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Wang R, Wang L, Liu T, Peng C. Effects of menthol on thirst during surgery patients fasting: A systematic review and meta-analysis of randomized controlled studies. Int J Nurs Pract 2024; 30:e13191. [PMID: 37582491 DOI: 10.1111/ijn.13191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 07/13/2023] [Accepted: 07/28/2023] [Indexed: 08/17/2023]
Abstract
AIMS We aim to analyse the effect of menthol on thirst intensity and thirst comfort in surgical patients. BACKGROUND Menthol has achieved good results in quenching thirst in patients in intensive care units, but its safety and reliability in perioperative fasting patients are unknown. DESIGN A systematic review with meta-analysis of intervention studies was performed. DATA SOURCES We used Chinese and English databases from their dates of inception to May 2022. Literature was retrieved from PubMed, Web of Science, Cochrane Library, Embase, CINHAL, SinoMed, CNKI, Wanfang and VIP database. REVIEW METHODS Two reviewers independently examined the records according to the eligibility criteria and extracted the data of each included study. RESULTS A total of seven studies were identified in this review, which included 537 surgical patients. Overall, menthol reduced thirst intensity in surgical patients and decreased thirst discomfort. Further subgroup analysis revealed that the menthol intervention significantly improved thirst intensity in surgical patients during preoperative and postoperative fasting periods. The Egger's tests showed no significant bias (p = 0.113 and 0.553, thirst intensity and thirst discomfort, respectively). CONCLUSION Menthol intervention effectively improved thirst intensity and thirst discomfort during fasting in surgical patients, but more large-scale, multicentre randomized controlled trials are required to confirm these findings further.
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Affiliation(s)
- Ran Wang
- Department of Anesthesia and Surgery, Xuanwu Hospital of Capital Medical University, Beijing, People's Republic of China
| | - Lin Wang
- Department of Anesthesia and Surgery, Xuanwu Hospital of Capital Medical University, Beijing, People's Republic of China
| | - Ting Liu
- Department of Anesthesia and Surgery, Xuanwu Hospital of Capital Medical University, Beijing, People's Republic of China
| | - Cao Peng
- Department of Anesthesia and Surgery, Xuanwu Hospital of Capital Medical University, Beijing, People's Republic of China
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Gungor S, Tosun B, Candir G, Ozen N. Effects of cold spray on thirst, frequency of oral care, and pain of general surgery intensive care unit patients. Sci Rep 2024; 14:9997. [PMID: 38693271 PMCID: PMC11063212 DOI: 10.1038/s41598-024-58199-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 03/26/2024] [Indexed: 05/03/2024] Open
Abstract
This study aims to investigate the effects of intraoral cold water spray on thirst, frequency of oral care and postoperative period pain at surgical incision site in patients having abdominal surgery. The study was carried out as a randomized controlled trial, registered under Clinical Trial Number: NCT05940818. The study involved 110 participants, divided equally into two groups (n = 55): the experimental group and the control group. Data were collected using patient information form, NRS, Intensive Care Oral Care Frequency Assessment Scale (ICOCFAS) and Visual Analog Scale (VAS). The severity of thirst at 1st, 8th, 16th h of post-operative period (p < 0.01) and the frequency of oral care application at 16th h were statistically significantly decreased in the experimental group when compared to the control group (p < 0.01).There wasn't statistically significant difference between the patients in the experimental and control groups in terms of pain at surgical incision site (p > 0.05). The patient's thirst and need for frequent oral care in the postoperative period were reduced by the application of a cold water spray. In patients undergoing abdominal surgery, the use of cold water spray application may be recommended to reduce thirst and the need for frequency of oral care application.
