Enhancing hospital well-being and minimizing intensive care unit trauma: Cushioning effects of psychosocial care
Usha Chivukula, Meena Hariharan, Suvashisa Rana, Marlyn Thomas, Asher Andrew
hospital well-being, Intensive Care Unit trauma, psychosocial care,Coronary artery bypass grafting
Citation Information :
Chivukula U, Hariharan M, Rana S, Thomas M, Andrew A. Enhancing hospital well-being and minimizing intensive care unit trauma: Cushioning effects of psychosocial care. Indian J Crit Care Med 2017; 21 (10):640-645.
Context: Hospitalization has the potential to induce hospital anxiety, while admission in the Intensive Care Unit (ICU) is found to surpass the anxiety and result in what is termed as “ICU Trauma.”
Aims: This study aimed to determine the impact of psychosocial care and quality of ICU on ICU trauma and hospital well-being in patients who underwent coronary artery bypass grafting (CABG).
Settings and Design: This correlational study involved 250 CABG patients, who were recruited from five major corporate hospitals.
Participants and Methods: The ICU Psychosocial Care Scale, Hospital Wellbeing Scale, and ICU Trauma Scale were used. Each of the participants was assessed individually. The ICU Practices Checklist was used to assess the environment of the ICU in the hospital.
Statistical Analysis Used: Descriptive statistics, correlation, and simple and multiple linear regression analyses were done.
Results: The results revealed the significant contribution of psychosocial care in ICU in enhancing hospital well-being as well as minimizing ICU trauma of patients who underwent CABG. The results of multiple regressions clearly indicated that psychosocial care was a powerful predictor of hospital well-being and ICU trauma.
Conclusions: Although psychosocial care was not a component of hospital well-being and had a negative correlation with ICU trauma, it contributed significantly with a cushioning effect to minimize trauma and helped enhance the feelings and experiences of well-being among patients in ICU.
Broomhead LR, Brett SJ. Clinical review: Intensive care follow-up – What has it told us? Crit Care 2002;6:411-7.
Almerud S, Alapack RJ, Fridlund B, Ekebergh M. Caught in an artificial split: A phenomenological study of being a caregiver in the technologically intense environment. Intensive Crit Care Nurs 2008;24:130-6.
Gjengedal E. Understanding a World of Critical Illness. A Phenomenological Study of Experiences of Respirator Patients and Their Caregivers [Dissertation] University of Bergen; 1994.
Samuelson K. Sedation during Mechanical Ventilation in Intensive Care: Sedation Practices and Patients' Memories, Stressful Experiences and Psychological Distress. [Dissertation] Lund University Sweden; 2006.
Tamburri LM, DiBrienza R, Zozula R, Redeker NS. Nocturnal care interactions with patients in critical care units. Am J Crit Care 2004;13:102-12.
Ryherd EE, Waye KP, Ljungkvist L. Characterizing noise and perceived work environment in a neurological critical care unit. J Acoust Soc Am 2008;123:747-56.
Granberg-Axèll A, Bergbom I, Lundberg D. Clinical signs of ICU syndrome/delirium: An observational study. Intensive Crit Care Nurs 2001;17:72-93.
Granberg Axèll AI, Malmros CW, Bergbom IL, Lundberg DB. Intensive Care Unit syndrome/delirium is associated with anemia, drug therapy and duration of ventilation treatment. Acta Anaesthesiol Scand 2002;46:726-31.
Dyer I. Preventing the ITU syndrome or how not to torture an ITU patient! Part I. Intensive Crit Care Nurs 1995;11:103-39.
Margolies L. Understanding the Effects of Trauma: Post-Traumatic Stress Disorder (PTSD). Psych Central; 2010. Available from: http://www.psychcentral.com/lib/understanding-the-effects-of-trauma-post-traumatic-stress-disorder-ptsd/0003971. [Last accessed on 2013 Jul 22].
Hariharan M, Chivukula U. Patient care in Intensive Care Units (ICUs): Biopsychosocial assessment. J Indian Health Psychol 2011;5:25-35.
