Enfermeria intensiva最新文献

{"title":"The effectiveness of family accompaniment and environmental measures to reduce the incidence of delirium incidence in an acute cardiovascular unit: A quasi-experimental study. It is possible to reduce delirium without using drugs, and it is better","authors":"Luis Guerra-Sánchez PhD ,&nbsp;Sara González-Alfonso RN ,&nbsp;Pablo Lerma-Lara RN ,&nbsp;Miguel Bernardino-Santos RN ,&nbsp;Rosario Cortijo-González RN ,&nbsp;Soraya Bustamante-González RN","doi":"10.1016/j.enfie.2025.500546","DOIUrl":"10.1016/j.enfie.2025.500546","url":null,"abstract":"<div><h3>Introduction</h3><div>The occurrence of delirium casts a shadow over the prognosis of patients, especially the critically ill. Prevention and treatment of delirium is more effective and with fewer adverse effects with multicomponent interventions than with pharmacological measures alone. The objective was to assess whether a non-pharmacological care-related intervention can reduce the incidence of delirium in an acute cardiovascular care unit.</div></div><div><h3>Methods</h3><div>Quasi-experimental study (before/after). ‘Before’: From November 2018 to March 2019, 190 patients aged 18 years and older, admitted to an acute cardiovascular care unit, were assessed using the Confusion Assessment Method for the ICU. From April to November 2019, a series of actions related to the physical environment and accompaniment were implemented. The ‘after’ started in November 2019 and 189 patients were assessed until early March 2020.</div></div><div><h3>Results</h3><div>The incidence of delirium before introducing the actions was 11,6%, which fell to 4,2% (<em>P</em> = ,012) after the actions.</div></div><div><h3>Discussion</h3><div>Management of delirium includes effective diagnosis, delirium prevention activities and treatment, which ideally should be free of side effects.</div></div><div><h3>Conclusions</h3><div>The implementation of a bundle of measures related to environmental changes and involving the family, significantly reduced the incidence of delirium, to less than half.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"36 3","pages":"Article 500546"},"PeriodicalIF":0.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144280857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intensive care and inpatient nurse’s intention to leave the profession. Association with psychologicosocial variables","authors":"Fernanda Gil-Almagro MSN, PhD ,&nbsp;Fernando J. García-Hedrera PhD ,&nbsp;F. Javier Carmona-Monge PhD ,&nbsp;Cecilia Peñacoba-Puente PhD","doi":"10.1016/j.enfie.2025.500524","DOIUrl":"10.1016/j.enfie.2025.500524","url":null,"abstract":"<div><h3>Introduction</h3><div>The intention to leave the health profession has been studied as one of the consequences of the work and emotional overload experienced by nurses during the pandemic. However, few studies have focused on ICU nurses. The studies on intention to leave the profession focus on working conditions and symptomatology, without analyzing the personal characteristics involved.</div></div><div><h3>Objective</h3><div>To explore the evolution of the intention to leave the profession in ICU nurses (with respect to hospitalization nurses). In addition, to analyse the possible differences in anxiety, burnout and psychosocial variables (self-efficacy, resilience, cognitive fusion) between nurses who intend to quit and those who do not.</div></div><div><h3>Method</h3><div>Observational, descriptive, longitudinal, prospective study with three data collection periods. Non-probabilistic convenience sampling was performed.</div></div><div><h3>Results</h3><div>Six months after the end of the confinement period in Spain, higher dropout percentages were observed in ICU (49.2%) than in hospitalization (33.3%) (<em>p</em> = .07). One year later, the percentages of intention to leave tend to be equal (50.8% in ICU and 43.9% in hospitalization) (<em>p</em> = .438). With respect to the differential profile of ICU nurses who intend to leave the profession (compared to those who do not), higher scores were observed in anxiety (<em>p</em> = .037), emotional exhaustion (<em>p</em> &lt; .001), decreased personal fulfilment (<em>p</em> = .031) and cognitive fusion (<em>p</em> = .023).