Pub Date : 2025-11-06DOI: 10.1016/j.aucc.2025.101458
Hongmei Liang RD, MSN, Long Liu MD
{"title":"Reply regarding: “Optimizing non-pharmacological strategies for UEVT prevention: Standard care and IPC in TBI patients with PICCs—Letter on Liang et al.”","authors":"Hongmei Liang RD, MSN, Long Liu MD","doi":"10.1016/j.aucc.2025.101458","DOIUrl":"10.1016/j.aucc.2025.101458","url":null,"abstract":"","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"39 1","pages":"Article 101458"},"PeriodicalIF":2.7,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145448920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Feasibility and pilot studies are an essential step in the development of clinical trials evaluating the effect of an intervention on patient-centred outcomes. Yet, challenges exist related to obtaining funding and conducting feasibility and pilot studies. This commentary provides an overview of five important areas of focus for early-career researchers (and is more broadly applicable), which emerged from a programmed session on feasibility and pilot studies at the 25th Annual Meeting on Clinical Trials in Intensive Care by the Australia and New Zealand Intensive Care Society Clinical Trials Group. The five areas included are as follows: (i) Building a program of research; (ii) Obtaining funding; (iii) Methodological excellence; (iv) Building a successful and diverse research team; and (v) Engaging with the clinical coalface.
{"title":"Feasibility and pilot studies in critical care—Our top five lessons learnt as early- and mid-career researchers in Australia and New Zealand","authors":"Kimberley J. Haines PhD, BHSc Physiotherapy , Antony Attokaran MBBS, FRACP, FCICM , Lee-anne Chapple BMedSci, MNutrDiet, PhD, APD , Julieann Coombes PhD , Bianca Crichton (Tainui, Ngāti Awa) BHealSc , Alisa M. Higgins PhD, MPH, BPhysio(Hons) , Carol Hodgson BAppSc(PT) FAAHMS FACP , Belinda Howe RN, BAppSc(Nursing), CCCert, MPH , Diane Mackle PhD, MN, BHSc (Nursing) , Alexis Poole BNSc(Hons), GDip.NSc Intensive Care, GCert.NSc Retrieval, PhD , Emma J. Ridley BNutriDietet, PhD , Manoj Saxena PhD, MB BChir, BSc(Immunology), FCICM , Neil Glassford BSc MBChB GCertClinUS PhD MRCP FCICM","doi":"10.1016/j.aucc.2025.101464","DOIUrl":"10.1016/j.aucc.2025.101464","url":null,"abstract":"<div><div>Feasibility and pilot studies are an essential step in the development of clinical trials evaluating the effect of an intervention on patient-centred outcomes. Yet, challenges exist related to obtaining funding and conducting feasibility and pilot studies. This commentary provides an overview of five important areas of focus for early-career researchers (and is more broadly applicable), which emerged from a programmed session on feasibility and pilot studies at the 25th Annual Meeting on Clinical Trials in Intensive Care by the Australia and New Zealand Intensive Care Society Clinical Trials Group. The five areas included are as follows: (i) Building a program of research; (ii) Obtaining funding; (iii) Methodological excellence; (iv) Building a successful and diverse research team; and (v) Engaging with the clinical coalface.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"39 1","pages":"Article 101464"},"PeriodicalIF":2.7,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145448919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.aucc.2025.101455
Melissa J. Bloomer RN, PhD, FACCCN , Ashleigh E. Butler RN, PhD, MACCCN , Laura A. Brooks RN, PhD, MACCCN , Alysia Coventry RN, MPhil MACCCN , Stephen McKeever RGN, PhD, MACCCN , Kristen Ranse RN, PhD, MACCCN , Jessie Rowe BN (Hons), Grad Dip Nurs Pract Paed Crit Care, MACCCN , Shontelle Thomas Grad Cert Nurse Pract Paed Intens Care, BN, MACCCN , Rebecca Thornton RN, PhD, MACCCN
Background
The provision of end-of-life care for children in intensive care is a stressful and traumatic event for parents with immediate and life-long impacts. End-of-life care for children is also challenging for critical care nurses who must balance the child’s clinical requirements concurrently with facilitating and supporting the needs of parents and family members.
Research question
What is the research evidence about nurses’ and parents’ experiences of the provision of end-of-life care in intensive care for children?
