Relationship Between Hygiene and Comfort Care and Pain in Patients Admitted to an ICU

Hospitalization in intensive care units is associated with high levels of pain, experienced both at rest and during nursing interventions. Hygiene and comfort care, essential to patient well-being, often require mobilization and manipulation maneuvers that can be nociceptive, intensifying pain and discomfort.

To analyze the relationship between the provision of hygiene and comfort care and the pain experienced by critically ill patients admitted to an intensive care unit, measured before, during, and after these interventions.

A quantitative, prospective, observational study with repeated measures was conducted in the intensive care unit of a Local Health Unit in Portugal. A total of 101 patients were assessed for pain using either the Numerical Rating Scale for perceived pain or the Behavioral Pain Scale for behavioral indicators at three time points: before, during, and after care.

Pain intensity significantly increased during hygiene and comfort care. NRS scores rose from 0.56 ± 1.27 at baseline to 1.35 ± 2.17 during care and decreased to 0.35 ± 0.81 after 30 minutes, remaining slightly above baseline (p < .001). BPS scores increased from 3.28 ± 0.70 to 4.10 ± 1.18 and returned to 3.41 ± 0.63 post-procedure (p < .001). Systolic and diastolic blood pressure also increased significantly during care (p < .001), reflecting nociceptive responses.

Hygiene and comfort care in intensive care unit settings significantly increase pain in critically ill patients. Pain assessment and management should be prioritized even during routine nursing interventions, reinforcing the importance of nursing practices that are sensitive to the comfort and well-being of these patients. Findings highlight the need for anticipatory analgesia and systematic pain assessment during routine hygiene care in Intensive Care Units nursing practice. Integrating these practices may enhance patient comfort and improve pain management in Intensive Care Units.