</div></div><div><h3>Conclusion</h3><div>A high percentage of ICU nurses show intention to leave the profession, and associations were found with the anxiety experienced at the beginning of the pandemic, with high emotional exhaustion and low personal fulfilment. It is important to highlight in our study the relationship between intention to leave the profession and personal variables such as cognitive fusion.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"36 2","pages":"Article 500524"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143769150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and psychometric validation of the Behavioral Indicators of Pain Scale-Brain Injury (ESCID-DC) for pain assessment in critically ill patients with acquired brain injury, unable to self-report and with artificial airway","authors":"Candelas López-López ,&nbsp;Gemma Robleda-Font ,&nbsp;Antonio Arranz-Esteban ,&nbsp;Teresa Pérez-Pérez ,&nbsp;Montserrat Solís-Muñoz ,&nbsp;María Carmen Sarabia-Cobo ,&nbsp;María Jesús Frade-Mera ,&nbsp;Susana Temprano-Vázquez ,&nbsp;Francisco Paredes-Garza ,&nbsp;Aaron Castanera-Duro ,&nbsp;Mónica Bragado-León ,&nbsp;Emilia Romero de-San-Pío ,&nbsp;Isabel Gil-Saaf ,&nbsp;David Alonso-Crespo ,&nbsp;Carolina Rojas-Ballines ,&nbsp;Ignacio Latorre-Marco ,&nbsp;Grupo ESCID-DC","doi":"10.1016/j.enfie.2025.500523","DOIUrl":"10.1016/j.enfie.2025.500523","url":null,"abstract":"<div><h3>Introduction</h3><div>The aim of this study was to develop and validate the adaptation of the behavioural indicators of pain scale (ESCID) for patients with acquired brain injury (ESCID-DC), unable to self-report and with artificial airway.</div></div><div><h3>Methods</h3><div>Multicenter study conducted in 2 phases: scale development and evaluation of psychometric properties. Two blinded observers simultaneously assessed pain behaviours with two scales: ESCID-DC and Nociception Coma Scale-Revised version-adapted for Intubated patients (NCS-R-I). Assessments were performed at 3 time points: 5 min before, during and 15 min after the application of the painfull procedures (tracheal suction and application of pressure to the right and left nail bed) and a non-painful procedure (rubbing with gauze). On the day of measurement, the Glasgow Coma Score (GCS) and the Richmond Agitation Sedation Scale (RASS) were evaluated. A descriptive and psychometric analysis was performed.</div></div><div><h3>Results</h3><div>A total of 4152 pain evaluations were performed in 346 patients, 70% men with a mean age of 56 years (SD = 16.4). The most frequent etiologies of brain damage were vascular 155 (44.8%) and traumatic 144 (41.6%). The median GCS and RASS on the day of evaluation were 8.50 (IQR = 7 to 9) and −2 (RIQ = −3 to −2) respectively. In ESCID-DC the median score was 6 (IQR = 4 to 7) during suction, 3 (RIQ = 1 to 4) for right pressure and 3 (RIQ = 1 to 5) for left pressure. During the non-painful procedure it was 0. The ESCID-DC showed a high discrimination capacity between painful and non-painful procedures (AUC &gt; 0.83) and is sensitive to change depending on the time of application of the scale. High interobserver agreement (Kappa &gt; 0.87), good internal consistency during procedures (α-Cronbach≥0.80) and a high correlation between the ESCID-DC and the NCS-R-I (<em>r</em> ≥ 0.75) were obtained.</div></div><div><h3>Conclusions</h3><div>The results of this study demonstrate that the ESCID-DC is a valid and reliable tool for assessing pain in patients with acquired brain injury, unable to self-report and with artificial airway.