Traumatic Stressors in the Intensive Care Unit: Viewpoints of Patients and Nurses




Background: Treatment in an intensive care unit (ICU) is both stressful and psychologically traumatic for patients. Many mental disorders can arise following traumatic and stressful events, including anxiety, depression, and post-traumatic stress disorder. Studies have investigated nurses’ and patients’ views on the stressors in a typical intensive care unit. However, there have been inconsistencies in the results of these studies. Moreover, only a limited number of studies have been conducted on this issue in Iran. Objectives: This study aimed to compare patients’ and nurses’ views of the traumatic stressors inherent in intensive care units. Methods: This cross-sectional study was conducted on 120 patients who were hospitalized in intensive care units, as well as 60 nurses in the intensive care units, in 2014. The study instrument consisted of two parts, namely a demographic questionnaire (age, sex, level of education for nurses, and length of hospitalization for patients) and Cochran and Ganong’s modified intensive care unit environmental stressor scale. All the nurses and literate patients answered the questionnaire through self-report. However, illiterate patients were interviewed and their answers were recorded in the questionnaires. The data were analyzed using descriptive statistics and the independent samples t-test. Results: Themean scores of the stressors were 123.23±17.81 and 125.16±17.35 from the nurses’ and patients’ viewpoints, respectively (P > 0.05). A lack of control over urine and stool, fear of death, pain, and having a tube in themouth or nose were themost important stressors from both the patients’ and nurses’ viewpoints. Moreover, the mean stressor scores were approximately the same in both groups for the first eight stressors. Conclusions: Nurses and patients had approximately similar views as to the top eight stressors in the average intensive care unit. However, it seems that nurses not only need more training in appraising intensive care unit patients’ stressors, but also in how to reduce or eliminate those stressors. Such an approach could be of importance in the provision of high quality care due to reducing stressors and meeting patients’ care-related needs in intensive care units. Hence, early intra-ICU clinical psychological intervention may help critically ill trauma patients recover from this stressful experience.