Symptom identification in the chronically critically ill

DOI

10.1097/NCI.0b013e3181c932a8

Document Type

Journal Article

Publication Date

1-1-2010

Publication Title

AACN Advanced Critical Care

Volume

21

Issue

1

First Page

64

Last Page

79

ISSN

15597768

Keywords

Chronic critical illness, Nonverbal communication, Symptom assessment

Abstract

Ascertaining the symptom experience of chronically critically ill (CCI) patients is difficult because of communication impairment and fluctuations in patient cognition and physiologic conditions. The use of checklist self-report ratings is hampered by the inability of most CCI patients to respond verbally to symptom queries. In addition to the communication problems caused by mechanical ventilation, the apparently diverse idioms of symptom expression add to the potential for miscommunication regarding symptom experience. Although patient communication impairment is a major barrier to symptom identification, symptom assessment and treatment are fundamental components of nursing care for CCI. This article reviews and describes the unique constellation of symptoms experienced by many critically ill patients. We report our observations of symptom communication among CCI patients and nurses and discuss inconsistency in the language of symptom expression among nurses and patients. Clinically applicable strategies to improve nurse-patient symptom communication and suggestions for refinement of symptom assessment in chronic critical illness are provided. © 2010, AACN.

Open Access

Green Accepted

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