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"36 2","pages":"Article 500523"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid response system and continuity of nursing care programme for the prevention of post-ICU syndrome","authors":"Gemma Leiva-Aguado RN, MSc ,&nbsp;Maria Isabel Calleja-Serrano RN ,&nbsp;Mara del Carmen Cuenca-Soriano RN ,&nbsp;Faustino Álvarez-Cebrián MD, PhD ,&nbsp;Álvaro Castellanos-Ortega MD, PhD","doi":"10.1016/j.enfie.2025.500543","DOIUrl":"10.1016/j.enfie.2025.500543","url":null,"abstract":"<div><div>The clinical deterioration of patients admitted to hospital wards, characterised by physiological abnormalities, can be predicted 6–24 h in advance and often depends on the nurse's ability to detect it early. In addition, advances in the treatment and care of the critically ill patient have increased survival after discharge from the intensive care unit (ICU). This, together with increased severity, frailty, prolonged stays and special treatment needs, means that ICU survivors may have physical weakness and mental and/or cognitive impairment that persists over time. In this context, it is necessary to provide personalised care that guarantees the continuity of nursing care in the different care settings through which patients and their families pass.</div><div>For all these reasons, a continuity of care nursing consultation was designed and implemented in conjunction with a surveillance system on all hospital wards and nurse monitoring for the prevention of post-acute syndrome after discharge from a critical care unit.</div><div>More than 665 adult inpatient beds are currently under surveillance. In the study period from February 2023 to January 2024, of the 2126 patients discharged from the critical care unit, 87 were in post-ICU follow-up, 55 in full follow-up and 32 in partial follow-up.</div><div>The implementation of a surveillance system, monitoring in the continuity of nursing care throughout the disease and during the recovery phases, at the different levels of care (critical care, hospitalisation, primary care), can prevent and/or minimise the physical, psychological and cognitive alterations of the post-ICU syndrome and can contribute to the recovery of the quality of life of patients and their families.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"36 2","pages":"Article 500543"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nursing diagnoses for patients hospitalized with COVID-19 in critical care units in Brazil: A cross-sectional study","authors":"Giovanna Maria de Lima-Medeiros RN ,&nbsp;Caio Rodrigo Menezes-dos-Santos RN ,&nbsp;Thiago de Jesus-Santos MSN ,&nbsp;Edilza Fraga-Santos RN ,&nbsp;Andreia Centenaro-Vaez PhD ,&nbsp;Fernanda Gomes de Magalhães Soares-Pinheiro PhD ,&nbsp;Damião da Conceição-Araújo PhD","doi":"10.1016/j.enfie.2025.500541","DOIUrl":"10.1016/j.enfie.2025.500541","url":null,"abstract":"<div><h3>Background</h3><div>The COVID-19 pandemic had a significant global impact, particularly on patients hospitalized in critical care units. Studies addressing nursing diagnoses in the context of the pandemic are essential to strengthen the evidence and contribute to the development of clinical practice.</div></div><div><h3>Objective</h3><div>Analyze the prevalence of nursing diagnoses in hospitalizations of critically ill adult patients with COVID-19 in northeastern Brazil.</div></div><div><h3>Method</h3><div>This is a cross-sectional study conducted in a university hospital in northeastern Brazil. The sample included 117 hospitalizations between 2020 and 2021. Data were retrospectively collected from electronic medical records and analyzed using absolute frequencies, percentages, and bivariate and multivariate analyses.</div></div><div><h3>Results</h3><div>The results revealed a predominance of nursing diagnoses such as risk for falls in adults (95.7%), risk for infection (94%), and bathing self-care deficit (89.7%). Patients on mechanical ventilation had higher prevalence rates of imbalanced nutrition, diarrhea and impaired physical mobility.</div></div><div><h3>Conclusions</h3><div>The prevalence of nursing diagnoses in critically ill COVID-19 patients highlights the complexity of care required and the importance of evidence-based practice to improve clinical outcomes.