Enfermeria intensiva最新文献

{"title":"Experience of an advanced practice nurse in an intensive care unit","authors":"R. Goñi-Viguria RN, MSN","doi":"10.1016/j.enfie.2025.100482","DOIUrl":"10.1016/j.enfie.2025.100482","url":null,"abstract":"<div><div>The intensive care units structure, the technological improvement and the severity of the patients, require that there be harmony between all the actors involved in assisting the critically ill patient. Added to this context is that the current role of the supervisor involves assuming more and more management skills, without losing sight of the need to frame professional practice within the framework of a philosophy of care. Given this challenge for the supervisor, the appearance in our environment of the Advance Practice Nurse figure (APN) is an opportunity. The APN is essential to improving patient care, staff development and the implementation of evidence-based practice.</div><div>This article describes how the APN works with the different members of the health team and what the results have been since their incorporation.</div><div>The APN leads efforts to maintain quality of care. They use their knowledge to assess gaps in practice and between practice settings, and to design and lead evidence-based practice changes so that benchmarks can be met in the most efficient and timely manner. Additionally, it supports the organization to respond to a constantly changing healthcare environment and is instrumental in achieving its goals.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"36 1","pages":"Article 100482"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parent experiences of child loss in a paediatric intensive care unit on human connection and compassionate care","authors":"Sara Alcón-Nájera RN, MsC, PhD ,&nbsp;María Teresa González-Gil RN, MsC, PhD","doi":"10.1016/j.enfie.2025.100504","DOIUrl":"10.1016/j.enfie.2025.100504","url":null,"abstract":"<div><h3>Introduction</h3><div>The death of a child in an Intensive Care Unit (ICU) is a rare event, the main causes being failed resuscitation efforts, brain death or limitation of the therapeutic effort. The family interpretation of this experience has a significant impact on mourning. Knowledge of the elements that condition this interpretation, is fundamental to be able to accompany and care.</div></div><div><h3>Aims</h3><div>General: to explore the experience of families who have suffered the loss of a child in the PICU. Specific: to describe the experience of \"human connection and family centred compassionate care\".</div></div><div><h3>Methodology</h3><div>A qualitative phenomenological study was carried out in the PICU of a high complexity hospital. Thirteen interviews were conducted (11 mothers/9 fathers), with an average duration of 60 min until thematic saturation. Data were analysed following Van Manen's hermeneutic approach.</div></div><div><h3>Results</h3><div>Compassionate family-centred care is based on the human connection between care team and family system with the objectives of: recognising care as a family affair, promoting a collaborative approach to care and strengthening family bonds. Their achievement requires: informing/training parents about the disease process and care, involving them in decision-making, facilitating their participation in care, generating spaces for honest communication with the care team, facilitating care respire and sibling visits, making, promoting \"family magic spaces”, and generating family memories.</div></div><div><h3>Conclusions</h3><div>The experience of losing a child in the PICU is conditioned by the care team's approach to the management of the families' suffering. The co-creation of a relationship space centred on their needs and mediated by sincere communication and real collaboration is valued as a valuable gift.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"36 1","pages":"Article 100504"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors associated with adverse medication events reported by nurses in a Pediatric Hospital in Mexico","authors":"Rosa María Hidalgo-Velasco RN ,&nbsp;Graciela Martínez-Velasco RN ,&nbsp;Martha Martínez-Salazar PhD ,&nbsp;Karina Juárez-González MSc ,&nbsp;Salvador Vázquez-Vega PhD","doi":"10.1016/j.enfie.2025.100492","DOIUrl":"10.1016/j.enfie.2025.100492","url":null,"abstract":"<div><h3>Introduction</h3><div>During pediatric medication administration, patient safety-related incidents such as sentinel event, adverse event or quasi-failure still occur.