Review methods
Following registration with the International Prospective Register of Systematic Reviews, a systematic review was undertaken. A combination of keywords, synonyms, and Medical Subject Headings were used across Cumulative Index for Nursing and Allied Health (CINAHL) Complete, Medline, and APA PsycInfo databases. Papers were independently assessed against inclusion and exclusion criteria. Included papers were assessed for quality. Narrative synthesis was used to analyse and present the findings.
Findings
From 40,904 records screened, 55 research publications were included, representing the perspectives of nurses, mothers, fathers, extended family, and legal guardians. Narrative synthesis revealed seven themes identified from the nurse and parent experiences: (i) communication; (ii) end-of-life decision-making; (iii) suffering; (iv) preparing for death; (v) at the end of life; (vi) after death; and (vii) nurse impacts. While there was mostly concordance between nurse and parent experiences, there was some discord between parents’ communication needs and nurses’ understanding of their role in communication. This review also highlighted how nurses commit to supporting parents in their grief and bereavement while concurrently managing their own emotions in response to a child’s death.
Conclusion
A child’s death cannot always be prevented. By exploring nurses’ and parents’ experiences of end-of-life care, as they occur simultaneously and in parallel, it is possible to build understanding and evolve practices to improve the experience of end-of-life care for children for all involved.
{"title":"Parents’ and nurses’ experiences of end-of-life care in intensive care for children: A systematic review","authors":"Melissa J. Bloomer RN, PhD, FACCCN , Ashleigh E. Butler RN, PhD, MACCCN , Laura A. Brooks RN, PhD, MACCCN , Alysia Coventry RN, MPhil MACCCN , Stephen McKeever RGN, PhD, MACCCN , Kristen Ranse RN, PhD, MACCCN , Jessie Rowe BN (Hons), Grad Dip Nurs Pract Paed Crit Care, MACCCN , Shontelle Thomas Grad Cert Nurse Pract Paed Intens Care, BN, MACCCN , Rebecca Thornton RN, PhD, MACCCN","doi":"10.1016/j.aucc.2025.101455","DOIUrl":"10.1016/j.aucc.2025.101455","url":null,"abstract":"<div><h3>Background</h3><div>The provision of end-of-life care for children in intensive care is a stressful and traumatic event for parents with immediate and life-long impacts. End-of-life care for children is also challenging for critical care nurses who must balance the child’s clinical requirements concurrently with facilitating and supporting the needs of parents and family members.</div></div><div><h3>Research question</h3><div>What is the research evidence about nurses’ and parents’ experiences of the provision of end-of-life care in intensive care for children?</div></div><div><h3>Review methods</h3><div>Following registration with the International Prospective Register of Systematic Reviews, a systematic review was undertaken. A combination of keywords, synonyms, and Medical Subject Headings were used across Cumulative Index for Nursing and Allied Health (CINAHL) Complete, Medline, and APA PsycInfo databases. Papers were independently assessed against inclusion and exclusion criteria. Included papers were assessed for quality. Narrative synthesis was used to analyse and present the findings.</div></div><div><h3>Findings</h3><div>From 40,904 records screened, 55 research publications were included, representing the perspectives of nurses, mothers, fathers, extended family, and legal guardians. Narrative synthesis revealed seven themes identified from the nurse and parent experiences: (i) communication; (ii) end-of-life decision-making; (iii) suffering; (iv) preparing for death; (v) at the end of life; (vi) after death; and (vii) nurse impacts. While there was mostly concordance between nurse and parent experiences, there was some discord between parents’ communication needs and nurses’ understanding of their role in communication. This review also highlighted how nurses commit to supporting parents in their grief and bereavement while concurrently managing their own emotions in response to a child’s death.</div></div><div><h3>Conclusion</h3><div>A child’s death cannot always be prevented. By exploring nurses’ and parents’ experiences of end-of-life care, as they occur simultaneously and in parallel, it is possible to build understanding and evolve practices to improve the experience of end-of-life care for children for all involved.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 6","pages":"Article 101455"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.aucc.2025.101489
Andrea P. Marshall RN, PhD
{"title":"The use of large data sets in clinical research: Don't throw the baby out with the bathwater","authors":"Andrea P. Marshall RN, PhD","doi":"10.1016/j.aucc.2025.101489","DOIUrl":"10.1016/j.aucc.2025.101489","url":null,"abstract":"","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 6","pages":"Article 101489"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The aim of this umbrella review was to synthesise existing evidence from systematic reviews on the impact of neuromuscular electrical stimulation on recovery in intensive care units.
