The Effect of Endotracheal Suctioning on Pain in Conscious Adult Patients in Intensive Care Unit.

BACKGROUND AND PURPOSE: Pain assessment and management are an important issue to ensure the comfort of patients in the intensive care unit, and reducing pain is an important nursing intervention. Therefore, it is important to evaluate pain correctly. For correct pain management, it is necessary to correctly determine the presence and severity of pain. The study was conducted to determine whether endotracheal suctioning was painless and whether the Behavioral Pain Scale (BPS) was an accurate assessment tool to assess pain during endotracheal suctioning. METHODS: This study is a prospective clinical study. Thirty-two patients were endotracheal suctioned using the same technique by the same person, and their before-procedure BPS and visual analog scale (VAS) scores were recorded. The study was conducted in the anesthesia and reanimation intensive care unit of a university hospital between December 12, 2020, and April 14, 2021. RESULTS: The before-procedure BPS and VAS scores indicated no pain. There was an increase in the procedure BPS score, whereas the VAS score did not change. CONCLUSIONS: Endotracheal suctioning did not cause pain in conscious patients when the procedure was performed with the correct catheter in accordance with the guideline. In addition, it can be said that BPS is not sufficient to evaluate pain, but the reason for its high level is because endotracheal suctioning is an uncomfortable procedure. Of course, more studies and further studies are needed for a clear result.It is important for health care professionals to relieve or reduce the pain of patients during the endotracheal aspiration procedure. In addition, the presence and severity of pain associated with the endotracheal aspiration procedure should be accurately measured. This study is registered in ClinicalTrials.gov with the IDNCT04634474.The data that support the findings of this study are available from the corresponding author upon reasonable request.

Quality Of Life and Coping With Stress in Relatives of Patients in Intensive Care Units During COVID-19.

BACKGROUND: Factors such as the thought of losing the patient, the uncertainty of the course of the disease, and the inability to obtain sufficient information about the patient are frightening and alarming for relatives of patients in the intensive care unit. OBJECTIVES: To determine the quality of life and the style of coping with stress of the relatives of patients hospitalized in the intensive care unit during the COVID-19 pandemic. METHODS: This study was descriptive and cross-sectional. A personal information form, the Styles of Coping With Stress Scale, and the 36-Item Short Form Health Survey were used to collect data. RESULTS: The sample size of the study was 162 relatives of patients in the intensive care unit. There was a highly significant (P = .001) positive correlation between the Styles of Coping With Stress mean scores of the participants and their quality of life (as shown by the 36-Item Short Form Health Survey). CONCLUSIONS: In addition to the uncertainty and fear associated with the COVID-19 pandemic, it is very distressing to have a relative who is a patient in the intensive care unit. In this context, it is especially important to improve the level of coping with stress of the relatives of patients in the intensive care unit and to increase their quality of life.

Evaluation of Reasons for Not Giving Donor Consent by Families of Patients With Brain Death: A Retrospective, Mixed-Method Study.

OBJECTIVES: The number of patients with organ failure is increasing day by day; today, the numbers of organs and tissues for transplant remain inadequate. This study, which was carried out in a hospital of Sivas Cumhuriyet University in Turkey, aimed to determine reasons for not giving consent for organ donation after brain death and to clarify the familial causes listed among these reasons. MATERIALS AND METHODS: This study was a retrospective, mixed-method study. Records of patients diagnosed with brain death and patient relatives who stated that they did not donate organs and who agreed to participate were included in the study. RESULTS: Of 48 patients diagnosed with brain death, 39 (81.3%) did not donate organs. Reasons for not donating could be grouped under 5 themes: distrust (communication defects, frustration, anger, not meeting expectations), thoughts that the procedure would not provide benefits, fear (not accepting death, not understanding brain death, and experiencing loss), unwillingness to impair body integrity, and phobia of social reactions. CONCLUSIONS: We found that some patient relatives who were not against and even supported organ donation decided not to donate organs at the last minute. Reasons for not giving donation consent included distrust, anger, and frustration resulting from communication problems with health professionals, making the candidate donor feel valueless, previous bad experiences and prejudgments about the institution, and not providing the appropriate physical conditions related to the comfort of the patient relative during the process. It is important to keep in mind that the organ donation process begins with the patient's admission to the hospital; if managed correctly, the process can affect the decision of relatives in a positive way. Identifying and preventing potential obstacles that could affect decisions may increase donation rates. Health professionals with special training on this subject are needed for these situations.

Effects of oral care solutions on mucous membrane integrity and bacterial colonization.

AIM: This research was conducted with the aim of determining the influence of three different oral care solutions on oral mucous membrane integrity in critically ill patients. BACKGROUND: Oral care is a basic part of nursing care in intensive care units. DESIGN: A randomized controlled trial was conducted. METHOD: A total of 60 patients (20 patients in each group) comprised the study sample of the research. Patients were randomly allocated to three groups. Patients in groups 1, 2 and 3 were administered mouth care three times a day using 5% sodium bicarbonate, 0·2% chlorhexidine and saline solution, respectively. Data were collected by means of a 'Descriptive characteristics form' and an 'oral assessment tool'. RESULTS: Mean scores of oral assessment tool increased according to days in all groups, however, this increase was found to be statistically insignificant (p > 0·05). Mean scores of the patients in saline solution group were seen to be lower than those of the other groups. When inter-group comparison of days was done, the difference between oral assessment scores was found to be statistically significant (p = 0·000). CONCLUSION: It was found that there was no difference between patient groups receiving saline solution, sodium bicarbonate and 0·2% chlorhexidine for mouth care in terms of oral mucous membrane integrity; oral mucosa of all patients was found to be mildly dysfunctioning. RELEVANCE TO CLINICAL PRACTICE: It is thought that standardized protocols for oral hygiene developed in the light of the findings of randomized controlled trials may improve the oral health in critically ill patients.