Pain distress: the negative emotion associated with procedures in ICU patients

Autor: Puntillo, Kathleen, Max, A, Timsit, Jean-François, Ruckly, Stephane, Chanques, Gérald, Robleda, Gemma, Roche-Campo, Ferran, Mancebo, Jordi, Divatia, Jigeeshu, Soares, Márcio, Ionescu, Daniela, Grintescu, I.M., Maggiore, S.M., Rusinova, K, Owczuk, R, Egerod, I, Papathanassoglou, E.D.E., Kyranou, Maria, Joynt , G.M., Burghi , G, Freebairn, R.C., Ho, K.M., Kaarlola, A, Gerritsen, R. T., Kesecioglu , J, Gerritsen, Rik, Kesecioglu, Jozef, Sulaj , M. M. S., Norrenberg, Michèle, Benoit, Dominique D., Seha, Myriam S. G., Hennein, Akram, Pereira, F.J., Benbenishty, J. S., Abroug, F, Aquilina, A, Monte, Julia.R.C., An , Y, Azoulay, Elie
Přispěvatelé: University of California [San Francisco] (UCSF), University of California, Hôpital Saint-Louis, Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Epidémiologie pronostique des cancers et affections graves, Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hospital de la Santa Creu i Sant Pau, Servei de Medicina Intensiva, Intensive Care Unit, Instituto Nacional de Câncer, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Department of Surgery, Clinicum, Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Hospital Verge de la Cinta
Rok vydání: 2018
Předmět:
Male
INTENSIVE-CARE-UNIT
SYMPTOMS
health care facilities
manpower
and services
[SDV]Life Sciences [q-bio]
Emotions
CLINICAL PAIN
Pain
Procedural
Critical Care and Intensive Care Medicine
Procedures
law.invention
0302 clinical medicine
law
030212 general & internal medicine
Prospective Studies
Pain Measurement
REST
Middle Aged
Intensive care unit
3. Good health
Distress
Anesthesia
Surgical Procedures
Operative
Anxiety
Female
medicine.symptom
medicine.medical_specialty
Critical Care
Pain medicine
MECHANISMS
03 medical and health sciences
Anesthesiology
medicine
Humans
Pain distress
Aged
business.industry
Pain Distress
ADULTS
Odds ratio
3126 Surgery
anesthesiology
intensive care
radiology
Cross-Sectional Studies
RATING-SCALES
Relative risk
ICU
EXPERIENCE
business
030217 neurology & neurosurgery
[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Stress
Psychological
Zdroj: Intensive Care Medicine
Intensive Care Medicine, Springer Verlag, 2018, 44, pp.1493-1501. ⟨10.1007/s00134-018-5344-0⟩
Intensive Care Medicine, 44(9), 1493. Springer Verlag
INTENSIVE CARE MEDICINE
r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname
Intensive Care Medicine, Springer Verlag, 2018, ⟨10.1007/s00134-018-5344-0⟩
ISSN: 1432-1238
0342-4642
Popis: International audience; 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.
Databáze: OpenAIRE
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