Methods
This umbrella review was conducted in accordance with the Joanna Briggs Institute methodological guidance, and its reporting followed the Preferred Reporting Items for Overviews of Reviews statement. The search was carried out in the databases Medline®, CINAHL®, Scopus®, SciELO®, Web of Science®, Cochrane®, and SportDiscus®, using both indexed terms specific to each database and free-text terms. To assess the methodological quality of the included systematic reviews, the AMSTAR 2, tool was usedcovering 16 domains related to review design and reporting quality. The search was conducted with no temporal limits, until December 2024.
Results
A total of 21 systematic reviews were included. The most frequently assessed outcomes were muscle strength, muscle mass, and duration of mechanical ventilation. Muscle strength was the most extensively investigated outcome, with 11 reviews reporting positive effects. The analysis of primary study overlap revealed a moderate degree of overlap (6.71%).
Conclusion
It is concluded that neuromuscular electrical stimulation is safe for critically ill patients, with positive effects on muscle strength, muscle mass, and the duration of mechanical ventilation. Although neuromuscular electrical stimulation demonstrates promising results in the rehabilitation of critically ill patients, the methodological quality of the available systematic reviews is variable. Therefore, there is a need for more robust and high-quality systematic reviews to strengthen the evidence base.
目的：本综述的目的是综合现有的关于神经肌肉电刺激对重症监护病房康复影响的系统综述证据。方法：该总括性综述按照Joanna Briggs研究所的方法指南进行，其报告遵循综述声明的首选报告项目。在Medline®、CINAHL®、Scopus®、SciELO®、Web of Science®、Cochrane®和SportDiscus®数据库中进行检索，使用每个数据库特定的索引术语和自由文本术语。为了评估纳入的系统评价的方法学质量，使用了AMSTAR 2工具，涵盖了与评价设计和报告质量相关的16个领域。搜寻工作一直持续到2024年12月，没有时间限制。结果：共纳入21篇系统评价。最常见的评估结果是肌肉力量、肌肉质量和机械通气持续时间。肌肉力量是研究最广泛的结果，有11篇综述报告了积极的效果。初级研究重叠分析显示有中等程度的重叠（6.71%）。结论：神经肌肉电刺激对危重患者是安全的，对肌力、肌量、机械通气时间均有积极影响。虽然神经肌肉电刺激在危重病人的康复中显示出有希望的结果，但现有系统评价的方法学质量是可变的。因此，需要更有力和高质量的系统评价来加强证据基础。
{"title":"Effects of neuromuscular electrical stimulation on recovery in intensive care units: An umbrella review","authors":"Joana Vila Pouca RN, MN , Narcisa Gonçalves RN, MN , Carla Silvia Fernandes RN, Phd","doi":"10.1016/j.aucc.2025.101456","DOIUrl":"10.1016/j.aucc.2025.101456","url":null,"abstract":"<div><h3>Aim</h3><div>The aim of this umbrella review was to synthesise existing evidence from systematic reviews on the impact of neuromuscular electrical stimulation on recovery in intensive care units.</div></div><div><h3>Methods</h3><div>This umbrella review was conducted in accordance with the Joanna Briggs Institute methodological guidance, and its reporting followed the Preferred Reporting Items for Overviews of Reviews statement. The search was carried out in the databases Medline®, CINAHL®, Scopus®, SciELO®, Web of Science®, Cochrane®, and SportDiscus®, using both indexed terms specific to each database and free-text terms. To assess the methodological quality of the included systematic reviews, the AMSTAR 2, tool was usedcovering 16 domains related to review design and reporting quality. The search was conducted with no temporal limits, until December 2024.</div></div><div><h3>Results</h3><div>A total of 21 systematic reviews were included. The most frequently assessed outcomes were muscle strength, muscle mass, and duration of mechanical ventilation. Muscle strength was the most extensively investigated outcome, with 11 reviews reporting positive effects. The analysis of primary study overlap revealed a moderate degree of overlap (6.71%).</div></div><div><h3>Conclusion</h3><div>It is concluded that neuromuscular electrical stimulation is safe for critically ill patients, with positive effects on muscle strength, muscle mass, and the duration of mechanical ventilation. Although neuromuscular electrical stimulation demonstrates promising results in the rehabilitation of critically ill patients, the methodological quality of the available systematic reviews is variable. Therefore, there is a need for more robust and high-quality systematic reviews to strengthen the evidence base.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 6","pages":"Article 101456"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
As life expectancy increases, intensive care units (ICUs) are treating more patients aged 90 years and older. Whether outcomes in nonagenarians differ significantly from those of octogenarians (aged 80–89 years) remains uncertain.
