Intensive and Critical Care Nursing最新文献

{"title":"Insights from clinicians on reconnecting with survivors of critical illness: An international qualitative investigation","authors":"Alexandra Malyon ,&nbsp;Peter Hartley ,&nbsp;Tammy L. Eaton ,&nbsp;Valerie Danesh ,&nbsp;Bronwen Connolly ,&nbsp;Nazir I. Lone ,&nbsp;Claire Brown ,&nbsp;Joanne McPeake","doi":"10.1016/j.iccn.2025.104212","DOIUrl":"10.1016/j.iccn.2025.104212","url":null,"abstract":"<div><h3>Background</h3><div>Over the last two decades multiple interventions have been implemented to support critical care survivors, each with limited success in improving quality of life and clinical outcomes. There has been limited evaluation of longitudinal critical illness recovery care, including any corresponding impact on the healthcare system or clinicians. The objective of this analysis was to explore the experience of clinicians reconnecting with survivors of critical illness and the subsequent impact that this reconnection was perceived to have within the healthcare system.</div></div><div><h3>Methods</h3><div>We conducted an international qualitative investigation using in-depth semi-structured interviews with clinicians from varied settings, including the UK National Health Service, USA Veteran Affairs, and USA Safety Net Hospitals. Clinicians represented different professional disciplines, specialities, and experience. Interviews were analysed using Framework Analysis.</div></div><div><h3>Results</h3><div>Nineteen clinicians were interviewed. Of those interviewed, 16 (84 %) were female, and the majority worked in critical care settings (n = 10, 53 %). In total, 16 healthcare system settings were represented across the interviews. Following the identification of how reconnection with survivors was operationalised, six themes were identified, and categorised into two domains. The first domain was the <em>Impact of reconnection for clinicians</em> and included: mitigation against emotional exhaustion; workplace meaning; and value placed on staff. The second domain was the <em>Impact on the critical care system and care delivery</em> and included humanisation of care delivery; richer insights to underpin decision-making; and the provision of data to drive improvements in care.</div></div><div><h3>Conclusions</h3><div>This multi-centre international investigation suggests that there are potentially benefits for clinician wellbeing as well as the delivery of care within the critical care setting from reconnection between survivors of critical illness and clinicians.</div></div><div><h3>Clinical Implications</h3><div>This research has explored the experience of reconnection between critical care survivors and clinicians from a clinician perspective. It has shown potential benefits for clinician wellbeing as well as the delivery of care within the critical care setting.</div><div>Reconnection and how it could be incorporated into critical care services should be considered in future research.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"91 ","pages":"Article 104212"},"PeriodicalIF":4.7,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concerns regarding the scientific validity of family satisfaction research in intensive care units – Response to Yu","authors":"Marco Riguzzi ,&nbsp;Lotte Verweij ,&nbsp;Rahel Naef","doi":"10.1016/j.iccn.2025.104180","DOIUrl":"10.1016/j.iccn.2025.104180","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"91 ","pages":"Article 104180"},"PeriodicalIF":4.7,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144893307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving healthcare workers’ psychological well-being through family involvement in the ICU: An interdisciplinary reflection – Letter on Cypress et al.","authors":"Dony Darma Sagita ,&nbsp;Sari Wardani Simarmata ,&nbsp;Della Raymena Jovanka ,&nbsp;Uliya Khoirun Nisa ,&nbsp;Apri Kasman","doi":"10.1016/j.iccn.2025.104204","DOIUrl":"10.1016/j.iccn.2025.104204","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"92 ","pages":"Article 104204"},"PeriodicalIF":4.7,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revolutionizing recovery: The impact of designed digital care therapy on preventing Post-Intensive care syndrome","authors":"Mona M. Elhady ,&nbsp;Abdelghafar M. Elhady ,&nbsp;Samaa Shohieb","doi":"10.1016/j.iccn.2025.104208","DOIUrl":"10.1016/j.iccn.2025.104208","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to evaluate the effect of implementing a designed digital care therapy (DCT) program on preventing post intensive care syndrome (PICS) among critically ill patients.