</div></div><div><h3>Objective</h3><div>To identify risk factors associated with adverse events during the medication of pediatric patients reported by nurses.</div></div><div><h3>Methods</h3><div>Cross-sectional study, non-probabilistic sampling. From January to October 2021, 411 reports from the Vencer II System were reviewed, of which only 140 reported notifications of incidents during the medication of pediatric patients. Using Root Cause Analysis 38 factors associated with adverse events were investigated. Descriptive and inferential statistics were used.</div></div><div><h3>Results</h3><div>Of the 411 reports reviewed, 140 (34.0%) correspond to incidents; 116 (83.0%) to adverse events and 24 (17.0%) to quasi-failure, no sentinel events were reported. In the human factor, six of the seven proximal factors had a frequency ≥ 40%. Work overload was significantly associated with the occurrence of adverse events; OR = 3.24 (95% CI [1.31–7.99]) (p = 0.008). Contrary to what has been reported, LASA (Look-Alike, Sound-Alike) medications and double-check omission were identified as protective against the occurrence of incidents; OR = 0.323 (95% CI [0.13−0.84]) (p = 0.017); OR = 0.39 (95% CI [0.15−0.99]) (p = 0.047).</div></div><div><h3>Conclusions</h3><div>Work overload was identified as a risk factor associated with the occurrence of adverse events, so it is necessary to evaluate this factor from objective medication and from the nurses' perception of it. Having a documented incident notification and response system in place will allow healthcare institutions to demonstrate diligence and transparency. Finally, the usefulness of Root Cause Analysis and the Ishikawa Diagram to identify factors that can cause incidents is again supported, so their integration into the VENCER II instrument would be useful.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"36 1","pages":"Article 100492"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electrophisiological monitoring of pain in non-communicative critically ill patients","authors":"C. López-López RN, MSc, PhD ,&nbsp;G. Robleda-Font RN, MSc, PhD ,&nbsp;G. Via-Clavero RN, MSc, PhD ,&nbsp;A. Castanera-Duro RN, MSc, PhD","doi":"10.1016/j.enfie.2024.100489","DOIUrl":"10.1016/j.enfie.2024.100489","url":null,"abstract":"<div><div>Electrophysiological monitoring of pain provides objective measures that allow for pain control and adjustment of analgesia in non-communicative patients.</div><div>Among the available electrophysiological devices, automated infrared pupillometry, Analgesia Nociception Index (ANI), and Nociception Level Index (NOL®) stand out. These non-invasive measurement systems analyze the sympathetic or parasympathetic nervous system response to painful stimuli by observing pupillary dilatation and reactivity (pupillometry), heart rate during respiration (ANI), or a combination of multiple parameters from the nociceptive-autonomic medullary circuit (NOL®). These methods have mainly been used in the monitoring of nociception related to procedures in critically ill patients.</div><div>Furthermore, they have allowed for the prediction, adjustment, and customization of analgesia administration prior to painful procedures. To obtain accurate measurements and properly interpret the values provided by these devices, it is important to consider certain limitations in their use, such as the administration of specific medications or the presence of certain pathologies, due to their influence on the autonomic nervous system response. It is also important to note that the reported level of evidence is limited, as randomized clinical trials in the context of intensive care unit regarding these devices are currently lacking.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"36 1","pages":"Article 100489"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurses' role in spiritual care for patients and families in intensive care units: A scoping review","authors":"M. Kappes RN, MSc ,&nbsp;C.A. Fernández-Silva RN, MSc ,&nbsp;L. Catalán RN, MSc ,&nbsp;C. Navalle RN ,&nbsp;M. Diaz RN ,&nbsp;I. Guglielmi RN, MSc","doi":"10.1016/j.enfie.2025.100494","DOIUrl":"10.1016/j.enfie.2025.100494","url":null,"abstract":"<div><h3>Introduction</h3><div>Critically ill patients and their families benefit from spiritual care. There is limited evidence on how spiritual care is delivered in intensive care units (ICUs).</div></div><div><h3>Aim</h3><div>The objective of this review was to determine how nurses include spiritual care for patients and families in ICUs.