Objective
The objective of this study was to compare ICU, in-hospital, and longer-term mortality (3 months–1 year) and treatment intensity between critically ill nonagenarians and octogenarians.
Methods
We conducted a systematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Ovid MEDLINE, Embase, and CENTRAL were searched through October 2024. Studies reporting outcomes for both age groups were included. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effect models.
Results
Eleven retrospective studies were included, involving 138,073 ICU patients (13,717 nonagenarians and 124,356 octogenarians). ICU mortality was comparable overall (OR: 1.30, 95% CI: 0.94–1.80), although heterogeneity was high (I2 = 87%). In-hospital mortality (OR: 1.20, 95% CI: 1.04–1.39, I2 = 82%) and longer-term mortality (OR: 1.65, 95% CI: 1.58–1.72, I2 = 0%) were significantly higher among nonagenarians. Use of renal replacement therapy was significantly lower in nonagenarians (OR: 0.35, 95% CI: 0.26–0.48). Sensitivity analysis excluding short-stay ICU admissions revealed increased ICU mortality in nonagenarians (OR: 1.46, 95% CI: 1.06–2.02), suggesting that the initial comparability may underestimate true differences.
Conclusion
Observed similarities in ICU mortality may reflect selection bias towards less severely ill nonagenarians. When short-stay admissions were excluded, a consistent pattern of worse outcomes emerged. These findings highlight the need for individualised ICU decision-making in the oldest old and support future research using matched cohorts that account for illness severity, treatment intensity, and frailty to better understand the true impact of advanced age.
{"title":"Systematic review and meta-analysis of intensive care unit outcomes in critically ill nonagenarians versus octogenarians: Impact on mortality, morbidity, and treatment intensity","authors":"Nattaya Raykateeraroj MD , Laurence Weinberg MD, PhD , Chayanan Thanakiattiwibun Msc , Suchanun Lao-amornphunkul MD , Nuanprae Kitisin MD","doi":"10.1016/j.aucc.2025.101454","DOIUrl":"10.1016/j.aucc.2025.101454","url":null,"abstract":"<div><h3>Introduction</h3><div>As life expectancy increases, intensive care units (ICUs) are treating more patients aged 90 years and older. Whether outcomes in nonagenarians differ significantly from those of octogenarians (aged 80–89 years) remains uncertain.</div></div><div><h3>Objective</h3><div>The objective of this study was to compare ICU, in-hospital, and longer-term mortality (3 months–1 year) and treatment intensity between critically ill nonagenarians and octogenarians.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Ovid MEDLINE, Embase, and CENTRAL were searched through October 2024. Studies reporting outcomes for both age groups were included. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effect models.</div></div><div><h3>Results</h3><div>Eleven retrospective studies were included, involving 138,073 ICU patients (13,717 nonagenarians and 124,356 octogenarians). ICU mortality was comparable overall (OR: 1.30, 95% CI: 0.94–1.80), although heterogeneity was high (I<sup>2</sup> = 87%). In-hospital mortality (OR: 1.20, 95% CI: 1.04–1.39, I<sup>2</sup> = 82%) and longer-term mortality (OR: 1.65, 95% CI: 1.58–1.72, I<sup>2</sup> = 0%) were significantly higher among nonagenarians. Use of renal replacement therapy was significantly lower in nonagenarians (OR: 0.35, 95% CI: 0.26–0.48). Sensitivity analysis excluding short-stay ICU admissions revealed increased ICU mortality in nonagenarians (OR: 1.46, 95% CI: 1.06–2.02), suggesting that the initial comparability may underestimate true differences.</div></div><div><h3>Conclusion</h3><div>Observed similarities in ICU mortality may reflect selection bias towards less severely ill nonagenarians. When short-stay admissions were excluded, a consistent pattern of worse outcomes emerged. These findings highlight the need for individualised ICU decision-making in the oldest old and support future research using matched cohorts that account for illness severity, treatment intensity, and frailty to better understand the true impact of advanced age.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 6","pages":"Article 101454"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hospital admission can be a stressful experience for patients and their families. Although healthcare professionals can also be patients, there is limited understanding of nurses’ experiences when caring for them in hospital settings.
