Association with perceived stress and feasibility of an app for patient-reported stressor experiences during...

Critically ill patients often experience substantial stress during their ICU treatment. The ICU Feel Better App is a novel mobile application that patients can use to evaluate ICU-related stressors during their stay. We aimed to investigate if using the app, without feedback to the ICU staff, would be associated with changes in perceived acute stress.

This prospective cohort study used a before-and-after design. Data were collected at the beginning of ICU treatment (T1) and at discharge from ICU (T2). The comparison group (N.=20) received treatment as usual, i.e. standard critical care including assessment and treatment of pain and delirium. The App group (N.=20) used the ICU Feel Better App, which included 24 common ICU-related stressors, between T1 and T2. Secondary outcomes included app use extent and patients' ratings of acceptance and usability.

No significant differences were observed in clinical characteristics or stress levels between treatment groups at T1, T2, and from T1 to T2. Each app session averaged a median of 1.82 minutes (IQR: 1.54-2.66), with users averaging 8.5 sessions over 3.5 days, totaling 16.16 minutes of use (IQR: 9.72-27.51). Patients found the app highly usable and acceptable, with assistance needed in only one session for three users and no premature terminations.

The lack of significant stress reduction suggests that the effectiveness of the app could be improved by incorporating feedback mechanisms to communicate patients' stressor evaluations to staff, prompting stress-reducing measures. Data on app use, acceptability, and usability indicate feasibility of the ICU Feel Better App.