</div></div><div><h3>Methodology</h3><div>A scoping review was conducted following the Joanna Briggs Institute methodology guidelines, with results reported using the PRISMA-ScR guidelines from March to April 2023. PubMed, Scopus by Elsevier, Web of Science (WOS), and the Ebsco search engine were consulted, including databases such as Medline Complete, Cinhal, and Academic Search Ultimate using the keywords: Nursing care, ICU, spirituality. Articles with qualitative and quantitative approaches of any design describing spirituality in nursing care for patients or families in ICUs were included, excluding editorials and letters to the editor. The time frame ranged from 2015 to 2023, with no language restrictions.</div></div><div><h3>Results</h3><div>A total of 316 articles were retrieved, after removing duplicates and applying inclusion criteria with critical reading, 11 studies were included, 6 with a quantitative approach and 5 with a qualitative approach. Conditions for spiritual care are described highlighting the need for physical space and nurse-related conditions such as motivation and empathy. Personal, organizational, and team-related barriers to spiritual care exist. Facilitators for spiritual care are described such as preparation, communication, and the presence of chaplains.</div></div><div><h3>Conclusions</h3><div>Nurses in ICUs have various ways to provide spiritual care to patients and families. These must be developed considering barriers such as physical space, personal, organizational, and team-related challenges.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"36 1","pages":"Article 100494"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of work life and intention to rotate in intensive care nurses. Cross-sectional study","authors":"L.P. Quiñones-Rozo RN, MSN, PhD,&nbsp;P.A. Largacha-Medina RN,&nbsp;I.Y. Bravo-Bolaños RN,&nbsp;G.E. Canaval-Erazo RN, MSc, PhD","doi":"10.1016/j.enfie.2025.100484","DOIUrl":"10.1016/j.enfie.2025.100484","url":null,"abstract":"<div><h3>Introduction</h3><div>The high demands and current working conditions of nursing professionals who work in intensive care units’ impact both their quality of life and their intention to rotate, and these in turn impact the quality of care.</div></div><div><h3>Objective</h3><div>Identify the relationship between quality of Work Life (QWL) and the intention to rotate and/or leave the organization of nursing profession in intensive care units.</div></div><div><h3>Method</h3><div>Analytical cross-sectional observational study with 101 nursing professionals (NP) working in adult intensive care with more than one year of experience in the area. Simple random probabilistic sampling – 51NP and non-probabilistic convenience sampling – 50NP. The Quality of Life at Work – CVT GOHISALO instrument is applied plus five questions on turnover intention and other sociodemographic questions. The exploratory statistical analysis considered frequency tables and Chi square measures of association to develop the Logit model with the CVT variable as the exposure and the intention to rotate as the outcome.</div></div><div><h3>Results</h3><div>The dimensions of Quality of Life at Work that show the greatest dissatisfaction are integration with work – D3 (61%), job satisfaction – D4 (72%), personal development – D6 (67%) and free time management – D7 (75%). There is a high intention to change to another institution (57%) and to migrate to another country (63%). The intention to change to another institution can be explained by job satisfaction and institutional support (p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>There is an inverse relationship between satisfaction with the dimensions of quality of life at work and the intention to change to another service, institution, or independent work, which would imply developing strategies that improve CVT to reduce the intention to rotate.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"36 1","pages":"Article 100484"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modification of an eye injury risk scale for critically ill children","authors":"Beatriz Vilchez-Rodriguez RN ,&nbsp;Marta Marcos-López RN ,&nbsp;Isabel Manzanal-Martín RN ,&nbsp;Pablo González-Navarro MSc ,&nbsp;Jesús López-Herce MD, PhD","doi":"10.1016/j.enfie.2025.100495","DOIUrl":"10.1016/j.enfie.2025.100495","url":null,"abstract":"<div><h3>Introduction</h3><div>There is no validated tool that assesses the risk of eye injury in intensive care units. The aim of this study was to analyse the ability to detect keratopathies after modification of an eye injury risk assessment scale in critically ill children.