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"36 2","pages":"Article 500541"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for impairments in quality of life and activities of daily living in survivors of critical illness: A systematic review of observational studies","authors":"Taís Silva-Nascimento RP ,&nbsp;Cleia Lima-Rocha RP ,&nbsp;Ludmilla Ruvenal-Heine-Lustosa RP ,&nbsp;Mikhail Santos-Cerqueira PhD ,&nbsp;Rodrigo Santos-de-Queiroz PhD ,&nbsp;Mansueto Gomes-Neto PhD","doi":"10.1016/j.enfie.2025.500527","DOIUrl":"10.1016/j.enfie.2025.500527","url":null,"abstract":"<div><h3>Introduction</h3><div>The number of survivors of critical illnesses has increased over the years, resulting in impacts on quality of life and daily activities.</div></div><div><h3>Objective</h3><div>To investigate which intra-hospital risk factors are associated with worsening quality of life and functionality, through the assessment of basic and instrumental activities of daily living, in survivors of critical illness after hospital discharge.</div></div><div><h3>Methods</h3><div>Systematic literature review carried out from September 2022 to December 2023, informed by a flowchart, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Search strategy carried out in the CINAHL, Embase and PubMed databases. The research was carried out by two researchers, without restrictions on language or year of publication. Studies were assessed using the Newcastle–Ottawa Quality Assessment Form for Cohort Studies.</div></div><div><h3>Results</h3><div>12 articles were included, 5 studies provided information on daily and instrumental activities, 7 on quality of life and 1 with all these outcomes. Risk factors such as depression, frailty, prolonged time on mechanical ventilation, and muscle weakness acquired in the ICU were considered factors associated with worsening quality of life. And depression, sepsis, prolonged stay in the ICU, and frailty are factors associated with worsening in the basic and instrumental activities of daily life.</div></div><div><h3>Conclusion</h3><div>Survivors of critical illness, in the first 3 months after discharge, present changes in quality of life, in basic and instrumental activities of daily living, which may persist for up to 12 months or more. This situation may be associated with risk factors at the time of admission to the intensive care unit.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"36 2","pages":"Article 500527"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internal consistency, minimal detectable change, and sensitivity to change of the Spanish version of the Barthel Index at intensive care unit discharge and three months later","authors":"Esther Cecilia Wilches-Luna PT, PhD ,&nbsp;Vilma Eugenia Muñoz-Arcos PT, MSc ,&nbsp;Paula Benavides-Candezano PT ,&nbsp;José Julián Bernal-Sánchez PT, PhD, MSc ,&nbsp;Ada Clarice Gastaldi PT, PhD","doi":"10.1016/j.enfie.2025.500539","DOIUrl":"10.1016/j.enfie.2025.500539","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the internal consistency (IC), minimal detectable change (MDC), and sensitivity to change of the Barthel Index (BI) at ICU discharge and three months post-hospital discharge.</div></div><div><h3>Methods</h3><div>A prospective longitudinal study was conducted between November 2016 and July 2017 in a medical-surgical intensive care unit (ICU). A total of 149 patients over 18 years with a BI score &gt;90 prior to ICU admission were included. The COSMIN checklist was utilized to evaluate the measurement properties. Clinical and demographic variables, BI scores, IC, MDC, and sensitivity to change were analyzed. The Cronbach's alpha coefficient (<em>α</em>) was calculated to determine the IC of the BI by domain and for the overall scale. Effect size (ES) indices and standardized mean response (SMR) were used for sensitivity to change. The MDC was identified using a distribution-based method, calculating the standard error of measurement (SEM). Floor and ceiling effects were assessed, with a threshold of less than 15% considered acceptable.</div></div><div><h3>Results</h3><div>A total of 141 patients were evaluated at discharge from the ICU. Of these, <em>n</em> <!-->=<!--> <!-->77 (41.7%) were men, with a mean age of 58.5<!--> <!-->±<!--> <!-->16.8 years; <em>n</em> <!-->=<!--> <!