</div></div><div><h3>Methods</h3><div>A quasi-experimental study was conducted on 120 patients in two ICUs at a tertiary hospital. Patients were randomly assigned to an intervention group (n = 60) that received DCT, including interactive games on mobiles and tablets, and a control group (n = 60) that received routine ICU care. Data were collected on physical complications, cognitive disabilities, psychological outcomes, and secondary outcomes related to PICS using validated assessment tools at baseline, during intervention, and at end of DCT program.</div></div><div><h3>Results</h3><div>DCT group showed a significant reduction in psychological complications (p &lt; 0.01), with reduced anxiety (2.733 ± 3.885), depression (5.966 ± 1.519), and delirium episodes (5 %) compared to control group (10.00 ± 3.434, 6.900 ± 0.959, &amp; 25 %, respectively). Physical outcomes improved significantly (p &lt; 0.01) in DCT group, with higher mean muscle strength (4.83 ± 0.874) compared to control group (3.20 ± 0.996). DCT group also had elevated cognitive functioning scores (94.466 ± 7.695), highlighting its effectiveness.</div></div><div><h3>Conclusions</h3><div>In this study, implementing a structured DCT program for critically ill patients was associated with reductions in physical, cognitive, and psychological impairments related to PICS. These findings suggest that DCT may enhance recovery outcomes and contribute positively to the quality of ICU care.</div></div><div><h3>Implications for Clinical Practice</h3><div>DCT has the potential to enhance recovery in ICU patients by addressing symptoms associated with PICS. Its integration into critical care practices could offer an innovative and accessible approach to rehabilitation, promoting improved physical, psychological, and cognitive outcomes. However, further research is warranted to validate these findings across diverse populations and to establish standardized protocols for its implementation.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"91 ","pages":"Article 104208"},"PeriodicalIF":4.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring family functioning through therapeutic conversations in caregivers of young children undergoing open-heart surgery: A qualitative study","authors":"Chih-Han Yang ,&nbsp;Shu-Chien Huang ,&nbsp;Chieh-Yu Liu ,&nbsp;Pei-Ching Liu ,&nbsp;Chi-Wen Chen","doi":"10.1016/j.iccn.2025.104206","DOIUrl":"10.1016/j.iccn.2025.104206","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric open-heart surgery poses significant challenges, as surgical risks and postoperative uncertainties profoundly affect families. Caregivers of young children often face anxiety, exhaustion, and helplessness during intensive care, highlighting the need for developmentally and emotionally responsive support.</div></div><div><h3>Objectives</h3><div>To explore the impact of therapeutic conversations on the cognitive, emotional, and behavioral domains of family functioning among caregivers of young children undergoing open-heart surgery.</div></div><div><h3>Design and methods</h3><div>This qualitative study employed content analysis to explore caregiver experiences. Semi-structured therapeutic conversations were conducted with 32 caregivers of young children undergoing open-heart surgery at two key time points: before the postoperative day 1 visit and before the child’s transfer from the intensive care unit. Conversations were guided by the circular questioning approach of the Calgary Family Intervention Model (CFIM).</div></div><div><h3>Results</h3><div>Analysis of therapeutic conversations identified six themes across cognitive, emotional, and behavioral domains. At previsit, caregivers focused on reducing uncertainty, managing stress, and sustaining coping strategies. By pretransfer, themes shifted to adapting caregiving roles, anticipating future challenges, and reorganizing family life.</div></div><div><h3>Conclusion</h3><div>Caregivers’ emotional responses shifted from initial anxiety to increased hope and proactive planning, demonstrating the positive impact of CFIM-guided therapeutic conversations.