Investigation of environmental stressors and individualized care perceptions of inpatients in the intensive care unit.

Background: Patients in intensive care units are faced with multiple stressors. The presence of invasive procedures, immobility, pain, lack of privacy, being away from family and loved ones, alarm sounds of devices, and frequent interruptions of sleep cause high levels of anxiety and restlessness in patients. The environmental characteristics of the intensive care unit can also create discomfort and stress in the individual, affecting their care satisfaction and therefore the perception of care.

Aim: This research was conducted to examine the environmental stressors and individualized care perceptions of intensive care patients.

Study design: The research was conducted in a descriptive and cross-sectional design.

Method: The sample of the research consisted of 190 patients who had been receiving care and treatment for at least 24 hours in the ICU of a city hospital in Manisa province. In data collection, a "Patient Information Form", the "Intensive Care Unit Environmental Stressors Scale (ICUESS)" and the "Individualized Care Scale-B (ICSB)" were used.

Results: The mean age of the patients was 62.52 ± 13.17 years, 51.1% (n = 97) of them were female, the mean length of stay in the ICU was 1.28 ± 0.45 days, 42.6% (n = 81) of the patients were in the second-level ICU, and 35.8% (n = 68) of them were found to be hospitalized in the ICU because of heart and vascular diseases. Patients' mean score was 109.27 ± 19.19 on the total Intensive Care Unit Environmental Stressors Scale (ICUESS) and 2.64 ± 0.81 on the total Individualized Care Scale-B (ICSB). The mean sub-dimension scores of the ICSB were 3.05 ± 0.92 on the "Decision Making Control", 2.85 ± 1.15 on the "Clinical Condition" and 1.65 ± 0.91 on the "Personal Life Situation." It was determined that some individual characteristics affected these mean scores. There was a very weak and negative correlation between patients' mean scores on the total ICUESS and total ICSB (p = .034, r: -.154), "Clinical Condition" (p = .019, r: -,170) and "Decision Making Control" (p = .045, r: -.145) sub-dimensions.

Conclusion: It was found that as patients' perceptions of environmental stressors increased, their perceptions of individualized care decreased, and some individual and disease characteristics affected these perceptions.

Relevance to clinical practice: Nurses in the intensive care unit can positively impact the perception of individualized care by addressing environmental stressors and implementing appropriate interventions to reduce them. They should continuously monitor patients and the ICU environment to identify stressors, such as noise, light or lack of privacy. By assessing patients' responses to these stressors, they can plan and implement appropriate interventions tailored to individual needs, thereby reducing the effects of these stressors. In doing so, nurses can improve the patient experience and support better outcomes for individualized care perceptions in the ICU.