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Womens Center for Mind-Body Health
Hospital Research (Intensive Care Unit) |
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The focus of this research database is on how stress affects women's health, and options for treatment using mind-body therapies. To obtain full summaries of the articles, see "How to Get Abstracts" below .
Intensive Care Unit
Injury and stress physiology
8826397 R,T Stress and immunity after traumatic injury: the mind-body link The effects of traumatic injury, stress and the perception of control on the immune system. 1996 AACN Clin Issues 7;3:351-8 Schrader, K. A.
12090434 JA Transient stress lymphocytosis: an immunophenotypic characterization of the most common cause of newly identified adult lymphocytosis in a tertiary hospital After an acute stressful event, some patients show a transient absolute increase in lymphocytes, predominantly certain T, B, and natural killer cells. After resolution of this increase, the subset pattern, however, remains altered. 2002 Am J Clin Pathol 117;5:819-25 Karandikar, N. J., Hotchkiss, E. C., Mckenna, R. W., and Kroft, S. H.
11750894 RCT The effect of stress doses of hydrocortisone during septic shock on posttraumatic stress disorder in survivors In patients in a study on use of large doses of hydrocortisone in septic shock, the medication had a significant protective effect on subsequent development of PTSD. 2001 Biol Psychiatry 50;12:978-85 Schelling, G., Briegel, J., Roozendaal, B., Stoll, C., Rothenhausler, H. B., and Kapfhammer, H. P.
10692080 JA Cortisol axis abnormalities early after stroke--relationships to cytokines and leptin In the immediate days after stroke, there can be significant disturbance of diurnal cortisol and leptin, mediated by cytokines. 2000 J Intern Med 247;2:179-87 Johansson, A., Ahren, B., Nasman, B., Carlstrom, K., and Olsson, T.
9846827 JA Immune consequences of stroke and cerebral palsy in adults Both stroke and cerebral palsy patients with unilateral brain damage manifested abnormally decreased lymphocyte responsiveness to stress lymphokine signals. 1998 J Neuroimmunol 91;1-2:113-20 Rogers, S. L., Coe, C. L., and Karaszewski, J. W.
Psychology
11246306 JA Self-reported symptom experience of critically ill cancer patients receiving intensive care Particularly stressful to ICU cancer patients were inability to communicate, sleep disruption, and limitations on visiting. 2001 Crit Care Med 29;2:277-82 Nelson, J. E., Meier, D. E., Oei, E. J., Nierman, D. M., Senzel, R. S., Manfredi, P. L., Davis, S. M., and Morrison, R. S
10660851 JA Stressors in ICU: perception of the patient, relatives and health care team Patients, relatives and health care team members all agreed that the major stressors of ICU patients were being in pain, being unable to sleep, and having tubes in the nose and/or mouth. 1999 Intensive Care Med 25;12:1421-6 Novaes, M. A., Knobel, E., Bork, A. M., Pavao, O. F., Nogueira-Martins, L. A., and Ferraz, M. B.
9231281 JA Patients' perceptions of the pre-operative information they need about events they may experience in the intensive care unit Pilot study of information elective ICU patients were glad they had been given beforehand, which included management of pain and nausea, likely site of pain, mouth care, and having a urinary catheter. They preferred this information to be given via a pre-operative nurse visit. 1997 J Adv Nurs 26;1:85-92 Watts, S. and Brooks, A.
10667504 JA Early psychological reactions to life-threatening injuries Two weeks after a traumatic accident, 4.1% of 121 Swiss patients showed PTSD and 19.9% subsyndromal PTSD with the exception of the time criterion. PTSD symptoms did not correlate with degree of injury, but rather pre-trauma life events, the patients' subjective appraisal of severity, their general attitude toward life, and their coping strategy. 2000 Crit Care Med 28;1:86-92 Schnyder, U., Morgeli, H., Nigg, C., Klaghofer, R., Renner, N., Trentz, O., and Buddeberg, C.
11167429 JA Psychological problems following ICU treatment British previous ICU patients subsequently contacted by mail reported 47% significant anxiety and depression and 38% PTSD symptoms, at least partially attributable to their ICU experience. 2001 Anaesthesia 56;1:9-14 Scragg, P., Jones, A., and Fauvel, N.