-->62 (41.6%) required invasive mechanical ventilation. One hundred twelve patients were reassessed three months after discharge. The overall IC was: <em>α</em> <!-->=<!--> <!-->0.70 at ICU discharge and <em>α</em> <!-->=<!--> <!-->0.96 at three months. Ninety two percent (<em>n</em> <!-->=<!--> <!-->103) of the patients showed values greater than or equal to the MDC of 10 points, with statistically significant differences identified in the type of weaning, tracheostomy, and length of stay in the ICU (<em>p</em> <!-->&lt;<!--> <!-->0.005).</div></div><div><h3>Conclusions</h3><div>The items of the Spanish version of the BI demonstrate acceptable IC at ICU discharge. The MDC was 10 points, validating its responsiveness and utility for monitoring the functional independence of critically ill patients at ICU discharge and three months after hospital discharge.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"36 2","pages":"Article 500539"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of the professional profile and working conditions of nurses in intensive care units","authors":"Diana Marcela Achury-Saldaña MSN ,&nbsp;Luisa Fernanda Achury-Beltrán MSN ,&nbsp;Sandra M. Rodríguez-Colmenares MSN ,&nbsp;Herly Ruth Alvarado-Romero MSN ,&nbsp;Martha Consuelo Romero-Torres RN ,&nbsp;Diana Lucero Pardo-Camacho RN ,&nbsp;María Teresa Diaz-Muñoz RN ,&nbsp;Marcela Moran-Vargas RN ,&nbsp;Janeth Daza-Ramírez RN ,&nbsp;David Andradre-Fonseca MSN","doi":"10.1016/j.enfie.2025.500525","DOIUrl":"10.1016/j.enfie.2025.500525","url":null,"abstract":"<div><h3>Introduction</h3><div>The development of political and academic actions aimed at increasing the quality of care and the outcomes of health care requires knowledge of the conditions of the nursing workforce in intensive care units.</div></div><div><h3>Aim</h3><div>To characterise the professional profile and working conditions of Intensive Care Unit nurses in Colombia.</div></div><div><h3>Methods</h3><div>Multicenter, cross-sectional observational study. A total of 433 Intensive Care Unit nurses in Colombia participated, the information was collected through an online survey. The information was analysed with RStudio statistical software. Descriptive statistics were used for the presentation of results.</div></div><div><h3>Results</h3><div>79.4% of the nursing professionals were women with a mean age of 35.6(±) 9.6 years. A total of 63.9% worked in private adult Intensive Care Units and only 22.4% had a degree in Critical Care. The competencies that are permanently applied are care management, problem solving and communication; however, those related to teamwork and personal development are not fully developed. Regarding working conditions, it was found that: 71.6% have a nurse-patient ratio of 1:6 or more; only 47.5% have an indefinite term contract; 62% work have a salary remuneration of 3.5 minimum wages and only 66.2% are satisfied with their work.</div></div><div><h3>Conclusion</h3><div>The profile of nurses shows the need to strengthen specialised training, while skills and working conditions must be improved to guarantee quality care and the well-being of staff.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"36 2","pages":"Article 500525"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurses’ job satisfaction and intention to leave the intensive care unit","authors":"Marta Santana-Martín RN ,&nbsp;José Manuel López-Álvarez MD, PhD ,&nbsp;Yeray Gabriel Santana-Padilla RN, MSN, PhD ,&nbsp;Luciano Santana-Cabrera MD, PhD ,&nbsp;Borja Nicolás Santana-López RN, MSN, PhD","doi":"10.1016/j.enfie.2025.500537","DOIUrl":"10.1016/j.enfie.2025.500537","url":null,"abstract":"<div><h3>Introduction</h3><div>Nurse turnover increases the shortfall in coverage of different health services. Research studies have found high quitting intention rates related to low levels of job satisfaction among nurses in different areas, including Intensive Care Units (ICU). The aim of this study was to compare the level of job satisfaction of ICU nurses according to the population of critically ill patients they care for (paediatric vs. adult) and their intention to leave the ICU.