Young Shin Cho

Purpose : In this study, we aimed to identify factors influencing the inpatient satisfaction in integrated nursing care service wards. Methods : Using data from the 2020 and 2021 healthcare service experience surveys conducted by the Ministry of Health and Welfare, this study analyzed a weighted sample of 416,020 participants using descriptive statistics, pairedt-test, Pearson’s correlation, and multiple linear regression analyses. Results : Inpatient satisfaction in integrated nursing care service wards was most significantly affected by the experiences with nursing services and perceived health status, followed by experiences with doctor services, length of hospitalization, age, experiences with medical institution services, education level, gender, presence of chronic diseases, type of hospital, and occupation. Most significant positive impacts were associated with experiences with nursing and doctor services, especially in general hospitals and high-level facilities, among males and elderly patients ＞ 60 years old. In contrast, high education level, presence of chronic diseases, and unemployment were associated with low inpatient satisfaction. Conclusion : Effective programs and guidelines must be developed and implemented to expand and promote the integrated nursing care and medical services and overall utilization of healthcare institutions, with a special focus on person-centered care.

Purpose : Post-intensive care syndrome (PICS) is characterized by a constellation of mental health, physical, and cognitive impairments, and is recognized as a long-term sequela among survivors of intensive care units (ICUs). The objective of this study was to explore the impact of intensive care experience (ICE) on the development of PICS in individuals surviving critical care.Methods : This secondary analysis utilized data derived from a prospective, multicenter cohort study of ICU survivors. The cohort comprised 143 survivors who were enrolled between July and August 2019. The original study's participants completed the Korean version of the ICE questionnaire (K-ICEQ) within one week following discharge from the ICU. Of these, 82 individuals completed the PICS questionnaire (PICSQ) three months subsequent to discharge from hospital. The influence of ICE on the manifestation of PICS was examined through Partial Least Squares-Structural Equation Modeling (PLS-SEM).Results : The R2 values of the final model ranged from 0.35 to 0.51, while the Q2 values were all greater than 0, indicating adequacy for prediction of PICS. Notable pathways in the relationship between the four ICE dimensions and the three PICS domains included significant associations from ‘ICE-awareness of surroundings’ to ‘PICS-cognitive’, from ‘ICE-recall of experience’ to ‘PICS-cognitive’, and from ‘ICE-frightening experiences’ to ‘PICS-mental health’. Analysis found no significant moderating effects of age or disease severity on these relationships. Additionally, gender differences were identified in the significant pathways within the model.Conclusion : Adverse ICU experiences may detrimentally impact the cognitive and mental health domains of PICS following discharge. In order to improve long-term outcomes of individuals who survive critical care, it is imperative to develop nursing interventions aimed at enhancing the ICU experience for patients.

Purpose : Sleep disturbances in patients in the intensive care unit (ICU) are related to health problems after discharge. Therefore, active prevention and management are required. Hence, identification of the factors that affect sleep in patients who are critically ill is necessary.Methods : The PubMed, Cochrane Library, CINAHL, EMBASE, and Web of Science databases were searched. Selection criteria were observational and experimental studies that assessed sleep as an outcome, included adult patients admitted to the ICU, and published between November 2015 and April 2022.Results : A total of 21,136 articles were identified through search engines and manual searches, and 42 articles were selected. From these, 22 influencing factors and 11 interventions were identified. Individual factors included disease severity, age, pain, delirium, comorbidities, alcohol consumption, sex, sleep disturbance before hospitalization, chronic obstructive pulmonary disease (COPD), cardiovascular disease, and high diastolic blood pressure (DBP), low hemoglobin (Hb), and low respiratory rate (RR). Environmental factors included light level, noise level, and temperature. Furthermore, treatment-related factors included use of sedatives, melatonin administration, sleep management guidelines, ventilator application, nursing treatment, and length of ICU stay. Regarding sleep interventions, massage, eye mask and earplugs, quiet time and multicomponent protocols, aromatherapy, acupressure, sounds of the sea, adaptive intervention, circulation lighting, and single occupation in a room were identified.Conclusion : Based on these results, we propose the development and application of various interventions to improve sleep quality in patients who are critically ill.

Choi HS, et al. Korean J Adult Nurs. 2023 Aug;35(3):234-244. https://doi.org/10.7475/kjan.2023.35.3.234

Kang J, et al. J Korean Acad Nurs. 2018 Jun;48(3):323-334. https://doi.org/10.4040/jkan.2018.48.3.323