Aim
The aims of this study were to explore the challenges nurses encounter while caring for hospitalised healthcare professionals and to compare experiences between participants in intensive care unit and acute care settings.
Methods
A cross-sectional exploratory study was conducted in July 2022 using an online survey via Research Electronic Data Capture (REDCap) with registered nurses who had cared for a healthcare professional-patient within the previous 3 years.
Results
Sixty-nine participants were included, with a mean age of 44.8 years and a mean of 18.8 years of experience as a registered nurse; 49% worked in intensive care and 51% in acute care settings, including surgery, emergency, and cardiology. A substantial 63.7% reported that caring for healthcare professional-patients was more challenging, while 49.3% found it more stressful than caring for non–healthcare professional-patients. Only 3% had received prior education that supported them in this role, despite 87% feeling prepared to deliver care and 75% feeling comfortable doing so. Open-ended questions reflecting on their experience caring for healthcare professional-patients generated three themes: enhanced support and knowledge needed to facilitate the role reversal of healthcare professionals becoming patients, recognising and respecting the evolving dynamics in caring for healthcare professionals as patients, and tailoring communication to align with individual needs and prior knowledge. There were no differences between intensive care unit participants and acute care participants regarding feeling prepared, experiencing stress, or feeling challenged caring for health professional-patients.
Conclusion
In conclusion, many nurses face significant challenges and heightened stress while caring for hospitalised healthcare professionals, whether in intensive care or acute care environments. The findings highlight a critical need for enhanced training and support to address the unique dynamics and communication requirements of these situations.
{"title":"The experiences and challenges of caring for a healthcare professional patient in intensive and acute care settings: A cross-sectional exploratory survey","authors":"Lynne Hunt RN, BN(Hons), Melissa Riegel RN, PhD, Robyn Gallagher RN, PhD, Thomas Buckley RN, PhD","doi":"10.1016/j.aucc.2025.101453","DOIUrl":"10.1016/j.aucc.2025.101453","url":null,"abstract":"<div><h3>Background</h3><div>Hospital admission can be a stressful experience for patients and their families. Although healthcare professionals can also be patients, there is limited understanding of nurses’ experiences when caring for them in hospital settings.</div></div><div><h3>Aim</h3><div>The aims of this study were to explore the challenges nurses encounter while caring for hospitalised healthcare professionals and to compare experiences between participants in intensive care unit and acute care settings.</div></div><div><h3>Methods</h3><div>A cross-sectional exploratory study was conducted in July 2022 using an online survey via Research Electronic Data Capture (REDCap) with registered nurses who had cared for a healthcare professional-patient within the previous 3 years.</div></div><div><h3>Results</h3><div>Sixty-nine participants were included, with a mean age of 44.8 years and a mean of 18.8 years of experience as a registered nurse; 49% worked in intensive care and 51% in acute care settings, including surgery, emergency, and cardiology. A substantial 63.7% reported that caring for healthcare professional-patients was more challenging, while 49.3% found it more stressful than caring for non–healthcare professional-patients. Only 3% had received prior education that supported them in this role, despite 87% feeling prepared to deliver care and 75% feeling comfortable doing so. Open-ended questions reflecting on their experience caring for healthcare professional-patients generated three themes: enhanced support and knowledge needed to facilitate the role reversal of healthcare professionals becoming patients, recognising and respecting the evolving dynamics in caring for healthcare professionals as patients, and tailoring communication to align with individual needs and prior knowledge. There were no differences between intensive care unit participants and acute care participants regarding feeling prepared, experiencing stress, or feeling challenged caring for health professional-patients.</div></div><div><h3>Conclusion</h3><div>In conclusion, many nurses face significant challenges and heightened stress while caring for hospitalised healthcare professionals, whether in intensive care or acute care environments. The findings highlight a critical need for enhanced training and support to address the unique dynamics and communication requirements of these situations.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 6","pages":"Article 101453"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-08-07DOI: 10.1016/j.aucc.2025.101301
Jessica M Hampton, Elizabeth C Ward, Lynette Morrison, Kellie Sosnowski, James Banham, Marilia Libera, Chanelle Louwen, Hayden White, Rachael Watson, Melissa A Day
Background: Psychological distress is common among intensive care unit (ICU) patients and can lead to long-term adverse psychological sequelae. While early psychological interventions may help mitigate these effects, their feasibility within critical care settings remains largely unexplored. Additionally, the role of psychologists in delivering such interventions in Australia remains unclear, particularly given inconsistencies in workforce availability and integration into standard care.