</div></div><div><h3>Methods</h3><div>Observational, retrospective study. We modified a designed scale of risk of ocular damage tested in 194 children without previous ocular pathology admitted to paediatric intensive care for more than 48 h. The original scale classified patients as high/medium/low risk according to a sum of 10 risk factors. The scale was simplified by eliminating the face mask and slow blinking. Intubation was replaced by mechanical ventilation. All patients were re-classified with the new scale and the early detection ability of the modified scale for eye damage was compared.</div></div><div><h3>Results</h3><div>There was no statistically significant difference between the two scales for the ability to detect patients at risk of eye injury (p = 0.4361). The new scale classified patients' risk of eye injury with the same reliability, with the exception of one patient whose eye injury with the new scale would have been detected one day later.</div></div><div><h3>Conclusions</h3><div>The new scale had a similar ability to detect eye injury risk as the original scale in critically ill children.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"36 1","pages":"Article 100495"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bowel rhythm in the lung transplant patient","authors":"Cristina González-Blasco RN ,&nbsp;Blanca Isabel Fernández-Alonso RN ,&nbsp;Beatriz Hernández-Iglesias RN ,&nbsp;Ignacio Zaragoza-García RN, PhD ,&nbsp;Marta María Torres-Romero RN ,&nbsp;Patricia Sotillo-Nieto RN ,&nbsp;Laura Alonso-Pérez RN","doi":"10.1016/j.enfie.2025.100503","DOIUrl":"10.1016/j.enfie.2025.100503","url":null,"abstract":"<div><h3>Introduction</h3><div>Lung transplantation is the option for patients with end-stage respiratory pathology. Among the acute post-surgical complications, constipation is novel and relevant, as it has been little studied. Knowing the incidence of patients with constipation during post-implantation allows the creation of an adequate care plan. Several authors relate it to poor postoperative prognosis.</div></div><div><h3>Methodology</h3><div>Descriptive, longitudinal and retrospective study. Target population: lung transplanted patients in a tertiary hospital with an ICU stay ≥3 days.</div></div><div><h3>Main variable</h3><div>Presence of constipation. Sociodemographic, clinical and pharmacological variables related to the patient’s bowel rhythm were collected. Prior authorization was obtained from the hospital research committee.</div></div><div><h3>Results</h3><div>44 transplanted patients were analyzed. The mean age was 52.75 ± 13.05 years, 59,1% were male. The 45,4% were overweight-obese. The main diagnosis is COPD. The majority were bipulmonary (88,6%). Constipation was between 97,7% and 67,9%. The median stool onset is 7,40 days. Prokinetics were introduced prophylactically in a median of 4 days and laxatives in 3 days. Enteral nutrition was introduced early in only 6,8% of patients.</div></div><div><h3>Conclusions</h3><div>A high percentage of lung transplanted patients present constipation; prophylaxis by means of prokinetics and laxatives is early, although enteral nutrition is not introduced early; it is necessary to review the nutritional protocol to avoid constipation.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"36 1","pages":"Article 100503"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced practice nursing, critical care, and Spain: A point of view","authors":"R. Galao-Malo DNP","doi":"10.1016/j.enfie.2024.100491","DOIUrl":"10.1016/j.enfie.2024.100491","url":null,"abstract":"<div><div>Advanced Practice Nursing (APN) continues to gain recognition. Despite the guidelines published by the International Council of Nurses in 2020, there is still some confusion about this concept. In general, APN is used in three different and not necessarily compatible ways: as an umbrella term that regulates four different roles, as a level of practice, or as a role itself. Specialization in nursing does not always imply advanced practice, although both concepts are not mutually exclusive. The “Acute Care Nurse Practitioners” in the United States can conduct physical examinations and medical histories, diagnose, prescribe medications, or request and interpret complementary tests. They pose no risk to patients and have shown positive clinical outcomes in Critical Care Units. They also add \"value\" by improving communication, interprofessional