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Affiliation(s)
- Serap Gungor
- Kahramanmaras Sutcu Imam University, Vocational School of Health Services, Kahramanmaras, Turkey.
| | - Betul Tosun
- Hacettepe University, Faculty of Nursing, Ankara, Turkey
| | - Gozde Candir
- Adana City Education and Research Hospital, General Surgery İntensive Care, Adana, Turkey
| | - Nurten Ozen
- Demiroglu Bilim University, Florence Nightingale Hospital School of Nursing, Department of English Nursing, İstanbul, Turkey
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Lian R, Zhou S, Guo Y, Liang H, Lin J, Li D, Wu W, Rao Y, Shao D, Zheng P, Yang X. The effect of ice-cold water spray following the model for symptom management on postoperative thirst in patients admitted to intensive care unit: A randomized controlled study. Intensive Crit Care Nurs 2024; 81:103571. [PMID: 38211420 DOI: 10.1016/j.iccn.2023.103571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 09/24/2023] [Accepted: 10/22/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND Postoperative thirst is common in patients admitted to the intensive care unit. Existing methods like wet cotton swabs or oral care prove ineffectual or operationally intricate. Currently, an efficacious postoperative thirst alleviation method remains elusive. Exploring a prompt, safe, and efficacious solution is of paramount importance. OBJECTIVE To assess the effect of ice-cold water spray applied following a symptom management model on postoperative thirst and to establish a framework for mitigating thirst in intensive care unit patients. RESEARCH DESIGN Single-center randomized controlled study. SETTING Surgical intensive care unit in a university-affiliated hospital. MAIN OUTCOME MEASURES 56 intensive care unit patients were selected and equally randomized. The experimental group received ice-cold water spray in conjunction with eight symptom management strategies, while the control group underwent standard care involving wet cotton swabs. Thirst intervention was initiated 0.5 hours after postoperative extubation, followed by subsequent interventions at 2-hour, 4-hour, and 6-hour intervals post-extubation. Thirst intensity, oral comfort, and the duration of relief from thirst were assessed and compared between groups before and 0.5 hours after each thirst intervention. RESULTS Across different interventions, the experimental group exhibited superior scores in thirst intensity and oral comfort compared to the control group. Additionally, the nursing time required to alleviate thirst in the experimental group was significantly shorter than that in the control group (P < 0.01). CONCLUSION Ice-cold water spray following the model for symptom management can effectively mitigate the postoperative thirst intensity in intensive care unit patients, improve oral comfort, and reduce the nursing time for relieving thirst. IMPLICATIONS FOR CLINICAL PRACTICE Clinical nurses can employ ice-cold water spray following the model for symptom management to ameliorate postoperative thirst intensity in ICU patients while enhancing oral comfort. Furthermore, the utilization of ice-cold water spray can reduce the nursing time required for relieving postoperative thirst in intensive care unit patients.
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Affiliation(s)
- Rongli Lian
- Intensive Care Unit, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong Province 519000, China
| | - Song Zhou
- Intensive Care Unit, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong Province 519000, China
| | - Yuan Guo
- Emergency Care Unit, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong Province 519000, China
| | - Haiyan Liang
- Intensive Care Unit, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong Province 519000, China
| | - Jing Lin
- Intensive Care Unit, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong Province 519000, China
| | - Dongni Li
- Intensive Care Unit, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong Province 519000, China
| | - Wenping Wu
- Intensive Care Unit, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong Province 519000, China
| | - Yuan Rao
- Intensive Care Unit, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong Province 519000, China
| | - Daxing Shao
- Intensive Care Unit, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong Province 519000, China
| | - Peici Zheng
- Intensive Care Unit, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong Province 519000, China
| | - Xiaoyue Yang
- Department of Nursing, The Fifth Affiliated Hospital of Sun Yat-Sen University, No.52, Meihua East Road, Xiangzhou District, Zhuhai, Guangdong Province 519000, China.
