Advertisement

Basic needs and their predictors for intubated patients in surgical intensive care units

Published:September 16, 2008DOI:https://doi.org/10.1016/j.hrtlng.2008.06.002

      Objective

      This study was conducted to investigate the basic needs and communication difficulties of intubated patients in surgical intensive care units (ICUs) and to identify predictors of the basic needs from the patient characteristics and communication difficulties.

      Methods

      In this descriptive correlational study, 80 surgical ICU patients were recruited and interviewed using 3 structured questionnaires: demographic information, scale of basic needs, and scale of communication difficulties.

      Results

      The intubated patients were found to have moderate communication difficulties. The sense of being loved and belonging was the most common need in the intubated patients studied (56.00 standardized scores). A significantly positive correlation was found between communication difficulties and general level of basic needs (r = .53, P < .01), and another positive correlation was found between the length of stay in ICUs and the need for love and belonging (r = .25, P < .05). The basic needs of intubated patients could be significantly predicted by communication difficulties (P = .002), use of physical restraints (P = .010), lack of intubation history (P = .005), and lower educational level (P = .005). These 4 predictors accounted for 47% of the total variance in basic needs.

      Conclusion

      The intubated patients in surgical ICUs had moderate basic needs and communication difficulties. The fact that the basic needs could be predicted by communication difficulties, physical restraints, and educational level suggests that nurses in surgical ICUs need to improve skills of communication and limit the use of physical restraints, especially in patients with a lower educational level.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Heart & Lung: The Journal of Cardiopulmonary and Acute Care
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Bergbom-Engberg I.
        • Haljamäe H.
        Assessment of patients' experience of discomforts during respirator therapy.
        Crit Care Med. 1989; 17: 1068-1072
        • Grap M.J.
        • Blecha T.
        • Munro C.
        A description of patients' report of endotracheal tube discomfort.
        Intensive Crit Care Nurs. 2002; 18: 244-249
        • Lindgren V.A.
        • Ames N.J.
        Caring for patients on mechanical ventilation: what research indicates is best practice.
        Am J Nurs. 2005; 105: 50-60
        • Patak L.
        • Gawlinski A.
        • Fung N.I.
        • Doering L.
        • Berg J.
        Patients' reports of health care practitioner interventions that are related to communication during mechanical ventilation.
        Heart Lung. 2004; 33: 308-321
        • Green A.
        An exploratory study of patients' memory recall of their stay in an adult intensive therapy unit.
        Intensive Crit Care Nurs. 1996; 12: 131-137
        • Pennock B.E.
        • Crawshaw L.
        • Maher T.
        • Price T.
        • Kaplan P.D.
        Distressful events in the ICU as perceived by patients recovering from coronary artery bypass surgery.
        Heart Lung. 1994; 23: 323-327
        • Hafsteindóttir T.B.
        Patient's experiences of communication during the respirator treatment period.
        Intensive Crit Care Nurs. 1996; 12: 261-271
        • Swaiss I.G.
        • Badran I.
        Discomfort, awareness and recall in the intensive care-still a problem?.
        Middle East J Anesthesiol. 2004; 17: 951-958
        • Rotondi A.J.
        • Chelluri L.
        • Sirio C.
        • Mendelsohn A.
        • Schulz R.
        • Belle S.
        • et al.
        Patients' recollections of stressful experiences while receiving prolonged mechanical ventilation in an intensive care unit.
        Crit Care Med. 2002; 30: 746-752
        • Yeh S.H.
        • Lee L.N.
        • Ho T.H.
        • Chiang M.C.
        • Lin L.W.
        Implications of nursing care in the occurrence and consequences of unplanned extubation in adult intensive care units.
        Int J Nurs Stud. 2004; 41: 255-262
        • Maslow A.H.