11271028 R Nurse-patient communication in the intensive care unit: a review of the literature Review of studies on ICU nurse communication suggests that despite a high level of knowledge and skill with respect to communication, ICU nurses tend to communicate poorly with patients. Possible explanations of high stress levels and a preoccupation with physical care and technology are discussed. 1999 Aust Crit Care 12;4:142-5 Llenore, E. and Ogle, K. R.
11342406 R,T Listening and focusing: holistic health care tools for nurses Description with case examples of the use of active listening and focusing, two techniques to reduce stress, create better coping strategies, make behavioral changes, and develop a collaborative approach with patients. 2001 Nurs Clin North Am 36;1:115-30 Klagsbrun, J.
11932474 JA Understanding the treatment preferences of seriously ill patients When seriously ill patients are asked about preferences regarding life-sustaining treatment, factors influencing their decision involve length of hospital stay, extent of testing, invasiveness of intervention, outcome, and likelihood of outcome. The possibility of death was less of a factor than the possibility of significant functional or cognitive impairment. 2002 N Engl J Med 346;14:1061-6 Fried, T. R., Bradley, E. H., Towle, V. R., and Allore, H.
11708352 JA Gender differences in older adults' preferences for life-sustaining medical treatments and end-of-life values Overall, men preferred life-sustaining treatments more than women, and women indicated a greater desire for a dignified death than men. 2001 Death Stud 25;2:127-49 Bookwala, J., Coppola, K. M., Fagerlin, A., Ditto, P. H., Danks, J. H., and Smucker, W. D.
12038508 JA Promoting a peaceful death in the ICU Care for the dying ICU patient needs to include physical, psychosocial and spiritual dimensions, as well as respect for the goals, preferences and choices of the patient and family. 2002 Crit Care Nurs Clin North Am 14;2:201-6 Kirchhoff, K. T.
ICU Syndrome
10196913 JA Patients' experience of being critically ill or severely injured and cared for in an intensive care unit in relation to the ICU syndrome. Part I ICU patients interviewed one week and 1-2 months after discharge described being in the ICU as a state of chaos...which resulted in feelings of extreme instability, vulnerability and fear, often experienced as prolonged inner tension. Even the most trivial events in circumstances or routines could trigger changes--either an increase or decrease--in patients' feelings. Nursing care provided an important degree of security and comfort. Combating this chaotic feeling appears to be a critical factor in inhibiting the development of ICU syndrome. 1998 Intensive Crit Care Nurs 14;6:294-307 Granberg, A., Bergbom Engberg, I., and Lundberg, D.
10264982 JA ICU syndrome: onset, manifestations, treatment, stressors, and prevention Description of an altered emotional state that occurs in a critical care setting, at times manifesting as delirium or psychosis. Some changes occur in 20-30% of people who spend more than 5-7 days in an ICU. Stressors include loss of day-night orientation, noise level, isolation, social isolation, medication effects, immobilization, sleep deprivation, depersonalization, and hearing staff communications. 1984 CCQ 6;4:21-8 Kleck, H. G.
11730446 JA Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU) Delirium is very common in an ICU setting and not currently monitored. This article suggests an assessment form that can be completed in 2 minutes for clinical and research purposes. In this study, 83.3% of ICU patients who were mechanically ventilated a mean of 2.4 days experienced delirium, and this was still present in 10.4% at discharge. 2001 JAMA 286;21:2703-10 Ely, E. W., Inouye, S. K., Bernard, G. R., Gordon, S., Francis, J., May, L., Truman, B., Speroff, T., Gautam, S., Margolin, R., Hart, R. P., and Dittus, R.
11797025 JA The impact of delirium in the intensive care unit on hospital length of stay In this study of 49 ICU patients, 24 of whom were ventilated, 81.3% developed delirium. Mean onset was 2.6 days, and mean duration 3.4 days. After accounting for all variables, duration of delirium was the single strongest predictor of length of stay both in the ICU and the hospital (p<.0001). 2001 Intensive Care Med 27;12:1892-900 Ely, E. W., Gautam, S., Margolin, R., Francis, J., May, L., Speroff, T., Truman, B., Dittus, R., Bernard, R., and Inouye, S. K.
