[Specific stress of intensive therapy: its analysis and suggestions for changes]

Proceeding from studies which make the environment of an intensive care unit responsible for psychopathological disturbances in thoracic patients, we made investigations on an operative intensive care unit concerning its influence on the psychical state of surgical patients. For this purpose photometry and noise measurements were made at the patient's bedside; additionally the environment of a ventilated patient was recorded continuously by means of a cine-camera. The results we obtained from noise measurements showed that all patients were affected with both sensorial monotony and sensorial overstimulation. Overstimulation results from sudden and unexpected noise (for example due to emergency admissions) on an intensive care unit. The analysis of the illumination intensity showed a day and night turn; that means, the patient was able to distinguish between daytime and nighttime but due to missing bearings no further temporal orientation was possible. The filmings demonstrated that there were numerous contacts between the patient and his environment which, however, did not last longer than 105 s on an average. These findings refer to the problem of the patient's social isolation; others show the loss of sleeping and resting stages. So the "resting stages", that means stages without visible contact, last between 1-3 min. In the light of the results, psychopathological disturbances in the patients of this intensive care unit are connected with the situational conditions of the unit. Suggestions concerning the removal of situational load-factors are deducible from these findings.