[Psychological stress factors in intensive care]

In three intensive care units we looked into the question whether there are environmental situations somewhat equally stressful for the patients using 52 stress items designed by ourselves for the study. The patients had to place the various items in a sequence of increasing annoyance just one day after discharge from the intensive care unit. The most annoying factor for all patients, almost independent of sex and diagnosis, was the item "lack of information and communication". The item "noise and unrest caused by the daily routine and the nursing staff of the intensive care unit" was put in the first place by patients aged more than 50 years. Helplessness and physical impairment are the most annoying factors reported by the ventilated patients. The item "dependence on technical devices" (e.g. ventilators, dialyzer etc.) was surprisingly quoted low by our patients. We conclude that a human orientated intensive care medicine approach should be developed. Further investigations concerning psychical care and help should be performed.