Association with perceived stress and feasibility of an app for patient-reported stressor experiences during treatment in an intensive care unit: a nonrandomized controlled study (ICU Feel Better App).

Abstract

Background: Critically ill patients often experience substantial stress during their ICU treatment. The ICU Feel Better App is a novel mobile application that patients can use to evaluate ICU-related stressors during their stay. We aimed to investigate if using the app, without feedback to the ICU staff, would be associated with changes in perceived acute stress.

Methods: This prospective cohort study used a before-and-after design. Data were collected at the beginning of ICU treatment (T1) and at discharge from ICU (T2). The comparison group (N.=20) received treatment as usual, i.e. standard critical care including assessment and treatment of pain and delirium. The App group (N.=20) used the ICU Feel Better App, which included 24 common ICU-related stressors, between T1 and T2. Secondary outcomes included app use extent and patients' ratings of acceptance and usability.

Results: No significant differences were observed in clinical characteristics or stress levels between treatment groups at T1, T2, and from T1 to T2. Each app session averaged a median of 1.82 minutes (IQR: 1.54-2.66), with users averaging 8.5 sessions over 3.5 days, totaling 16.16 minutes of use (IQR: 9.72-27.51). Patients found the app highly usable and acceptable, with assistance needed in only one session for three users and no premature terminations.

Conclusions: The lack of significant stress reduction suggests that the effectiveness of the app could be improved by incorporating feedback mechanisms to communicate patients' stressor evaluations to staff, prompting stress-reducing measures. Data on app use, acceptability, and usability indicate feasibility of the ICU Feel Better App.