</div></div><div><h3>Implications for clinical practice</h3><div>Nurses should incorporate targeted, relationship-based emotional support strategies, particularly in intensive care settings, to enhance caregiver well-being and strengthen family functioning during the critical postoperative recovery period.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"91 ","pages":"Article 104206"},"PeriodicalIF":4.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should ICU delirium be routinely treated with haloperidol? No!","authors":"Mark van den Boogaard ,&nbsp;Barbara C. van Munster ,&nbsp;Thomas H. Ottens","doi":"10.1016/j.iccn.2025.104211","DOIUrl":"10.1016/j.iccn.2025.104211","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"91 ","pages":"Article 104211"},"PeriodicalIF":4.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recognizing excellence: launch of the ICCN Scholarly Impact Certificate","authors":"Stijn Blot,&nbsp;Alberto Lucchini,&nbsp;Frances Fengzhi Lin","doi":"10.1016/j.iccn.2025.104209","DOIUrl":"10.1016/j.iccn.2025.104209","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"91 ","pages":"Article 104209"},"PeriodicalIF":4.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effectiveness of noninvasive ventilation interfaces in critically ill adults: A systematic review and Bayesian network meta-analysis","authors":"Bianca Maria Schneider Pereira Garcia ,&nbsp;Aléxia Gabriela da Silva Vieira ,&nbsp;Ana Carolina Pereira Nunes Pinto ,&nbsp;Raquel Afonso Caserta Eid ,&nbsp;Pedro Rodrigues Genta ,&nbsp;Caroline Gomes Mól ,&nbsp;Ricardo Kenji Nawa","doi":"10.1016/j.iccn.2025.104202","DOIUrl":"10.1016/j.iccn.2025.104202","url":null,"abstract":"<div><h3>Objectives</h3><div>To systematically review the effectiveness of different types of interfaces in the treatment of critically ill patients with respiratory failure requiring NIV.</div></div><div><h3>Methods</h3><div>Parallel randomized controlled trials (RCTs) were identified through a search conducted in the MEDLINE, CENTRAL, EMBASE, and LILACS databases. Review Manager 5 software was used for direct comparisons. Risk ratios (RR) with 95% confidence interval (CI) or credible interval (CrI) were used for dichotomous outcomes. Continuous outcomes were reported as mean differences (MD) with 95% CIs. MetaInsight software was used for conducting network <em>meta</em>-analysis (NMA) with Bayesian random-effects models.</div></div><div><h3>Results</h3><div>A systematic search was conducted on August 4, 2022, and last updated on November 6, 2024. Seven studies were included, involving 406 patients, and four different interfaces (helmet, oronasal, nasal, and full-face) were utilized. Helmet may reduce intubation rate, ICU and hospital length of stay, when compared to oronasal mask (RR 0.38 [95% CrI 0.2 to 0.75], RR −3.34 [95% CrI −6.94 to 0.49] and RR −2.4 [95% CrI −6.23 to 1.62]), with low certainty of the evidence. Furthermore, the evidence is very uncertain regarding the effects of the helmet on reducing serious adverse events, with very low certainty of the evidence. The evidence remains uncertain for the outcomes of in-hospital mortality, serious adverse events, mild and moderate adverse events, comfort, and tolerance.</div></div><div><h3>Conclusions</h3><div>The helmet interface probably reduces the length of stay and intubation rates when used for non-invasive ventilation in critically ill patients with respiratory failure. However, the findings should be interpreted with caution as it generates from RCT with small sample sizes.</div></div><div><h3>Implications for clinical practice</h3><div>This network <em>meta</em>-analysis offers comparative evidence to guide clinical decision-making regarding interface selection during noninvasive ventilation, with the potential to enhance treatment effectiveness and patient outcomes.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"91 ","pages":"Article 104202"},"PeriodicalIF":4.