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Picó-Munyoz R, Tárrega A, Laguna L. Origins of thirstiness sensation and current food solutions. Compr Rev Food Sci Food Saf 2023; 22:4433-4450. [PMID: 37583300 DOI: 10.1111/1541-4337.13229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 06/15/2023] [Accepted: 08/01/2023] [Indexed: 08/17/2023]
Abstract
The sensation of thirstiness is the desire to drink water. In certain situations, the ingestion of liquid water can be restricted. As a result, thirstiness is not relieved, resulting in an uncomfortable and distressing situation. The present review describes thirstiness and hydration, the food products and beverages that cause thirstiness, and the beverages and food products currently available to quench thirstiness in individuals with restricted access to liquid ingestion. It also discusses how to measure the effectiveness of calming thirstiness. To diminish thirstiness distress, different alternatives to liquids are proposed. Individuals with swallowing disorders are given thickened water, individuals with restricted water ingestion are given ice cubes or ice popsicles of different flavors, and sportspeople are given energy gels. However, current beverage solutions seem not to relieve thirst fully, although some stimuli like iced water, flavors (especially lemon and mint), or acids seem to work better than plain stimuli and could be added to existing products. Therefore, there is still a need to incorporate these strategies into beverage and food formulations and to test their effectiveness.
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Affiliation(s)
- Ruth Picó-Munyoz
- Consumer Perception and Behavior and Adapted Nutrition Laboratory, Institute of Agrochemistry and Food Technology (IATA, CSIC), Paterna, Spain
| | - Amparo Tárrega
- Consumer Perception and Behavior and Adapted Nutrition Laboratory, Institute of Agrochemistry and Food Technology (IATA, CSIC), Paterna, Spain
| | - Laura Laguna
- Consumer Perception and Behavior and Adapted Nutrition Laboratory, Institute of Agrochemistry and Food Technology (IATA, CSIC), Paterna, Spain
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Saltnes-Lillegård C, Rustøen T, Beitland S, Puntillo K, Hagen M, Lerdal A, Hofsø K. Self-reported symptoms experienced by intensive care unit patients: a prospective observational multicenter study. Intensive Care Med 2023; 49:1370-1382. [PMID: 37812229 PMCID: PMC10622338 DOI: 10.1007/s00134-023-07219-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/30/2023] [Indexed: 10/10/2023]
Abstract
PURPOSE The purpose of this study is to describe the prevalence, intensity and distress of five symptoms in intensive care unit (ICU) patients and to investigate possible predictive factors associated with symptom intensity. METHODS This is a prospective cohort study of ICU patients. A symptom questionnaire (i.e., Patient Symptom Survey) was used to describe the prevalence, intensity and distress of pain, thirst, anxiousness, tiredness, and shortness of breath over seven ICU days. Associations between symptom intensity and possible predictive factors were assessed using the general estimating equation (GEE) model. RESULTS Out of 603 eligible patients, 353 (Sample 2) were included in the present study. On the first ICU day, 195 patients (Sample 1) reported thirst as the most prevalent symptom (66%), with the highest mean intensity score (6.13, 95% confidence interval (CI) [5.7-6.56]). Thirst was the most prevalent (64%) and most intense (mean score 6.05, 95%CI [5.81-6.3]) symptom during seven days in the ICU. Anxiousness was the most distressful (mean score 5.24, 95%CI [4.32-6.15]) symptom on the first day and during seven days (mean score 5.46, 95%CI [4.95-5.98]). During seven days, analgesic administration and sepsis diagnosis were associated with increased thirst intensity. Older age and being mechanically ventilated were associated with decreased pain intensity, and analgesic administration was associated with increased pain intensity. Family visits and female gender were associated with increased intensity of anxiousness and shortness of breath, respectively. CONCLUSIONS Self-reporting ICU patients experienced a high and consistent symptom burden across seven days. Certain variables were associated with the degree of symptom intensity, but further research is required to better understand these associations.
