Purpose
Patients in the Intensive Care Unit (ICU) experience a variety of symptoms. This descriptive correlational study aimed to determine the prevalence of symptoms and the physiological and situational factors associated with these symptoms in ICU patients.
Methods
We analyzed the Electronic Medical Records (EMRs) of 1,214 cases admitted to and discharged from the ICUs of a university hospital in Seoul over a 1-year period from June to September 2022. This analysis utilized standardized instruments embedded in EMRs and a natural language analysis framework developed by the researchers. Descriptive statistics, the x 2 test, the Fisher exact test, and multivariate logistic regression were employed to identify common symptoms and their related factors.
Results
In total, 85.7% of the cases had at least one symptom during their ICU stay, and 36.6% experienced 2 symptoms. Pain was the most frequently experienced symptom, affecting 69.5% of cases, followed by agitation (29.7%), dyspnea (29.7%), and delirium (4.8%). Multivariate logistic regression analysis indicated that the length of ICU stay influenced pain (odds ratio [OR]=1.04; 95% confidence interval [CI], 1.02~1.06; p<.001), delirium (OR=1.08; 95% CI, 1.06~1.11; p<.001), agitation (OR=1.07; 95% CI, 1.05~1.10; p<.001), and dyspnea (OR=1.19; 95% CI, 1.13~1.26; p<.001).
Conclusion
Pain, agitation, and dyspnea are common in ICU patients and are associated with the length of their ICU stay. Our study identifies factors related to these symptoms that could be targeted to manage and reduce their occurrence, providing a foundation for future research on various symptom assessment tools and natural language transcripts.

Purpose
This study investigated the knowledge, performance, and barrier awareness of Intensive Care Unit (ICU) medical staff concerning the prevention and management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption (PADIS) in critically ill adult patients, and aimed to identify the factors influencing the performance of evidence-based PADIS management.
Methods
This cross-sectional and correlational study included 189 medical staff (17 physicians, 172 nurses) working in ICUs in two hospitals and recruited between July 13 and 31, 2022. Multiple linear regression analysis was performed to identify the factors associated with the PADIS-related performance of medical staff.
Results
The evidence-based performance level for PADIS prevention and management had a mean score of 3.55±0.37 out of 5 points, and the mean knowledge score was 28.23±3.00 out of 33 points. The mean awareness score for barriers to implementing PADIS prevention and management guidelines was 2.91±0.39 out of 5 points. Multiple regression analysis indicated that knowledge of delirium (β=.19, p=.014) and awareness of barriers within the individual domains of medical staff (β=-.20, p=.034) significantly influenced PADIS-related performance.
Conclusion
To implement evidence-based practices for the prevention and management of PADIS, steps should be taken to improve the knowledge and awareness of medical staff regarding PADIS. This could be improved through organizational support, such as systematic education and staffing. Specifically, an education program centered on delirium could significantly improve PADIS-related knowledge and performance.

Citations

• Review of advanced emergency evacuation procedures in hospital buildings: comprehensive analysis and insights
  Hao Wu, Ruimin Nie, Xu Zeng, Chuanjie Cheng, Jing Pan, Daguang Han, Haidar Hosamo
  Frontiers in Built Environment.2024;[Epub]     CrossRef

PURPOSE
The purpose of this study was to provide basic data about agitation in patients with dementia by surveying the literature.
METHODS
Key words used for search through hand-search and electronic database (CINHAL, Pubmed, Google scholar, Riss, Kiss, DBpia) included 'dementia', 'Alzheimer disease', 'agitation', 'aggression or aggressive behavior', 'problem or disruptive behavior', and 'abnormal behavior.' Seventeen studies met the inclusion criteria for the Meta-analysis and 'R' version 3.2.2 was used to analyze the correlated effect size.
RESULTS
Study results showed that variables related to agitation were identified as the demographic (age, gender), dementia-related (cognition, medication uses), physical (Activity of Daily Living [ADL], pain), psychological (depression, psychotic symptom, caregiver burden) and environmental (psychosocial environment) factors. The effect size between the correlated variables and agitation were low to moderate (caregiver burden .36; ADL -.24; psychotic symptom and depression .21; pain .19; cognition -.15; medication uses .12; and psychosocial environment -.12).
CONCLUSION
Based on the findings of this study, strategies to improve patients' depressive and psychotic symptoms and ADL and to reduce caregivers' burden are needed for prevention and management of agitation in patients with dementia.