Abstract
BackgroundCommunication and information in order to reduce anxiety in the intensive care unit (ICU) has been described as area needing improvement. Therefore, the aim of this trial was to evaluate whether a structured information program that intensifies information given in standard care process reduces anxiety in ICU patients.MethodsMulticenter, two-armed, non-blinded, parallel-group randomized controlled trial in hospitals in the cities of Marburg, Halle, and Stuttgart (Germany). The trial was performed in cardiac surgery, general surgery, and internal medicine ICUs. Two-hundred and eleven elective and non-elective ICU patients were enrolled in the study (intervention group, n = 104; control group, n = 107). The experimental intervention comprised a single episode of structured oral information that was given in addition to standard care and covered two main parts: (1) A more standardized part about predefined ICU specific aspects – mainly procedural, sensory and coping information, and (2) an individualized part about fears and questions of the patient. The control group received a non-specific episodic conversation of similar length additional to standard care. Both conversations took place at the beginning of the ICU stay and lasted 10–15 minutes. Study nurses administered both interventions. The primary outcome ICU-related anxiety (CINT-Score, 0–100 pts., higher scores indicate higher anxiety) was assessed after admission to a regular ward.ResultsThe primary outcome could be measured in 82 intervention group participants and 90 control group participants resulting in mean values of 20.4 (SD 14.4) compared to 20.8 (SD 14.7) and a mean difference of −0.2 (CI 95% -4.5 to 4.1).ConclusionsA structured information intervention additional to standard care during ICU stay had no demonstrated additional benefit compared to an unspecific communication of similar duration. Reduction of anxiety in ICU patients will probably require more continuous approaches to information giving and communication.Trial registrationClinicalTrials.gov NCT00764933.
Highlights
Communication and information in order to reduce anxiety in the intensive care unit (ICU) has been described as area needing improvement
A total of 1838 ICU patients were assessed for eligibility
We conclude that a single episode information intervention in the ICU has no benefit to cognitively unimpaired patients with a low intervention profile compared to a nonspecific personal conversation
Summary
Communication and information in order to reduce anxiety in the intensive care unit (ICU) has been described as area needing improvement. Psychological and physical stress in ICUs often is associated with higher levels of anxiety and feelings of uncertainty and helplessness [6,7]. International guidelines emphasize the importance of effective communication for patient-centered care, especially with critically ill patients, but still there is little evidence on effective interventions [19,20]. This coincides with a recent Delphi study that rated priorities of ICU-related research in the domain of patient wellbeing [21]: Strategies to reduce stress and anxiety, and strategies to improve communication to meet patients’ informational needs were identified as highly important [21]
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