Intensive Care Unit Caregivers Perception of Patient Discomfort: A Qualitative Study

Background: Being hospitalized in an intensive care unit ICU often involves pain and discomfort. While pain is commonly alleviated with analgesics, discomfort is more difficult to diagnose and treat, thus po-tentially leading to incorrect analgesic administration.Aim: To describe intensive care unit practitioners' perceptions of discomfort in the ICU, and their meth-ods to discern between pain and non-pain discomfort.Methods: Twenty-five intensive care unit practitioners (7 doctors and 18 nurses) were interviewed from medical and general intensive care units at one institution in Jerusalem, Israel. Data collection was per-formed using semi-structured interviews. Interviews were audio-recorded and transcribed. Transcrip-tions were coded and categorized by two researchers independently. Content analysis identified common themes.Results: Two main discomfort themes were identified: unpleasant physical sensations and unpleasant psychologic feelings, with further subcategories. Physiologic and non-physiologic signs such as facial ex-pression and motor activity helped to diagnose discomfort. Trial and error and cause and effect were used to differentiate pain from other sources of discomfort.Conclusions: Practitioners saw pain as a dominant source of discomfort. Treating overall discomfort should focus on improving the quality of the total intensive care unit experience. Strategies to diagnose non-pain discomfort and pain were similar. Differentiating pain from non-pain discomfort is essential in order to provide appropriate treatment for pain and non-pain-related discomfort.(c) 2022 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.