11589328 JA Intensive care unit syndrome: a consideration of psychological interventions Patients with "ICU syndrome" may show symptoms of distress, agitation, bewilderment, poor orientation, delusions and hallucinations. "The capacity to tolerate stress during an admission ...is associated with personality factors, clinical/physical state, psychological/ emotional support, and treatment regime." Article reviews strategies to decrease these symptoms with environmental changes and help of family and staff, reviews the almost non-existent literature on psychological interventions, and describes two cases in which patients were helped to understand that their delusional imagery was not real. 2001 Br J Med Psychol 74;Pt 3:369-77 Bennun, I.
10761954 R,T Intensive care unit syndrome: a dangerous misnomer Author feels there is no such entity as "ICU syndrome", and that labeling a patient as such may cause hospital staff to not search for treatable medical causes of delirium. 2000 Arch Intern Med 160;7:906-9 McGuire, B. E., Basten, C. J., Ryan, C. J., and Gallagher, J.
9202938 JA The psychological and psychiatric consequences of the ICU stay Discusses management of regression, delirium and paranoia in ICU patients. Although ICU patients may function as adults intellectually, they may regress to a childlike emotional state in order to adapt to being taken care of. However, this also makes them more vulnerable to stress, more resentful of difficult treatments, and more angry at hospital personnel. 1997 Eur J Anaesthesiol Suppl 15;45-7 Blacher, R. S.
10264984 JA Sensory overload and noise in the ICU: sources of environmental stress Optimal well-being is related to the ability to integrate sensory input. In an ICU setting, there is a tremendous amount of sensory input, the flow which a patient cannot control or from which escape is not possible. Continuous lighting, crowding, smells, painful touch and noise are discussed in detail in this article, with recommendations for adjustments. 1984 CCQ 6;4:66-80 Baker, C. F.
10747570 JA The psychological and physiological effects of an intensive-care unit environment on healthy individuals 10 healthy volunteers who were admitted to the ICU for 4 days and 3 nights developed significant depression symptoms. The findings of increased feelings of depression attributable solely to being in an ICU setting are inconsistent with the type of environment generally considered necessary to alleviate patient anxiety and tension...The negative perception of this environment strongly suggests room for improvement. 1999 Clin Perform Qual Health Care 7;2:77-82 Tanimoto, S., Takayanagi, K., Yokota, H., and Yamamoto, Y.
12032042 JA Preoperative factors associated with postoperative change in confusion assessment method score in hip fracture patients Preoperative risk factors for elderly hip fracture patients who subsequently developed delirium postop were: 1) normal white blood cell count (possibly indicating inability to mount a stress response), 2) abnormal serum sodium , and 3) ASA physical status >II (2 & 3 reflecting a preop medical condition). 2002 Anesth Analg 94;6:1628-32, table of contents Zakriya, K. J., Christmas, C., Wenz, J. F. Sr, Franckowiak, S., Anderson, R., and Sieber, F. E.
11380743 RT A nurse-led interdisciplinary intervention program for delirium in elderly hip-fracture patients In a randomized trial, elderly hip fracture patients were evaluated for delirium postop. Early intervention and treatment by a delirium resource nurse or psychogeriatrician led to a significant decrease in length and severity of delirium, with a trend toward decreased hospital stay. 2001 J Am Geriatr Soc 49;5:523-32 Milisen, K., Foreman, M. D., Abraham, I. L., De Geest, S., Godderis, J., Vandermeulen, E., Fischler, B., Delooz, H. H., Spiessens, B., and Broos, P. L.
Families
10683641 R,T Family presence during invasive procedures and resuscitation Review of studies and description of a study and protocol at Parkland in Dallas that now allows family members to be present during invasive procedures and CPR. Family members felt this was a right, obligation and natural event, and follow-up did not show they suffered traumatic effects. Benefits for the family include knowing that everything possible was done, feeling they had supported the patient, reducing family anxiety and fear, and easing their bereavement. Family did not disrupt the procedures as some staff had feared. Nurses supported the program 96%, physicians 79%, but residents only 19%. 2000 Am J Nurs 100;2:32-42; quiz 43 Meyers, T. A., Eichhorn, D. J., Guzzetta, C. E., Clark, A. P., Klein, J. D., Taliaferro, E., and Calvin, A.