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Affiliation(s)
- Christin Saltnes-Lillegård
- Department of Postoperative and Intensive Care Nursing, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
- Department of Public Health Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Tone Rustøen
- Department of Public Health Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Sigrid Beitland
- Specialised Health Care Services, Quality and Clinical Pathways, Norwegian Directorate of Health, Oslo, Norway
| | - Kathleen Puntillo
- Department of Physiological Nursing, School of Nursing, University of California San Francisco, San Francisco, CA, USA
| | - Milada Hagen
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
- Department of Public Health, Oslo Metropolitan University, Oslo, Norway
| | - Anners Lerdal
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Research Department, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Kristin Hofsø
- Department of Postoperative and Intensive Care Nursing, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
- Lovisenberg Diaconal University College, Oslo, Norway
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Phelan C, Hammond L, Thorpe C, Allcroft P, O'Loughlin M. A Novel Approach to Managing Thirst and Dry Mouth in Palliative Care: A Prospective Randomized Cross-Over Trial. J Pain Symptom Manage 2023; 66:587-594.e2. [PMID: 37562697 DOI: 10.1016/j.jpainsymman.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/30/2023] [Accepted: 08/03/2023] [Indexed: 08/12/2023]
Abstract
CONTEXT Thirst and xerostomia are significant and highly distressing symptoms experienced by patients receiving palliative and end-of-life care. OBJECTIVES Determine a reduction of thirst intensity and perceptions of dry mouth on a numerical scale following both the experimental intervention (mini mint ice cubes) and control (plain ice chips). METHODS Cross-over Randomized Controlled Trial (RCT) to assess the effectiveness of novel intervention in the treatment of dry mouth and the sensation of thirst in palliative care patients. RESULTS Patients rated the severity of their symptoms of dry mouth and thirst using a numeric rating scale (NRS). On commencing the study and preintervention, all patients suffered severe dry mouth and thirst (≥5/10). Mint and plain ice cubes produced improvement of symptoms immediately after interventions. Results from dry mouth ratings show, a decrease of 1.6 points for plain ice cubes (P < 0.0001), on average, ratings for mint ice cubes decreased 3.7 (P < 0.0001). For the sensation of thirst, the plain ice cube intervention group rating decreased 1.7 points (P < 0.006), ratings for mint ice cubes decreased 3.4 points (P < 0.0001). The average decrease in dry mouth and thirst intensity scores from preintervention to postintervention were significantly greater for mint ice cubes (P < 0.05) and 86.6% of patients preferred mint ice cubes. CONCLUSION This trial found that while usual mouth care and the intervention were both able to reduce the intensity of dry mouth and the sensation of thirst, the mint intervention had a greater response.
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Affiliation(s)
- Caroline Phelan
- Research Centre for Palliative Care (C.P., L.H., C.T., P.A., M.O.), Death and Dying, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia.
| | - Lauren Hammond
- Research Centre for Palliative Care (C.P., L.H., C.T., P.A., M.O.), Death and Dying, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia
| | - Courtney Thorpe
- Research Centre for Palliative Care (C.P., L.H., C.T., P.A., M.O.), Death and Dying, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia
| | - Peter Allcroft
- Research Centre for Palliative Care (C.P., L.H., C.T., P.A., M.O.), Death and Dying, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia; Southern Adelaide Local Health Network (P.A., M.O.), Southern Adelaide Palliative Services, Bedford Park, Australia
| | - Muireann O'Loughlin
- Research Centre for Palliative Care (C.P., L.H., C.T., P.A., M.O.), Death and Dying, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia; Southern Adelaide Local Health Network (P.A., M.O.), Southern Adelaide Palliative Services, Bedford Park, Australia
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7
