RESUMEN
BACKGROUND: The physiological state of critically ill patients is severely impaired by illness or trauma and is uncomfortable. Such experiences cause long-term anxiety and post-traumatic stress disorder. OBJECTIVE: This study aimed to understand discomfort and comfort based on the experiences of critically ill adult patients in the intensive care unit and to explore ways to improve their comfort. METHODS: This qualitative descriptive study was conducted with 15 critically ill patients (age range: 46-81 years; six females) in the intensive care unit using semistructured interviews and participant observation. The data collected were analysed using Braun and Clarke's thematic analysis. Data were collected from the intensive care unit and general ward of a university hospital in Japan. FINDINGS: Six themes related to discomfort and comfort were identified. The three themes related to discomfort were "overlapping uncertainties", "being unable to control physical discomfort", and "having to endure psychologically and situationally". The three themes related to comfort were "feeling connected brings calm", "routine care relieves pain and thirst", and "ease when one can decide for oneself". Participants' discomfort involved physical and psychological factors and was related to treatments, procedures, care, and the environment. Moreover, more than half of the patients endured unmet needs. Comfort was brought about by providing routine care for physical discomforts that critically ill patients often experience, feeling alive and connected to others and encouraging independence. CONCLUSION: Recognising the potential for physical and psychological discomfort, as well as communication and other difficulties, in critically ill patients is crucial. Patients may also experience discomfort when healthcare providers take the lead, which underscores the importance of involving patients in their care. By showing respect for patients' intentions and involving them in decision-making, healthcare providers can improve patient comfort and promote a more collaborative approach to care.
RESUMEN
BACKGROUND: Early intervention in prehospital settings is important for treating patients with acute coronary syndrome (ACS). Emergency medical technicians (EMTs) are the essential first responders who treat these patients, and their current attitudes towards electrocardiograms (ECGs) have not been identified. This study investigated the awareness of EMTs of ECGs to shorten hospital arrival time, improving patient prognosis.MethodsâandâResults: An anonymous questionnaire survey, with 27 statements about ECG and ACS response, was administered to 395 EMTs. The statements were related to interest, motivation, learning status, confidence, and norms pertaining to ECGs, a sense of perceived behavioral control, and training courses. The primary outcome was the perception of EMTs that their interpretation of an ECG affected patient prognosis (Statement [S] 1). Participants assigned scores for each statement using a scale ranging from 1 (strongly disagree) to 10 (strongly agree). The mean score for S1 was 7.09. Mean scores for statements regarding confidence and learning status were 3.96 and 3.53, respectively. The participants had a positive impression of training courses (score >5.5). CONCLUSIONS: The EMTs experience was that their interpretation of an ECG could affect the prognosis of patients with ACS. Conversely, they lacked confidence reading ECGs, but were willing to attend ECG training courses. Therefore, efficient training programs need to be established to achieve a better prognosis for ACS patients.