11355495 JA During invasive procedures and resuscitation: hearing the voice of the patient Patients whose family members had been present during invasive procedures and CPR were interviewed. They felt they were being comforted (She gave me her strength.), received help (If you're having a hard time communicating with someone, they can tell people.), maintained family connectedness (Any time we have problems, we go through them together.), and that it reminded providers of personhood (...there are family members there to remind them that I am not just a broken bone and I am not just a car wreck, that I am a person, that it is me.). 2001 Am J Nurs 101;5:48-55 Eichhorn, D. J., Meyers, T. A., Guzzetta, C. E., Clark, A. P., Klein, J. D., Taliaferro, E., and Calvin, A. O.
11430607 R,T The needs of children visiting on adult intensive care units: a review of the literature and recommendations for practice Reviews current available research on child visitation in the ICU, prompted by the case of a child who was not allowed to visit his mother who subsequently died. Imposing restrictive visiting policies does not respect the rights of patients and their families to be together and to support each other during a period of stress and crisis. 2001 J Adv Nurs 34;1:61-8 Clarke, C. and Harrison, D.
11930416 JA Coping strategies of rural families of critically ill patients Family members of critically ill patients from a rural area used coping strategies essentially the same as an urban population--talking the problem over with friends, praying, thinking about the good things in life, trying to handle things one step at a time, and trying to see the good side of the situation. 2000 J Am Acad Nurse Pract 12;4:123-7 Hunsucker, S., Flannery, J., and Frank, D.
11807920 JA Waiting: the experience of persons in a critical care waiting room Detailed descriptions of interviews with relatives waiting outside the ICU, to help personnel better understand and support family members' experience. 2002 Res Nurs Health 25;1:58-67 Bournes, D. A. and Mitchell, G. J.
11588478 E Family stress in the intensive care unit Untreated family stress may lead to lack of trust of healthcare providers, inability to comply with hospital regulations and decisions, anger and hostility, and litigation. Situations that contribute to stress are lack of ICU waiting areas, lack of multidisciplinary meetings between nurses and physicians to discuss care and treatment, and lack of a quiet room for consultation with family members. Author recommends caring for the patient as a dynamic part of a greater whole--the family. 2001 Crit Care Med 29;10:2025-6 Patricia Lange, M.
11249369 JA Family stresses, strengths, and outcomes after critical injury An important predictor of family adaptation to sudden critical injury is the number of total stresses occurring in the family, not just those related to hospitalization of a family member. 2000 Crit Care Nurs Clin North Am 12;2:237-44 Leske, J. S.
9644362 JA Perceived and unmet needs of critical care family members Family members of ICU patients may experience stress, disorganization and helplessness, which may lead to anxiety. Top ten needs of ICU patients' families were: 1) to be called at home regarding changes in the patient's condition, 2) to know the prognosis, 3) to have questions answered honestly, 4) to feel that the hospital personnel care about the patient, 5) to know specific facts concerning the patient's prognosis, 6) to know how the patient is being treated medically, 7) to know exactly what is being done for the patient, 8) to receive information about the patient once a day, 9) to see the patient frequently, 10) to be assured that the best possible care is being given to the patient. 1998 Crit Care Nurs Q 21;1:58-67 Mendonca, D. and Warren, N. A.
11657147 JA Extubating Mrs. K: psychological aspects of surrogate decision making Explores the legal and psychological aspects of surrogate medical decisions. 1999 J Law Med Ethics 27;1:81-6 Powell, T.
10174442 JA The benefits of music in hospital waiting rooms Music in family waiting rooms outside the ICU decreased visitors stress levels, and stress levels were inversely related to perception of hospital customer service. 1997 Health Care Superv 16;2:31-40 Routhieaux, R. L. and Tansik, D. A.
11868730 JA Caregivers of ICU patients discharged home: what burden do they face? With healthcare reform cost-cutting leading to earlier hospital discharges, families of ICU patients face an enormous economic, social, physical and psychological burden as they deal with the complexities of an ICU recovery. Article discusses discharge planning strategies and interventions aimed at minimizing this impact. 2001 Intensive Crit Care Nurs 17;4:219-27 Johnson, P., Chaboyer, W., Foster, M., and van der Vooren, R.
