Relationship Between Hygiene and Comfort Care and Pain in Patients Admitted to an ICU.

IF 2.5 4区 医学 Q2 NURSING
Ana Catarina Ferreira Marçalo, João Filipe Fernandes Lindo Simões, Neuza Maia
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Abstract

Introduction: Hospitalization in intensive care units is associated with high levels of pain, experienced both at rest and during nursing interventions. Hygiene and comfort care, essential to patient well-being, often require mobilization and manipulation maneuvers that can be nociceptive, intensifying pain and discomfort.

Objective: To analyze the relationship between the provision of hygiene and comfort care and the pain experienced by critically ill patients admitted to an intensive care unit, measured before, during, and after these interventions.

Methods: A quantitative, prospective, observational study with repeated measures was conducted in the intensive care unit of a Local Health Unit in Portugal. A total of 101 patients were assessed for pain using either the Numerical Rating Scale for perceived pain or the Behavioral Pain Scale for behavioral indicators at three time points: before, during, and after care.

Results: Pain intensity significantly increased during hygiene and comfort care. NRS scores rose from 0.56 ± 1.27 at baseline to 1.35 ± 2.17 during care and decreased to 0.35 ± 0.81 after 30 minutes, remaining slightly above baseline (p < .001). BPS scores increased from 3.28 ± 0.70 to 4.10 ± 1.18 and returned to 3.41 ± 0.63 post-procedure (p < .001). Systolic and diastolic blood pressure also increased significantly during care (p < .001), reflecting nociceptive responses.

Conclusions: Hygiene and comfort care in intensive care unit settings significantly increase pain in critically ill patients. Pain assessment and management should be prioritized even during routine nursing interventions, reinforcing the importance of nursing practices that are sensitive to the comfort and well-being of these patients. Findings highlight the need for anticipatory analgesia and systematic pain assessment during routine hygiene care in Intensive Care Units nursing practice. Integrating these practices may enhance patient comfort and improve pain management in Intensive Care Units.

ICU患者卫生、舒适护理与疼痛的关系
在重症监护病房住院与高水平的疼痛相关,无论是在休息时还是在护理干预期间。卫生和舒适护理对患者的健康至关重要,但往往需要采取行动和操作,这可能会造成伤害,加剧疼痛和不适。目的:分析提供卫生和舒适护理与入住重症监护病房的危重患者所经历的疼痛之间的关系,测量这些干预之前,期间和之后。方法:在葡萄牙当地一家卫生单位的重症监护病房进行了一项定量、前瞻性、观察性研究。在护理前、护理中和护理后三个时间点,采用感知疼痛的数值评定量表或行为疼痛量表对101例患者进行疼痛评估。结果:在卫生和舒适护理过程中疼痛强度明显增加。NRS评分从基线时的0.56±1.27分上升至护理期间的1.35±2.17分,30分钟后下降至0.35±0.81分,均略高于基线(p < 0.001)。术后BPS评分由3.28±0.70上升至4.10±1.18,恢复至3.41±0.63 (p < 0.001)。收缩压和舒张压在护理期间也显著升高(p < 0.001),反映了伤害性反应。结论:重症监护病房环境中的卫生和舒适护理显著增加危重患者的疼痛。即使在常规护理干预中,疼痛评估和管理也应优先考虑,加强对这些患者的舒适和福祉敏感的护理实践的重要性。研究结果强调了在重症监护室护理实践中进行常规卫生护理时预期镇痛和系统疼痛评估的必要性。整合这些做法可以提高病人的舒适度,并改善重症监护病房的疼痛管理。
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来源期刊
Pain Management Nursing
Pain Management Nursing 医学-护理
CiteScore
3.00
自引率
5.90%
发文量
187
审稿时长
>12 weeks
期刊介绍: This peer-reviewed journal offers a unique focus on the realm of pain management as it applies to nursing. Original and review articles from experts in the field offer key insights in the areas of clinical practice, advocacy, education, administration, and research. Additional features include practice guidelines and pharmacology updates.
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