Background
Patients in intensive care units (ICUs) can be adversely affected by distressing symptoms.
When critically ill patients are unable to self-report symptoms, ICU nurses become
proxy reporters.
Objective
The purpose of this prospective, descriptive study was to explore how ICU nurses assess
and treat distressing symptoms in critically ill patients at high risk of dying.
Methods
Twenty-two nurses participated in this single-site, prospective, descriptive study
and described their patients' symptoms and how the symptoms were being managed in
response to interviews that used open-ended questions. Taped interviews were transcribed
verbatim, and themes were identified.
Results
Three major themes were derived from the data: 1) signs of symptoms, (2) treatment
of symptoms, and (3) “symptoms” versus “signs.” Most nurses did not make distinctions
between the assessment of “signs” of disease and the assessment of “symptoms,” and
consequently, signs and symptoms were frequently inventoried collectively.
Conclusion
Critically ill patients experience a broad range of symptoms. Continued attempts to
validate nonverbal measures of symptoms are warranted because lack of such measures
may adversely affect symptom treatment for critically ill patients. Furthermore, heightened
awareness and increased education of nurses to differentiate between signs and symptoms
lay the foundation for increasing attention on symptoms, improving accuracy of symptom
assessment, and guiding appropriate symptom management.
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Article info
Publication history
Published online: September 22, 2008
Identification
Copyright
© 2008 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