coordination, or adherence to protocols. The “Clinical Nurse Specialists” in Critical Care help improve quality, staff education, and provide care to complex patients. They have a beneficial impact on reducing nosocomial infections, adverse events, hospital stay, or costs. The implementation of APN roles in Spain faces challenges due to its circumstances, such as the high number of physicians or the lack of systematic and transparent measurement of outcomes. Historically, the nursing corporation has promoted a disproportionately positive view of the Spanish healthcare system and nursing. The corporation has followed the model of medical specialization without supporting studies and a framework that hinders its integration into APN. The orthodox vision of Spanish nursing still holds significant weight, where experience is valued more than education, complicating the expansion of competencies. Numerous regional projects have been developed without a unified voice or approach. APN should not be a distraction from continuing to advocate for improvements in nurses' working conditions.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"36 1","pages":"Article 100491"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143292746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The comfort perception in the critically ill patient from the Kolcaba theoretical model","authors":"M.D. Gonzalez-Baz RN, MSN, PhD ,&nbsp;E. Pacheco-del Cerro RN, MSN, PhD ,&nbsp;M.I. Durango-Limárquez RN, MSN ,&nbsp;A. Alcantarilla-Martín RN ,&nbsp;R. Romero-Arribas RN ,&nbsp;J. Ledesma-Fajardo RN ,&nbsp;M.N. Moro-Tejedor RN, MSN, PhD","doi":"10.1016/j.enfie.2024.03.001","DOIUrl":"10.1016/j.enfie.2024.03.001","url":null,"abstract":"<div><h3>Background</h3><div><span>The stay in a critical care unit (CCU) has a serious impact on physical condition causing numerous discomfort factors such as pain or difficulty in communicating. All of these are associated with possible </span>sequelae following discharge from the Intensive Care Unit (ICU) named post-ICU syndrome. The Kolcaba Comfort Theory allows, from a holistic approach, to identify care needs from the patient's perspective using instruments such as the General Comfort Questionnaire (GCQ).</div></div><div><h3>Objectives</h3><div>To determine the comfort level of patients admitted to the CCU using the GCQ of Kolcaba and to identify the discomfort factors.</div></div><div><h3>Methods</h3><div>Cross-sectional descriptive observational prospective study. Population: 580 patients admitted to adult CCU<span> of two high complexity hospitals from June 2015 to March 2020 with stay ≥24 h were interviewed. Descriptive analysis, Student's t-test and ANOVA and multivariate analysis were performed using SPSS v26 and STATA v16.</span></div></div><div><h3>Results</h3><div>The mean age was 52,62 (16,21), 357 (61,6%) were male and 434 (74,8%) were believers. The type of admission was planned in 322 (55,5%) and the most prevalent reason for admission was surgical 486 (83,8%). The median pain score (NRS) was 3,00 [0–4] and severity score (APACHE II) was 13,26 (5,89), the median length of stay was 4,00 [2–7] days. The mean comfort level was 3,02 (0,31) showing the highest value Reanimation 3.02 (0.30) and the lowest Trauma and Emergency Unit 2.95 (0.38). Statistically significant differences were found between the units in the comfort level of patients &gt;65 years of age (p = 0.029). The Relief comfort type obtained the lowest mean 2.81 (0.33) and the physical context 2.75 (0.41) in the three units. In the multivariate analysis, statistically significant differences were found between the comfort level and the pain level: no pain (p = 0,000) OR 4,361 CI [2,184−8,707], mild pain (p = 0,000) OR 4,007 CI [2,068−7,763], moderate pain (p = 0,007) OR 2,803 CI [1,328−5,913], and the APACHE II score equal to or greater than 10 (p = 0,000) OR 0,472 CI [0,316−0,705].</div></div><div><h3>Conclusions</h3><div>The comfort level showed high scores in all three units. The physical and environmental contexts and the relief comfort type negatively affected the perception of comfort. The variables that explained comfort were pain and severity of illness. The evaluation of comfort from the patient's perspective through the GCQ could be considered an indicator of quality of nursing interventions.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"35 4","pages":"Pages 264-277"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140320186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}