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Chung J, Tjia J, Zhang N, O'Connor BT. Anticholinergic Burden and Xerostomia in Critical Care Settings. Dimens Crit Care Nurs 2023; 42:310-318. [PMID: 37756502 DOI: 10.1097/dcc.0000000000000606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Although previous studies have established the association of medications with anticholinergic adverse effects and xerostomia, anticholinergic burden and xerostomia in critical care settings are poorly characterized. The objective of this study was to determine the impact of medication burdens associated with anticholinergic adverse effects, particularly the occurrence of xerostomia (dry mouth) in a critical care setting. In addition, this study explored the correlation between the timing of the first instance of xerostomia and the administration timing of medication known to have anticholinergic adverse effects. METHODS A retrospective case-control study was used with the MIMIC (Medical Information Mart for Intensive Care) III database. The MIMIC-III clinical database is a publicly available, deidentified, health-related database with more than 40 000 patients in critical care units from 2001 to 2012. Cases of xerostomia (n = 1344) were selected from clinical notes reporting "dry mouth," "xerostomia," or evidence of pharmacological treatment for xerostomia; control (n = 4032) was selected using the propensity analysis with 1:3 matching on covariates (eg, age, sex, race, ethnicity, and length of stay). The anticholinergic burden was quantified as the cumulative effect of anticholinergic activities using the Anticholinergic Burden Scale. RESULTS Anticholinergic burden significantly differed between xerostomia patients and control subjects (P = .04). The length of stay was a statistically significant factor in xerostomia. The probability of developing the symptom of xerostomia within 24 hours was .95 (95%) for patients of xerostomia. CONCLUSIONS Anticholinergic Burden Scale is associated with xerostomia in the critical care setting, particularly within 24 hours after admission. It is crucial to carefully evaluate alternative options for medications that may have potential anticholinergic adverse effects. This evaluation should include assessing the balance between the benefits and harms, considering the probability of withdrawal reactions, and prioritizing deprescribing whenever feasible within the initial 24-hour period.
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Hammond L, Chakraborty A, Thorpe C, O'Loughlin M, Allcroft P, Phelan C. Relieving Perception of Thirst and Xerostomia in Patients with Palliative and End-of-life Care Needs: A Rapid Review. J Pain Symptom Manage 2023; 66:e45-e68. [PMID: 36828290 DOI: 10.1016/j.jpainsymman.2023.02.315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 02/12/2023] [Accepted: 02/15/2023] [Indexed: 02/24/2023]
Abstract
CONTEXT Thirst and dry mouth are interlinked symptoms that frequently cause significant distress for patients with life-limiting conditions. OBJECTIVES The objective of this rapid review was to identify and synthesize effective interventions that relieve perceptions of thirst and dry mouth of patients with palliative care and end-of-life care needs. METHODS Eligible studies were undertaken in clinical settings, with patients experiencing thirst-related distress and/or dry mouth. This review of peer-reviewed literature was conducted following aspects of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. The main outcomes of interest were: 1) efficacy of thirst and dry mouth interventions for patient, and 2) patient, caregiver, and staff acceptability and satisfaction of the interventions. Scientific journal articles were retrieved through searches in electronic databases of MEDLINE (Ovid), CINAHL (EBSCO), and AgeLine (EBSCO). RESULTS Eleven studies were included for analysis and synthesis of the results. Most studies either focused on a dry mouth intervention or reported dry mouth outcomes within a broader thirst intervention (n = 9/11 studies). Standard oral care was the common intervention type (n = 5/11). All but one dry mouth intervention reported statistical improvement in outcomes of interest. All studies that reported on thirst were conducted in an Intensive Care Unit (ICU) setting (n = 4/4). No studies specifically addressed thirst in patients in specialist palliative care settings. CONCLUSION Evidence from this review suggests that thirst interventions established within the ICU setting may prove effective for treatment of terminally ill patients receiving specialist palliative care.
