ARTICLE INFO

Article Type

Original Research

Authors

Mahmoudi   M. (*)
Asgari   P. (1)
Hekmatpou   D. (1)
Khajehgoodary   M. (1)
Rafiei   F. (2)






(*) Medical Surgical Nursing Department, Nursing & Midwifery Faculty, Arak University of Medical Sciences, Arak, Iran
(1) Medical Surgical Nursing Department, Nursing & Midwifery Faculty, Arak University of Medical Sciences, Arak, Iran
(2) Statistics Department, Nursing & Midwifery Faculty, Arak University of Medical Sciences, Arak, Iran

Correspondence

Address: Complex of Pyambar Azam, Faculty of Nursing & Midwifery, Arak University of Medical Sciences, Sardasht Square, Arak, Iran
Phone: +988634173524
Fax: +988634173524
mokhtar.mahmoudi@arakmu.ac.ir

Article History

Received:  September  15, 2015
Accepted:  November 30, 2015
ePublished:  December 15, 2015

BRIEF TEXT


… [1-11] Auditory, visual, and tactile stimulations in patients hospitalized in ICU reduce anxiety, hospitalized length, and long-term prognosis of the disease. In addition, since stimulations due to the patient’s family are familiar to the patient, they might be proper sources for sensory stimulations [12, 13].

There are few studies about the effects of an increase in the visitation time on the patients in Iran, and their results are contradictory [14]. … [15-17]

The aim of this study was to investigate the effects of an increase in the visitation time on pain and consciousness level in patients hospitalized in ICU.

This is a clinical trial study.

Patients hospitalized in the intensive care units (surgery and neurology intensive care units) of Arak Valieasr Hospital (Iran) were studied in 2014 (10 months).

60 patients were selected, using Available Sampling Method [18].

The patients were divided into two groups including intervention (n=30) and control (n=30), via sample size determination formula and based on Random Allocation through Draw Method. Data was collected, using a demographic characteristic questionnaire. Wong-Baker Facial Scale, scored between zero and 10, was used to match its faces with the face signs of the patient. Patient’s consciousness level was recorded, using 15-score Glasgow Comma Scale in 3 items including “eye opening” (4 scores), “verbal response” (5 scores), and “best motor response” (6 scores). The study method was two-blinded. Sampling was done at morning and evening shifts. Surgery ICU was assumed as control group and the visitors could only be there 10min at 3 p.m. according to the unit routine. Neurology ICU was assumed as intervention group and the visitors could be there 10min at 9 a.m., 12 p.m., and 3 p.m. The effects of the presence of the visitors on pain indices and consciousness levels of the patients were recorded 10min before the visit time, during the visit time, and 10min and 30min after the visit time in intervention and control groups, using the questionnaire. Data was analyzed, using SPSS 20 software and Chi-square test. In addition, Paired T and Independent T tests were used to compare the differences between “before” and “after” mean physiologic indices in each group. And Repeated Measures Analysis of Variance was used to investigate the change process of the physiologic indices in the groups.

Most of the subjects in intervention and control groups aged between 50-59 and 40-49years, respectively. Most of the subjects of both groups were male and married, living with their own families (their spouses and children). The most diagnosed disease was trauma. The most common underlying disease was diabetes. Both groups were homogeneous in demographic characteristics and there was no significant difference (Table 1). In intervention group, there was a significant reduction in the pain index at 9 a.m. compared to before the visit. The reduction process was maintained 10min and 30min latter via a significant change process. However, there was no considerable change in the consciousness level during the visit time in the groups after the intervention. In addition, its change process was not significant in intervention group (before, during, 10min latter, and 30min latter). There was a significant reduction in the pain index during the visit time at 12 p.m. in intervention and control groups than before the visit time. And the decrease process was maintained 10min and 30min latter being significant. Nevertheless, there was no considerable increase in the consciousness level during the visit time and its change process was not significant at the times (before, during, 10min latter, and 30min latter). There was no significant difference at any visit time at 3 p.m. in control group, which showed that un-planned and limited visit had no considerable effect on the enhancement of conscience level and reduction of pain in the patients. However, there was a significant reduction in the pain index of intervention group during the visit time than before the time. Nevertheless, there was no significant difference in the consciousness level in the intervals (before, during, 10min after, and 30min after), as control group did (Table 2). There were significant differences between the measured pain indices in intervention group at different times (9 a.m., 12 p.m., and 3 p.m.). However, there were no significant differences between the measured consciousness levels at different times (9 a.m., 12 p.m., and 3 p.m.). There were no significant differences between pain indices and consciousness levels in control group at different visit times (10min before, during, and 30min after).

Before the intervention, there was no significant difference between pain indices and consciousness level in intervention and control groups. There is no significant difference in physiologic indices before the visit [18]. In intervention group, there was a significant reduction in pain index during the visit at first (9 a.m.), second (12 p.m.), and third (3 p.m.) stages. Nevertheless, the increase in the visit time did not affect the patients’ consciousness level. Familiar and early sensory stimulations result in an increase in the consciousness level of the patients with brain injury [19]. In addition, a revision on the visit rules of ICU can lead to a better situation for good senses due to the presence of the family members. The result is inconsistent with the present results. Stimulations due to the presence of family members are more useful than the nurses’ presence [20]. Sensory stimulations lead to an increase in the consciousness level [21]. 3-4 times a day planned visits in ICU can lead to a higher satisfaction level in the family members of the patient and reductions in pain, anxiety, and stress in the patients [9]. The results are consistent with the present results. Open and planned visits can reduce the patient’s pain. In addition, the presence of the family members significantly leads to a reduction in the patient’s anxiety [22]. Visiting the family members does not result in any change in serum cortisol and physiologic indices in patients hospitalized in ICU [23]. More visit time leads to significant increases in comfort and physiologic indices, as well as a reduction in the anxiety [24]. The results are consistent with the present results. Planned visits lead to reductions in the physiologic indices and pain, as well as an improvement in the treatment consequences [25]. Planning the visits for the presence of the family members and friends leads to no important change in the clinical cardio-vascular indices [26]. There are increases in the physiologic indices in the patients during the visits [18].

To reach more accurate results, the study should be repeated with a greater sample size and a longer duration in other intensive care units.

Small sample size was one of the limitations.

More visit time leads to a reduction in the mean pain index in the patients hospitalized in ICU.

Research Deputy and all the participating nurses are appreciated.

There is no conflict.

The study was confirmed by Ethics Committee of Medical Studies of Arak University of Medical Sciences.

The study was funded by Research and Technology Deputy of Arak University of Medical Sciences.

TABLES and CHARTS

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