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Pain distress: the negative emotion associated with procedures in ICU patients
KA. Puntillo, A. Max, JF. Timsit, S. Ruckly, G. Chanques, G. Robleda, F. Roche-Campo, J. Mancebo, JV. Divatia, M. Soares, DC. Ionescu, IM. Grintescu, SM. Maggiore, K. Rusinova, R. Owczuk, I. Egerod, EDE. Papathanassoglou, M. Kyranou, GM. Joynt,...
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, multicentrická studie
NLK
ProQuest Central
od 1997-01-01 do Před 1 rokem
Medline Complete (EBSCOhost)
od 2000-01-01 do Před 1 rokem
Nursing & Allied Health Database (ProQuest)
od 1997-01-01 do Před 1 rokem
Health & Medicine (ProQuest)
od 1997-01-01 do Před 1 rokem
- MeSH
- chirurgie operační škodlivé účinky MeSH
- emoce * MeSH
- lidé středního věku MeSH
- lidé MeSH
- měření bolesti MeSH
- péče o pacienty v kritickém stavu statistika a číselné údaje MeSH
- procedurální bolest psychologie MeSH
- prospektivní studie MeSH
- průřezové studie MeSH
- psychický stres etiologie MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
PURPOSE: The intensity of procedural pain in intensive care unit (ICU) patients is well documented. However, little is known about procedural pain distress, the psychological response to pain. METHODS: Post hoc analysis of a multicenter, multinational study of procedural pain. Pain distress was measured before and during procedures (0-10 numeric rating scale). Factors that influenced procedural pain distress were identified by multivariable analyses using a hierarchical model with ICU and country as random effects. RESULTS: A total of 4812 procedures were recorded (3851 patients, 192 ICUs, 28 countries). Pain distress scores were highest for endotracheal suctioning (ETS) and tracheal suctioning, chest tube removal (CTR), and wound drain removal (median [IQRs] = 4 [1.6, 1.7]). Significant relative risks (RR) for a higher degree of pain distress included certain procedures: turning (RR = 1.18), ETS (RR = 1.45), tracheal suctioning (RR = 1.38), CTR (RR = 1.39), wound drain removal (RR = 1.56), and arterial line insertion (RR = 1.41); certain pain behaviors (RR = 1.19-1.28); pre-procedural pain intensity (RR = 1.15); and use of opioids (RR = 1.15-1.22). Patient-related variables that significantly increased the odds of patients having higher procedural pain distress than pain intensity were pre-procedural pain intensity (odds ratio [OR] = 1.05); pre-hospital anxiety (OR = 1.76); receiving pethidine/meperidine (OR = 4.11); or receiving haloperidol (OR = 1.77) prior to the procedure. CONCLUSIONS: Procedural pain has both sensory and emotional dimensions. We found that, although procedural pain intensity (the sensory dimension) and distress (the emotional dimension) may closely covary, there are certain factors than can preferentially influence each of the dimensions. Clinicians are encouraged to appreciate the multidimensionality of pain when they perform procedures and use this knowledge to minimize the patient's pain experience.
Anesthesia and Intensive Care Department Clinical Emergency Hospital Bucharest Romania
AP HP Réanimation Medicale et des maladies infectieuses Hôpital Bichat 75018 Paris France
Consultant Critical Care Mansoura Emergency University Hospital Mansoura Egypt
Department of Anaesthesia and Intensive Care Mater Dei Hospital Msida Malta
Department of Anaesthesiology and Intensive Therapy Medical University of Gdansk Gdansk Poland
Department of Critical Care Medicine Peking University People's Hospital Beijing China
Department of Intensive Care Ghent University Ghent Belgium
Department of Intensive Care Medical Centre Leeuwarden Leeuwarden The Netherlands
Department of Intensive Care Medicine University Medical Center Utrecht Netherlands
Department of Nursing Cyprus University of Technology Limassol Cyprus
Department of Surgery Helsinki University Hospital Helsinki Finland
ICU Hadassah Hebrew University Hospital Jerusalem Israel
ICU Maennedorf Spital Maennedorf Maennedorf Switzerland
INSERM IAME UMR 1137 Team DesCID 75018 Paris France
Intensive Care Services Hawke's Bay Hospital Hastings New Zealand
Intensive Care Unit CHU F Bourguiba Monastir Tunisia
Intensive Care Unit Hospital Maciel Sanatorio Americano Montevideo Uruguay
Intensive Care Unit Rigshospitalet University of Copenhagen Copenhagen Denmark
Medical Intensive Care Unit University of Paris Diderot Saint Louis Hospital Paris France
Servei de Medicina Intensiva Hospital de Sant Pau Barcelona Spain
Servei de Medicina intensiva Hospital Verge de la Cinta Tortosa Spain
Servicio Medicina Crítica y Cuidados Intensivos Clínica Las Américas Medellín Colombia
Servico Cuidados Intensivos Hospital Santo Antonio Centro Hospitalar do Porto Porto Portugal
Citace poskytuje Crossref.org
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- $a Puntillo, Kathleen A $u Department of Physiological Nursing, University of California, San Francisco, 2 Koret Way, Box 0610, San Francisco, CA, 94143-0610, USA. kathleen.puntillo@ucsf.edu.
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- $a PURPOSE: The intensity of procedural pain in intensive care unit (ICU) patients is well documented. However, little is known about procedural pain distress, the psychological response to pain. METHODS: Post hoc analysis of a multicenter, multinational study of procedural pain. Pain distress was measured before and during procedures (0-10 numeric rating scale). Factors that influenced procedural pain distress were identified by multivariable analyses using a hierarchical model with ICU and country as random effects. RESULTS: A total of 4812 procedures were recorded (3851 patients, 192 ICUs, 28 countries). Pain distress scores were highest for endotracheal suctioning (ETS) and tracheal suctioning, chest tube removal (CTR), and wound drain removal (median [IQRs] = 4 [1.6, 1.7]). Significant relative risks (RR) for a higher degree of pain distress included certain procedures: turning (RR = 1.18), ETS (RR = 1.45), tracheal suctioning (RR = 1.38), CTR (RR = 1.39), wound drain removal (RR = 1.56), and arterial line insertion (RR = 1.41); certain pain behaviors (RR = 1.19-1.28); pre-procedural pain intensity (RR = 1.15); and use of opioids (RR = 1.15-1.22). Patient-related variables that significantly increased the odds of patients having higher procedural pain distress than pain intensity were pre-procedural pain intensity (odds ratio [OR] = 1.05); pre-hospital anxiety (OR = 1.76); receiving pethidine/meperidine (OR = 4.11); or receiving haloperidol (OR = 1.77) prior to the procedure. CONCLUSIONS: Procedural pain has both sensory and emotional dimensions. We found that, although procedural pain intensity (the sensory dimension) and distress (the emotional dimension) may closely covary, there are certain factors than can preferentially influence each of the dimensions. Clinicians are encouraged to appreciate the multidimensionality of pain when they perform procedures and use this knowledge to minimize the patient's pain experience.
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