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the environment on health status of intensive care unit patients: Functional data analysis using wearable monitoring systems","authors":"Francisco J. Rodríguez-Cortés ,&nbsp;Juan Antonio Arias-López ,&nbsp;Manuel Oviedo-de la Fuente ,&nbsp;Jose M. Jiménez-Pastor ,&nbsp;Luna López-Coleto ,&nbsp;Pedro Arévalo-Buitrago ,&nbsp;Juan de la Cruz López-Carrasco ,&nbsp;Rocío Valverde-León ,&nbsp;Pablo Jesús López-Soto ,&nbsp;Ignacio Morales-Cané","doi":"10.1016/j.iccn.2025.104183","DOIUrl":"10.1016/j.iccn.2025.104183","url":null,"abstract":"<div><h3>Objectives</h3><div>Environmental factors in critical care units (ICUs) can significantly impact patient health. Traditional analysis methods often struggle with the continuous temporal data from wearable monitoring devices. This study explores the novel application of functional data analysis (FDA), a methodology well suited for continuous signals, to assess how environmental exposures influence ICU patient outcomes over time. Specifically, it examines the most impactful environmental variables. It evaluates FDA’s effectiveness in analysing continuous data from wearable monitoring devices, in contrast to traditional methods that overlook temporal patterns by using average or isolated measurements.</div></div><div><h3>Methods</h3><div>A prospective cohort study was conducted in a tertiary-level reference ICU in southern Spain, where wearable sensors were used to collect physiological and environmental data from 77 adult patients continuously. Functional data analysis (FDA) techniques were employed to explore temporal patterns in the collected signals.</div></div><div><h3>Results</h3><div>Noise intensity (decibels) was the most significant environmental variable, correlating with Richmond Agitation-Sedation Scale (RASS) scores and heart rate (HR). Functional additive models significantly improved model performance, achieving R² values up to 0.78 for RASS prediction in trauma patients. Effects varied across patient diagnosis subgroups.</div></div><div><h3>Conclusions</h3><div>FDA techniques, particularly functional additive models, better model complex relationships between environmental and physiological variables in the ICU. Environmental impacts differ across patient types, suggesting the need for specialised environmental interventions based on patient condition.</div></div><div><h3>Implications for Clinical Practice</h3><div>This study underscores the need for environmental monitoring in ICUs and highlights the potential of wearable sensors and advanced statistical analysis to optimise patient care and improve outcomes by tailoring environmental interventions to specific patient needs.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"91 ","pages":"Article 104183"},"PeriodicalIF":4.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parents’ experience of being present or absent during anesthesia induction of children under six months of age. A mixed randomized controlled study","authors":"Lisbet Andersson ,&nbsp;Nathalie Danielsson ,&nbsp;Ali-Reza Modiri ,&nbsp;Peter Frykholm","doi":"10.1016/j.iccn.2025.104207","DOIUrl":"10.1016/j.iccn.2025.104207","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate parents’ experiences of being present during anesthesia induction in young infants.</div><div>Design.</div><div>A mixed randomized controlled study.</div></div><div><h3>Methods</h3><div>Parents of the included infants were randomized to either one parent present during induction or control (not present). In the holding area, parents completed the Amsterdam Preoperative Anxiety and Information Scale (APAIS) before and after the induction. Differences in APAIS between groups as well as before and after scores were analyzed. Postoperatively, available parents were interviewed, and data were analysed using meaning-oriented thematic analysis.</div></div><div><h3>Results</h3><div>Pre-induction anxiety was common in both fathers (51 %) and mothers (73 %) but there was no difference in the full APAIS score between present and absent groups. However, the qualitative data revealed that parents preferred to be present despite different levels of anxiety. Being present was to gain certainty, to be able to protect and to be a resource. Being absent was to be floating in uncertainty, not being allowed to protect or to be a resource.</div></div><div><h3>Conclusions</h3><div>Pre-induction anxiety was common, especially in mothers. If given the choice, most parents would prefer to be present. Parents can be a resource for both the infant and anesthesia team during induction.</div></div><div><h3>Implications for Clinical Practice</h3><div>Setting up routines for parental presence during anesthesia induction is important. The parents’ message to the anesthesia team and to the organization is let the parents of small infants be present during induction.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"91 ","pages":"Article 104207"},"PeriodicalIF":4.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}