Imagery
1740089 JA Imagery: helping ICU patients control pain and anxiety Lists the many uses of relaxation and imagery in critical care nursing, gives case examples, discusses pitfalls, and explains how nurses can incorporate this into their care. 1992 Dimens Crit Care Nurs 11;1:57-62 Heath, A. H.
10373843 CT The willingness of family members of critically ill adults to learn the coping technique of imagery Pilot study on teaching family members imagery to help them cope with their ICU vigil; few were willing to try it as presented. 1999 J Holist Nurs 17;1:71-87 Schweer, D. K., Hart, L. K., Glick, O. J., and Mobily, P. C.
6366623 JA Imagery enhances venipuncture Repeated unsuccessful attempts at drawing blood or starting IVs can lead to anxiety, a burst of adrenaline, and peripheral vasoconstriction, shutting down blood vessels further. Instructions for relaxation imagery at the bedside to counteract this response. 1984 NITA 7;1:36 Courtemanche, J. B.
8063459 JA Apnea in postsurgical hypnotherapy of an esophageal cancer patient: a brief communication Case report of use of hypnosis in an esophageal cancer patient who could not swallow after surgery. Hypnotic treatment involved reenactment of the successful surgery, which however led to an apnic episode that the therapist had to then resolve. 1994 Int J Clin Exp Hypn 42;3:179-83 Jones, M. M. 10595045 CT
Massage
11040555 MA Effects of massage in acute and critical care Review of 22 studies showing benefit of massage in reducing anxiety as well as physiologic relaxation measurements. 2000 AACN Clin Issues 11;1:77-96 Richards, K. C., Gibson, R., and Overton-McCoy, A. L.
10595045 CT Immediate effects of a five-minute foot massage on patients in critical care 5 minute foot massage in ICU patients showed a significant decrease in heart rate, blood pressure and respirations during the intervention. 1999 Intensive Crit Care Nurs 15;2:77-82 Hayes, J. and Cox, C.
9656043 RCT Effect of a back massage and relaxation intervention on sleep in critically ill patients Review of many studies looking at non-pharmacologic interventions for sleep in the ICU; this study demonstrated that back massage increased quality and quantity of sleep in ICU patients. 1998 Am J Crit Care 7;4:288-99 Richards, K. C.
Music
11697072 JA Use of music therapy and other ITNIs in acute care 85.2% of a sample of Midwestern RNs knew of music therapy, and 69.6% reported using it. Primary uses were to reduce anxiety and enhance sleep. ICUs were one of the highest areas of use. Largest barrier to use was lack of nursing time. 2001 J Psychosoc Nurs Ment Health Serv 39;10:26-37 Gagner-Tjellesen, D., Yurkovich, E. E., and Gragert, M.
11249367 R,T State of the science of music interventions. Critical care and perioperative practice Review of the use of music in a surgical and critical care setting. 2000 Crit Care Nurs Clin North Am 12;2:219-25 White, J. M.
8631212 R,T Music therapy: a nursing intervention for the control of pain and anxiety in the ICU: a review of the research literature Thorough review of use of music in critical care patients shows benefits of decreased pain and anxiety. Article contains recommendations on planning and implementing a music program in an ICU setting. 1995 Dimens Crit Care Nurs 14;6:295-304 Henry, L. L.
2311487 CT Music therapy results for ICU patients Listening to music in the ICU significantly decreased mean arterial pressure and reduced anxiety, depression and pain. Sample ICU music budget included. 1990 Dimens Crit Care Nurs 9;1:39-45 Updike, P.
10076111 RCT Intradermal normal saline solution, self-selected music, and insertion difficulty effects on intravenous insertion pain Listening to preferred music decreased IV insertion pain. 1999 Heart Lung 28;2:114-22 Jacobson, A. F.
Head Trauma
11014529 MA Do women fare worse: a meta-analysis of gender differences in traumatic brain injury outcome Gender differences in traumatic brain injury. 2000 J Neurosurg 93;4:539-45 Farace, E. and Alves, W. M.