Aims/objectives: The aim of this study was to (i) outline the development of a psychologist-led screening and intervention protocol in an Australian ICU and (ii) evaluate its preliminary feasibility. It also examined the suitability of a potential outcome measure to inform future trial design.
Methods: The Medical Research Council's framework for developing complex interventions in health was applied. The intervention was designed for an Australian metropolitan ICU. It consisted of a modular-based psychological intervention tailored to the patient's level of psychological distress. A single-arm prospective pilot study was conducted, and 30 patients were recruited. Feasibility was assessed based on recruitment rates, patient engagement, and outcome measure completion.
Results: Recruitment challenges were observed, with a low eligibility screening rate. Staffing constraints and consent-related barriers further limited recruitment. Intervention engagement was high, with 96% of consenting participants completing at least one intervention component. Outcome measure completion rates supported the feasibility of a larger trial, with preliminary findings suggesting a significant reduction in negative emotional affect over time. Consistent with the Medical Research Council's framework, refinements to the intervention are recommended.
Conclusions: The findings support the feasibility of a psychologist-led intervention in the ICU, though refinements are necessary to improve recruitment, streamline delivery, and enhance engagement. This study highlights the potential of early psychological interventions to improve patients' emotional well-being. Addressing staffing limitations and consent barriers could enhance accessibility and effectiveness in future trials.
Registration: This trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12623000619640), with the first participant recruited on 4/07/2023.
{"title":"The development and feasibility of a psychologist-led screening and modular-based psychological intervention in an Australian intensive care unit: A pilot study.","authors":"Jessica M Hampton, Elizabeth C Ward, Lynette Morrison, Kellie Sosnowski, James Banham, Marilia Libera, Chanelle Louwen, Hayden White, Rachael Watson, Melissa A Day","doi":"10.1016/j.aucc.2025.101301","DOIUrl":"10.1016/j.aucc.2025.101301","url":null,"abstract":"<p><strong>Background: </strong>Psychological distress is common among intensive care unit (ICU) patients and can lead to long-term adverse psychological sequelae. While early psychological interventions may help mitigate these effects, their feasibility within critical care settings remains largely unexplored. Additionally, the role of psychologists in delivering such interventions in Australia remains unclear, particularly given inconsistencies in workforce availability and integration into standard care.</p><p><strong>Aims/objectives: </strong>The aim of this study was to (i) outline the development of a psychologist-led screening and intervention protocol in an Australian ICU and (ii) evaluate its preliminary feasibility. It also examined the suitability of a potential outcome measure to inform future trial design.</p><p><strong>Methods: </strong>The Medical Research Council's framework for developing complex interventions in health was applied. The intervention was designed for an Australian metropolitan ICU. It consisted of a modular-based psychological intervention tailored to the patient's level of psychological distress. A single-arm prospective pilot study was conducted, and 30 patients were recruited. Feasibility was assessed based on recruitment rates, patient engagement, and outcome measure completion.</p><p><strong>Results: </strong>Recruitment challenges were observed, with a low eligibility screening rate. Staffing constraints and consent-related barriers further limited recruitment. Intervention engagement was high, with 96% of consenting participants completing at least one intervention component. Outcome measure completion rates supported the feasibility of a larger trial, with preliminary findings suggesting a significant reduction in negative emotional affect over time. Consistent with the Medical Research Council's framework, refinements to the intervention are recommended.</p><p><strong>Conclusions: </strong>The findings support the feasibility of a psychologist-led intervention in the ICU, though refinements are necessary to improve recruitment, streamline delivery, and enhance engagement. This study highlights the potential of early psychological interventions to improve patients' emotional well-being. Addressing staffing limitations and consent barriers could enhance accessibility and effectiveness in future trials.</p><p><strong>Registration: </strong>This trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12623000619640), with the first participant recruited on 4/07/2023.</p>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 6","pages":"101301"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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