</div></div><div><h3>Methods</h3><div>A cross-sectional descriptive study in which nurses from public ICUs on the island of Gran Canaria, two adult units and one paediatric unit, participated. An electronic questionnaire was sent out, which included questions on socio-demographic and occupational variables, the validated Font Roja job satisfaction survey and a final question on the participant's own intention to leave. Comparative analysis was performed using Chi-square for qualitative variables and Mann Whitney U for quantitative variables.</div></div><div><h3>Results</h3><div>A total of 152 nurses were recruited, 55.9% of whom expressed their intention to leave the ICU. Although both types of units had a higher number of nurses who wanted to leave the ICU, there was a higher proportion in the paediatric ICU who had this intention in the short period of time (30.4% vs. 7.0%) (χ² = 11,691; p = .003). Job satisfaction was generally good (3.37/5), being lower among those who did intend to leave (3.97 vs 2.91; <em>p</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>There is a high intention to leave among the professionals consulted. Paediatric ICU nurses had the highest intention to leave the ICU in the short term (&lt;6 months). An inverse relationship was found between intention to leave and job satisfaction.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"36 2","pages":"Article 500537"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143881678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moral distress in critical care nurses caring for patients undergoing ECMO: A cross-sectional study","authors":"Elisangela da-Conceição-Jorge RN ,&nbsp;João Paulo-Vitorino RN ,&nbsp;Donna M-Wilson RN, PhD ,&nbsp;Filipe Utuari-de-Andrade-Coelho RN, PhD","doi":"10.1016/j.enfie.2025.500533","DOIUrl":"10.1016/j.enfie.2025.500533","url":null,"abstract":"<div><h3>Background</h3><div>Extracorporeal membrane oxygenation (ECMO) is commonly used now in cases of refractory cardiac and pulmonary failure. Moral distress among nurses is often present; nevertheless, the literature regarding this topic is scarce.</div></div><div><h3>Objective</h3><div>To identify the level of moral distress among nurses providing direct care to patients undergoing ECMO by applying the Moral Distress Scale Revised (MDSR).</div></div><div><h3>Method</h3><div>This is a cross-sectional study conducted in an Adult Intensive Care Unit (ICU) in Brazil, involving nurses providing direct care to patients undergoing ECMO. Data on nurse sociodemographic and professional characteristics were collected, along with MDSR data and Moral Distress Index (MDI).</div></div><div><h3>Results</h3><div>A total of 30 nurses were included, of whom 80.0% were female, with an age of 32 (27.7–38.2) years, professional experience time of 5 (3.0–11.2) years, duration of direct support care experience of 2.5 (1.4–4.0) years, and 83.3% had completed an institutional ECMO course. The questions in the MDRS with the highest mean scores which indicate moral distress were 3 (8.57<!--> <!-->±<!--> <!-->4.83), 6 (7.20<!--> <!-->±<!--> <!-->4.73), 16 (6.10<!--> <!-->±<!--> <!-->6.13), 2 (5.87<!--> <!-->±<!--> <!-->4.39) and 7 (5.77<!--> <!-->±<!--> <!-->4.26), with these collectively resulting in a mean MDI of 70.7<!--> <!-->±<!--> <!-->48.02, indicating a significant intensity and frequency of moral distress experienced by the research participants.</div></div><div><h3>Conclusion</h3><div>Moral distress for nursing professionals caring for ECMO patients appears to be linked to the need for ongoing questioning, discussions, and reflections among the working teams. The greatest intensity and frequency of moral distress were attributed to adhering to the family's wishes to sustain life even when it might not be in the best interest of the patient. The study highlights the importance of developing educational programs to identify and mitigate the presence of moral distress and its triggering factors in critical care teams, aiming to reduce its impact over time.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"36 2","pages":"Article 500533"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}