Authors (including presenting author) :
LEUNG PWR, AU SY, FONG KM, LIN KW, WONG WF, CHAN MM, NG WYG & Leung KHA
Affiliation :
Intensive Care Unit, Queen Elizabeth Hospital
Introduction :
Patients under critical conditions receive a number of therapies. They are surrounded by multiple monitoring and invasive lines and tubes. They also receive invasive supports like mechanical ventilation, renal replacement therapy and even ECMO. Ongoing assessment and nursing care procedures disturbed their rest time and they can experience enormous psychological distress and environmental discomfort such as lighting, noise, alarm, room temperature change. Acute delirium and post-traumatic stress disorder are not uncommon as a result, but they are often neglected. There are limited tools to assess ICU patients’ discomfort until the publication of the Inconforts des Patients de ReAnimation (IPREA) questionnaire, which is a 16-item French questionnaire on quantitative assessment of ICU-related self-perceived discomfort, and the areas of discomfort could be identified and quantified. In our study, this questionnaire was translated to 2 versions of Chinese and then back-translated to French to ensure its consistency. We applied this questionnaire to assess the discomfort of our ICU patients and will test its validity in our population.
Objectives :
To identify and quantify predictors of discomfort perceived by ICU survivors in our ICU setting by adopting the IPREA questionnaire\
To validate this questionnaire in our Chinese critically-ill patients
Methodology :
A self-administered, Chinese version of IPREA questionnaire was given to our Chinese patients who stayed in ICU for at least 3 consecutive days on the day of discharge by bedside nurses. Ten percent of them would be randomly selected to repeat the questionnaire within the next 24 hours to test the reproducibility. The study period was from Mar 2019 and is still ongoing. Up to November 2019, 200 subjects were recruited out of the target number of 330 and the preliminary results were presented.
Result & Outcome :
Two hundred patients were so far recruited. 55% were men and the mean age was 54.01 +/- 16.11 years old. The mean length of staying in ICU was 5+/- 3 days. Most (79%) were admitted for emergency. Among all the discomfort reported, most were related to personal sensation. One hundred and thirty (65%)patients complained of thirst, which ranked the top complaint, followed by 45% of lack of sleep, 42% of hunger and 36% of pain, which were all top 5 complaints. Unfamiliar surroundings also proved great discomfort to them with being annoyed by invasive lines found in 47% of patients, which ranged the second highest discomfort, followed by "No phone" nearby in 34%. Patients were lest concerned about the comfort of the bed (15%), lack of privacy( 12%) or being isolated (13%).
The study is ongoing and the results helped us to implement measures to improve their comfort, which has all along be a neglected field. With enough sample, we could validate this test in our Chinese population so that discomfort could become a measurable ICU outcomes, and this would be the first Hong Kong Chinese ICU comfort assessment tool.