        Motivation and personality.
        Harper & Row, New York1970
        • Fowler S.B.
        Impaired verbal communication during short-term oral intubation.
        Nurs Diagn. 1997; 8: 93-98
        • Leathart A.J.
        Communication and socialization (1): an exploratory study and explanation for nurse-patient communication in an ITU.
        Intensive Crit Care Nurs. 1994; 10: 93-104
        • Happ M.B.
        • Tuite P.
        • Dobbin K.
        • DiVirgilio-Thomas D.
        • Kitutu J.
        Communication ability, method, and content among nonspeaking nonsurviving patients treated with mechanical ventilation in the intensive care unit.
        Am J Crit Care. 2004; 13: 210-220
        • Hupcey J.E.
        Feeling safe: the psychosocial needs of ICU patients.
        J Nurs Scholarsh. 2000; 32: 361-367
        • Granberg A.
        • Bergbom-Engberg I.
        • Lundberg D.
        Patients' experience of being critically ill or severely injured and cared for in an intensive care unit in relation to the ICU syndrome Part 1.
        Intensive Crit Care Nurs. 1998; 14: 294-307
        • Happ M.B.
        • Roesch T.K.
        • Kagan S.H.
        Patient communication following head and neck cancer surgery: a pilot study using electronic speech-generating devices.
        Oncol Nurs Forum. 2005; 32: 1179-1187
        • Ashurst S.
        Nursing care of the mechanically ventilated patient in ITU: 2.
        Br J Nurs. 1997; 6 (478-9, 482-5): 475-476
        • Williams M.L.
        An algorithm for selecting a communication technique with intubated patients.
        Dimens Crit Care Nurs. 1992; 11: 222-229
        • Wojnicki-Johansson G.
        Communication between nurse and patient during ventilator treatment: patient reports and RN evaluations.
        Intensive Crit Care Nurs. 2001; 17: 29-39
        • Knaus W.A.
        • Draper E.A.
        • Wagner D.P.
        • Zimmerman J.E.
        APACHE Π: a severity of disease classification system.
        Crit Care Med. 1985; 13: 818-829
        • Kho M.E.
        • McDonald E.
        • Stratford P.W.
        • Cook D.J.
        Interrater reliability of APACHE Π scores for medical-surgical intensive care patients: a prospective blinded study.
        Crit Care. 2007; 16: 378-383
        • Endacott R.
        Clarifying the concept of need: a comparison of two approaches to concept analysis.
        J Adv Nurs. 1997; 25: 471-476
        • Menzel L.K.
        Ventilated patients' self-esteem during intubation and after extubation.
        Clin Nurs Res. 1999; 8: 51-68
        • Carpenito L.J.
        Nursing diagnosis application to clinical practice.
        Lippincott, Philadelphia1983
        • Menzel L.K.
        A comparison of patients' communication-related responses during intubation and after extubation.
        Heart Lung. 1997; 26: 363-371
        • Erdfelder E.
        • Faul F.
        • Buchner A.
        G POWER: a general power analysis program.
        Behav Res Methods Instrum Comput. 1996; 28: 1-11
        • Lee Y.W.
        Communication needs in intubated patients after open-heart surgery: need frequency, effectiveness, difficulty and satisfaction of communication [dissertation].
        National Taiwan University, Taipei2000
        • So M.H.
        • Chan D.S.K.
        Perception of stressors by patients and nurses of critical care units in Hong Kong.
        Int J Nurs Stud. 2004; 41: 77-84
        • Adamson H.
        • Murgo M.
        • Boyle M.
        • Kerr S.
        • Crawford M.
        • Elliott D.
        Memories of intensive care and experiences of survivors of a critical illness: an interview study.
        Intensive Crit Care Nurs. 2004; 20: 257-263
        • McKinley S.
        • Nagy S.
        • Stein-Parbury J.
        • Bramwell M.
        • Hudson J.
        Vulnerability and security in seriously ill patients in intensive care.
        Intensive Crit Care Nurs. 2002; 18: 27-36
        • Magnus V.S.
        • Turkington L.
        Communication interaction in ICU: patient and staff experiences and perceptions.
        Intensive Crit Care Nurs. 2006; 22: 167-180
        • Happ M.B.
        Communicating with mechanically ventilated patients: state of the Science.
        AACN Clin Issues Crit Care Nurs. 2001; 12: 247-258