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 |
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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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