Wade DM, Howell DC, Weinman JA, Hardy RJ, Mythen MG, Brewin CR, et al. Investigating risk factors for psychological morbidity three months after intensive care: A prospective cohort study. Crit Care 2012;16:R192.
Blumenthal JA, Lett HS, Babyak MA, White W, Smith PK, Mark DB, et al. Depression as a risk factor for mortality after coronary artery bypass surgery. Lancet 2003;362:604-9.
Schweickert WD, Pohlman MC, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: A randomised controlled trial. Lancet 2009;373:1874-82.
Bergmann P, Huber S, Mächler H, Liebl E, Hinghofer-Szalkay H, Rehak P, et al. The influence of medical information on the perioperative course of stress in cardiac surgery patients. Anesth Analg 2001;93:1093-9.
Friesner SA, Curry DM, Moddeman GR. Comparison of two pain-management strategies during chest tube removal: Relaxation exercise with opioids and opioids alone. Heart Lung 2006;35:269-76.
Hwang SL, Chang Y, Ko WJ, Lee MB. Stress-reducing effect of physician's tape-recorded support on cardiac surgical patients in the Intensive Care Unit. J Formos Med Assoc 1998;97:191-6.
Contrada RJ, Boulifard DA, Hekler EB, Idler EL, Labouvie EW, Spruill TM, et al. Psychosocial factors in heart surgery: Pre-surgical vulnerability and postsurgical recovery. Health Psychol2008;7:309-19.
Currid T. Meeting the psychological needs of physically ill. Nurs Times 2012;108:22-5.
Arthur HM, Daniels C, McKelvie R, Hirsh J, Rush B. Effect of a preoperative intervention on preoperative and postoperative outcomes in low-risk patients awaiting elective coronary artery bypass graft surgery. A randomized, controlled trial. Ann Intern Med 2000;133:253-62.
Mampuya WM. Cardiac rehabilitation past, present and future: An overview. Cardiovasc Diagn Ther 2012;2:38-49.
National Accreditation Board for Hospitals & Healthcare Providers. NABH Accredited Hospitals; 2012. Available from: http://www.nabh.co/main/hospitals/accredited.asp. [Last accessed on 2013 Jul 04].
Joint Commission International Accreditation Standards for Hospitals. Joint Commission International. 4th ed. USA; 2010. Available from: http://www.jointcommissioninternational.org. [Last accessed on 2013 Jun 22].
Thompson DR, Hamilton DK, Cadenhead CD, Swoboda SM, Schwindel M, Anderson DC, et al. Guidelines for Intensive Care Unit design. Crit Care Med 2012;40:1586-600.
Tennant R, Hiller L, Fishwick R, Joseph S, Weich S, Stewart-Brown S. Warwick Edinburg Mental Wellbeing Scale (WEMWS): Development and UK validation. Health Qual Life Outcomes 2007;5:63.
Davidson JR, Book SW, Colket JT, Tupler LA, Roth S, David D, et al. Assessment of a new self-rating scale for post-traumatic stress disorder. Psychol Med 1997;27:153-60.
Wilkin K, Slevin E. The meaning of caring to nurses: An investigation into the nature of caring work in an Intensive Care Unit. J Clin Nurs 2004;13:50-9.
Frazier SK, Moser DK, O'Brien JL, Garvin BJ, An K, Macko M, et al. Management of anxiety after acute myocardial infarction. Heart Lung 2002;31:411-20.
Deja M, Denke C, Weber-Carstens S, Schröder J, Pille CE, Hokema F, et al. Social support during Intensive Care Unit stay might improve mental impairment and consequently health-related quality of life in survivors of severe acute respiratory distress syndrome. Crit Care 2006;10:R147.
Barskova T, Oesterreich R. Post-traumatic growth in people living with a serious medical condition and its relations to physical and mental health: A systematic review. Disabil Rehabil 2009;31:1709-33.
Hudetz JA, Gandhi SD, Iqbal Z, Patterson KM, Byrne AJ, Warltier DC, et al. History of post-traumatic stress disorder is associated with impaired neuropsychometric performance after coronary artery surgery. J Cardiothorac Vasc Anesth 2010;24:964-8.