11570931 CT The effects of live, taped, and no music on people experiencing posttraumatic amnesia Patients with posttraumatic amnesia were significantly less agitated (p<.0001) and more oriented (p<.001) when listening to music of their choice. There was no difference between live and taped music. In follow-up, 77% recalled the music they had heard while in the amnetic state. 2001 J Music Ther 38;3:170-92 Baker, F.
3591717 JA Hypnotic imagery and suggestion as an adjunctive treatment in a case of coma Case report of use of hypnotic imagery with coma patient; specific suggestions listed for each phase of improvement to recovery. 1987 Am J Clin Hypn 29;4:255-9 Johnson, G. M.
Orthopedic trauma
2675983 CT Behavioral strategies for the reduction of pain and anxiety associated with orthopedic trauma Patients with severe orthopedic trauma who were treated with biofeedback or a relaxation tape showed equally significant decreases in systolic blood pressure, temperature, discomfort and anxiety. 1989 Biofeedback Self Regul 14;2:101-14 Achterberg, J., Kenner, C., and Casey, D.
10069091 RCT Using hypnosis to accelerate the healing of bone fractures: a randomized controlled pilot study Small pilot study from Mass General in Boston showed trends in faster healing and decreased pain with use of hypnosis for fracture healing. 1999 Altern Ther Health Med 5;2:67-75 Ginandes, C. S. and Rosenthal, D. I.
10418348 R,T Orthopedic massage: a model for alternative treatment of cumulative trauma disorders Review of a variety of massage treatment methods useful and appropriate in orthopedic trauma. 1999 AAOHN J 47;4:175-84; quiz 185-6 Lowe, W.
Respiratory/ventilator issues
9929792 R,T Pain management and pulmonary dysfunction Discussion of all the ways pain can interfere with pulmonary function, depending on pain etiology. 1999 Crit Care Clin 15;1:151-66, vii Desai, P. M.
8680700 R Panic anxiety, dyspnea, and respiratory disease. Theoretical and clinical considerations Discusses the pathophysiologic relationship between dyspnea, hyperventilation and panic anxiety, and suggests that behavioral approaches to panic can improve functional status and quality of life in patients with pulmonary problems. Pulmonary disease constitutes a risk factor for the development of panic, which carries significant morbidity in this population. 1996 Am J Respir Crit Care Med 154;1:6-17 Smoller, J. W., Pollack, M. H., Otto, M. W., Rosenbaum, J. F., and Kradin, R. L.
1408866 RCT Relaxation to reduce dyspnea and anxiety in COPD patients A relaxation tape helped patients with chronic lung disease decrease dyspnea, anxiety and airway obstruction. 1992 Nurs Res 41;4:242-6 Gift, A. G., Moore, T., and Soeken, K.
10334141 RCT Reduction in ventilator response to CO2 with relaxation feedback during CO2 rebreathing in normal adults Cites several studies showing the benefits of relaxation biofeedback in ventilator weaning; study measurements suggest that the mechanism of this improvement is via the reduction of neural respiratory drive. 1999 Chest 115;5:1285-92 Holliday, J. E. and Veremakis, C.
10719976 JA Successful use of hypnosis as an adjunctive therapy for weaning from mechanical ventilation Case report of successful use of hypnosis in a very difficult case of ventilator weaning. 2000 Anesthesiology 92;3:890-2 Treggiari-Venzi, M. M., Suter, P. M., de Tonnac, N., and Romand, J. A.
11604980 RCT Effects of music therapy on anxiety in ventilator-dependent patients Ventilator-dependent patients were significantly less anxious after listening to music of their choice vs. a quiet rest period. 2001 Heart Lung 30;5:376-87 Wong, H. L., Lopez-Nahas, V., and Molassiotis, A.
11040559 R,T Music therapy as a nursing intervention for patients supported by mechanical ventilation Reviews use of and suggestions for future research on music therapy for patients receiving ventilator assistance. 2000 AACN Clin Issues 11;1:128-38 Chlan, L. L.
9622403 RCT Effectiveness of a music therapy intervention on relaxation and anxiety for patients receiving ventilatory assistance Nonsedated patients on ventilators were significantly less anxious while listening to music. 1998 Heart Lung 27;3:169-76 Chlan, L.
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