Comparison impact of sensory excitation performed by family members and nurses on the level of consciousness in patients who are admitted to Intensive Care Unit

Document Type: Original Quantitative and Qualitative Research Paper

Authors

1 Postgraduate student, Master of critical nursing Sciences, Department of Nursing, School of Nursing and Midwifery, Lorestan University of medical sciences, Lorestan, Iran

2 Assistant Professor in Nursing Management, Department of Nursing, School of Nursing and Midwifery, Lorestan University of medical sciences, Lorestan, Iran

3 Assistant Professor in Nursing Management, Department of Nursing, University of Welfare and Rehabilitation Sciences, Tehran, Iran

4 MS in Biostatistics, Department of Hygiene, Lorestan University of medical sciences, Lorestan, Iran

Abstract

Background: Appropriate sensory excitation can improve brain synaptic contact and establish consciousness.
Aim: The aim of this study was to investigate the sensory excitation delivered by family members and nurses on the level of consciousness in patients who are admitted to ICU.
Method: In this clinical trial, 69 patients admitted to ICU in Ashair and Shafa Hospital, Khorammabad, were randomly assigned into two interventions and one control group. The first intervention group received sensory excitation by family members, and the second intervention group by the nurses. Control group were not received any intervention. Intervention was applied two hours a day at 4-5 pm and 8-9 pm to the intervention groups for six days. For all subjects in these three groups, the level of consciousness was measured twice at 5 minutes before and 30 minutes after intervention by the research assistant using Glasgow Coma Scale (GCS). The data were analyzed by SPSS software version 18 using repeated measures and ANOVA tests.
Results: A significant discrepancy was observed between experimental groups in average increasing in GCS before and after intervention based on covariance analysis test results (P<0.001). In addition, the first intervention groups showed the higher increase in GCS score (0.388±0.032 units) and the second intervention the moderate increase (0.268±0.032 units). The lowest increase was found in control group (0.44±0.032 units).
Conclusion: Sensory excitation performed by family members is more effective to improve the level of consciousness of coma patients than the nurses, thus it is suggested to provide conditions in which the nearest family members can do the sensitive excitation program for patients hospitalized in ICU ward subject to receiving adequate training.

Keywords


  1. Worrell J. Nursing Implication in the care of the patient experiencing sensory deprevention Adv. Concept in Nursing.Lippincott co. 1977; 130-42.
  2. Mccuire A. Issues in the prevention of neurotrauma. Nur.Clin.North. America 1986; 21 (4): 549-50.
  3. Helwick L. Stimulation programs for coma patients. Crit Care Nur.Aug, 1994; 74-52.
  4. Chamberlain A. et al. Traumatic Brain inyurg Rehabilitation, services, Treatment and outcomes (1st Ed).1995.
  5. Salehi J. Human Injuries due to traffic accidents and review Casualties in the Mashhad city. Nabz Journal .1991; 1(5):1-7. (Persian)
  6. Kater M. Response of head-injured patients to sensory stimulation. West J. Nur. Res 1989; 11 (1): 20-32.
  7. Marino P. The ICU book. 3rd ed. Philadelphia: Lippincott; 2007.
  8. Joseph TG, Chrlotte TT. Rehabilitation management of patient with disorder of consciousness. Head Trauma Rehab 2004; 19(3): 254-65.
  9. Samuelson K.A.M., Lundberg D, Fridlund B. Stressful experiences in relation to depth of sedation in mechanically ventilated patients. Crit Care Nure 2007; 12(2): 93-104.
  10. Basampor SH, Zakerymogaddam M, Fagihzadeh S, Godarzi F. Impact of Organizedauditorystimulation on the comatose patient'slevel of consciousness. Tehran Journal of Nursing and Midwifery Faculty.2007; 4: 15-22. (Persian)
  11. SHadfar Z, Hoshmand P. Impact of sensory excitation on the head trouma comatose patient'slevel of consciousness. Journal of Sabzevar University of medical Science 2002; 3: 1-8. (Persian)
  12. Derstine JB, Hargrove SD. Comprehensive rehabilitation nursing. Philadelphia: W. B. Saunders; 2001. P. 391.
  13. Abbasi M, Mohammadi E, Sheaykh Rezayi A. Effect of a regular family visiting program as an affective, auditory, and tactile stimulation on the consciousness level of comatose patients with a head injury. Jpn J Nurs Sci. 2009; 6(1):6-21.
  14. McCormick AJ, Curtis JR, Stowell-Weiss P, Toms C, Engelberg R. Improving social work in intensive care unit palliative care: results of a quality improvement intervention. J Palliat Med. 2010; 13 (3): 297 - 304.
  15. Darlenel L, Mary EK. Traumatic brain injury. Criticale care nursing 2001; l23 (4): 18-24.
  16. Lannoo E, Colardyn F, Jannes C, De Soete G. Course of neuropsychological recovery from moderate-to-severe head injury: a 2-year follow-up. Brain Inj 2001 Jan; 15(1):1-13.
  17. Deja M, Denke C, Weber-Carstens S, Schröder J, E Pille C, Hokema F.Social support during intensive care unit stay might improve mental impairment and consequently health-related quality of life in survivors of severe acute respiratory distress syndrome. Universitätsmedizin Berlin 2006; 10 (5):1-12.
  18. Suzanne M, Marianne CH Atashzadeh F, Pishgoie A, Heidary M. AACN Essentials of Critical Care Nursing. Tehran. Jamenegar-Salemi publisher. 2011. .P. 289. (Persian)
  19. Mary B H, Robert M, Susan M, Leslie A, Hoffman F, Valerie A, Judith A. Family presence and surveillance during weaning from prolonged mechanical ventilation. Heart & lung & LUNG 2007; 36 (1):47–57.
  20. Boyek, K. et al. touching story. Elderly Care. 1994, 6 (3): 21-22.
  21. Abbas-Zadeh A, Abazry F, Amin MR. Psychosocial needs of hospitalized patient’s family in intensive care unit. Mashhad Journal of Nursing and Midwifery Faculty 2000; 2: 7-13. (Persian)
  22. Taga M, Mehdizadeh A, Tahmasebi S. Cause’s ofcomaandthe prognosis ofthemonth, Sina hospital. Tehran Journal of Medicine Faculty2002; 60 (5): 7-13. (Persian)
  23. Solimani M. Impact of Quran recitationon the head trouma comatose patient's level of consciousness.the thesisi for the degree of M.S.C in medical surgical nursing, Tehran. Tarbiat Modares University, 1998.
  24. Suzanne A, Bernda B. Medical Surgical Nursing. Tehran. Boshra publisher. 2005. P. 138. (Persian)
  25. Sazbon, L. Groswaser, Z. Outcome is 134 patients with prologed post traumatic unawareness. J. NeuroSurgery.1990; 72:75-80.
  26. Davis AE, Gimenez A.Cognitive-behavioral recovery in comatose patients following auditory sensory stimulation. J Neurosci Nurs. 2003 Aug; 35(4): 202- 14.
  27. Karma D, Rawat AK. Effect of stimulation in coma. Indian Pediatr. 2006 Oct; 43(10): 856-60.