Lukas Ehlen  1 , Elena Schönthaler  2 , Maximilian Markus Wunderlich  3 , Alawi Lütz  1   4 , Felix Balzer  3 , Björn Weiss  1 , Claudia D Spies  1
Affiliations
Review

Perceived Severity of Stressors in the Intensive Care Unit: A Systematic Review and Semi-Quantitative Analysis of the Literature on the Perspectives of Patients, Health Care Providers and Relatives

Henning Krampe et al. J Clin Med. .

Abstract

The aim of this study was to synthesize quantitative research that identified ranking lists of the most severe stressors of patients in the intensive care unit, as perceived by patients, relatives, and health care professionals (HCP). We conducted a systematic literature search in PubMed, MEDLINE, EMBASE, PsycInfo, CINAHL, and Cochrane Library from 1989 to 15 May 2020. Data were analyzed with descriptive and semi-quantitative methods to yield summarizing ranking lists of the most severe stressors. We synthesized the results of 42 prospective cross-sectional observational studies from different international regions. All investigations had assessed patient ratings. Thirteen studies also measured HCP ratings, and four studies included ratings of relatives. Data indicated that patients rate the severity of stressors lower than HCPs and relatives do. Out of all ranking lists, we extracted 137 stressor items that were most frequently ranked among the most severe stressors. After allocation to four domains, a group of clinical ICU experts sorted these stressors with good to excellent agreement according to their stress levels. Our results may contribute to improve HCPs' and relatives' understanding of patients' perceptions of stressors in the ICU. The synthesized stressor rankings can be used for the development of new assessment instruments of stressors.

Keywords: ICU experience; intensive care; perceived stress; stressful experience; stressor.

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Conflict of interest statement

The authors declare that they have no competing interest regarding the content of the manuscript. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results. C.D.S. reports grants from Drägerwerk AG & Co. KGaA, grants from Deutsche Forschungsgemeinschaft/German Research Society, grants from Deutsches Zentrum für Luft- und Raumfahrt e.V. (DLR)/German Aerospace Center, grants from Einstein Stiftung Berlin/Einstein Foundation Berlin, grants from Gemeinsamer Bundesausschuss/Federal Joint Committee (G-BA), grants from Inneruniversitäre Forschungsförderung/Inner University Grants, grants from Projektträger im DLR/Project Management Agency, grants from Stifterverband/Non-Profit Society Promoting Science and Education, grants from European Society of Anaesthesiology and Intensive Care, grants from Baxter Deutschland GmbH, grants from Cytosorbents Europe GmbH, grants from Edwards Lifesciences Germany GmbH, grants from Fresenius Medical Care, grants from Grünenthal GmbH, grants from Masimo Europe Ltd., grants from Pfizer Pharma PFE GmbH, personal fees from Georg Thieme Verlag, grants from Dr. F. Köhler Chemie GmbH, grants from Sintetica GmbH, grants from Stifterverband für die deutscheWissenschaft e.V./Philips grants from Stiftung Charité, grants from AGUETTANT Deutschland GmbH, grants from AbbVie Deutschland GmbH & Co. KG, grants from Amomed Pharma GmbH, grants from InTouch Health, grants from Copra System GmbH, grants from Correvio GmbH, grants from Max-Planck-Gesellschaft zur Förderung der Wissenschaften e.V., grants from Deutsche Gesellschaft für Anästhesiologie & Intensivmedizin (DGAI), grants from Stifterverband für die deutscheWissenschaft e.V./Metronic, grants from Philips Electronics Nederland BV, grants from BMG, grants from BMBF, grants from Deutsche Forschungsgemeinschaft/German Research Society, outside the submitted work. In addition, C.D.S has a patent 102014215211.9 licensed, a patent 102018114364.8 licensed, a patent 102018110275.5 licensed, a patent 502015010534.8 licensed, a patent 502015010347.7 licensed, and a patent 102014215212.7 licensed outside the submitted work; F.B. reports grants from Einstein Foundation, grants from Vifor Pharma, grants from German Federal Ministry of Health, grants from Berlin Institute of Health, grants from German Federal Ministry of Education and Research, personal fees from Elsevier Publishing, grants from German Federal Ministry of Economics and Transportation, non-financial support from European Society of Intensive Care Medicine, non-financial support from Robert Koch Institute, grants from Hans Böckler Foundation, outside the submitted work.

Figures

Figure 2
Figure 2
Summary of the results of the systematic review.
Figure 1
Figure 1
PRISMA flowchart.
See this image and copyright information in PMC

References

    1. Rotondi A.J., Chelluri L., Sirio C., Mendelsohn A., Schulz R., Belle S., Im K., Donahoe M., Pinsky M.R. Patients’ recollections of stressful experiences while receiving prolonged mechanical ventilation in an intensive care unit. Crit. Care Med. 2002;30:746–752. doi: 10.1097/00003246-200204000-00004. - DOI - PubMed
    1. Ballard K.S. Identification of environmental stressors for patients in a surgical intensive care unit. Issues Ment. Health Nurs. 1981;3:89–108. doi: 10.3109/01612848109140863. - DOI - PubMed
    1. Cochran J., Ganong L.H. A comparison of nurses’ and patients’ perceptions of intensive care unit stressors. J. Adv. Nurs. 1989;14:1038–1043. doi: 10.1111/j.1365-2648.1989.tb01515.x. - DOI - PubMed
    1. Cornock M.A. Stress and the intensive care patient: Perceptions of patients and nurses. J. Adv. Nurs. 1998;27:518–527. doi: 10.1046/j.1365-2648.1998.00555.x. - DOI - PubMed
    1. Granja C., Lopes A., Moreira S., Dias C., Costa-Pereira A., Carneiro A. Patients’ recollections of experiences in the intensive care unit may affect their quality of life. Crit. Care. 2005;9:R96–R109. doi: 10.1186/cc3026. - DOI - PMC - PubMed

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