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Affiliation(s)
- Lauren Hammond
- Research Centre for Palliative Care, Death and Dying, College of Nursing and Health Sciences, Flinders University (L.H., A.C., C.T., M.O., P.A., C.P.), Bedford Park, South Australia
| | - Amal Chakraborty
- Research Centre for Palliative Care, Death and Dying, College of Nursing and Health Sciences, Flinders University (L.H., A.C., C.T., M.O., P.A., C.P.), Bedford Park, South Australia
| | - Courtney Thorpe
- Research Centre for Palliative Care, Death and Dying, College of Nursing and Health Sciences, Flinders University (L.H., A.C., C.T., M.O., P.A., C.P.), Bedford Park, South Australia
| | - Muireann O'Loughlin
- Research Centre for Palliative Care, Death and Dying, College of Nursing and Health Sciences, Flinders University (L.H., A.C., C.T., M.O., P.A., C.P.), Bedford Park, South Australia; Southern Adelaide Local Health Network, Southern Adelaide Palliative Services (M.O., P.A.), Bedford Park, South Australia
| | - Peter Allcroft
- Research Centre for Palliative Care, Death and Dying, College of Nursing and Health Sciences, Flinders University (L.H., A.C., C.T., M.O., P.A., C.P.), Bedford Park, South Australia; Southern Adelaide Local Health Network, Southern Adelaide Palliative Services (M.O., P.A.), Bedford Park, South Australia
| | - Caroline Phelan
- Research Centre for Palliative Care, Death and Dying, College of Nursing and Health Sciences, Flinders University (L.H., A.C., C.T., M.O., P.A., C.P.), Bedford Park, South Australia.
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Çiftçi B, Yıldız GN, Avşar G, Köse S, Aydın E, Doğan S, Çelik Ş. Development of the Thirst Discomfort Scale: A Validity and Reliability Study. Am J Crit Care 2023; 32:176-183. [PMID: 37121897 DOI: 10.4037/ajcc2023954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND Thirst is a sensation associated with a dry mouth and the desire or craving to drink water. Surgical patients are among those hospitalized individuals who are at high risk of developing both osmotic and hypovolemic thirst. OBJECTIVES To develop a new measurement tool for evaluating the thirst-related discomfort of surgical patients and to assess its validity and reliability. METHODS The study population consisted of patients admitted to the surgical clinics of a research hospital in Turkey between January and March 2022. The new measurement tool was developed in several stages: a pilot implementation phase with 51 patients and the main implementation phase with 198 patients. Data were collected by means of face-to-face interviews with patients. Exploratory factor and confirmatory factor analyses were performed using IBM SPSS Statistics, version 22, and IBM SPSS Amos. RESULTS The final Thirst Discomfort Scale consisted of 12 items in 3 subdimensions. The Cronbach α values of the scale subdimensions ranged from 0.787 to 0.848, and the Cronbach α value for the scale as a whole was 0.886. The scale explained 66.237% of the total variance of the data. CONCLUSION The Thirst Discomfort Scale consisting of 12 items and 3 subdimensions is a valid and reliable measurement tool for evaluating thirst-related discomfort of surgical patients.
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Affiliation(s)
- Bahar Çiftçi
- Bahar Çiftçi is an assistant professor, Department of Fundamentals of Nursing, Atatürk University, Atateknokent, Erzurum, Turkey
| | - Güzel Nur Yıldız
- Güzel Nur Yıldız is an instructor, Department of Dialysis, Muş Alparslan University, Muş, Turkey
| | - Gülçin Avşar
- Gülçin Avşar is an associate professor, Department of Fundamentals of Nursing, Atatürk University, Atateknokent, Erzurum, Turkey
| | - Sema Köse
- Sema Köse is an instructor, Department of Nursing, Erzincan Binali Yıldırım University, Erzincan, Turkey
| | - Esra Aydın
- Esra Aydın is an instructor, Department of Dialysis, Gümüşhane University, Gümüşhane, Turkey
| | - Sevgi Doğan
- Sevgi Doğan is a research assistant, Department of Fundamentals of Nursing, Atatürk University, Erzurum, Turkey
| | - Şeymanur Çelik
- Şeymanur Çelik is a research assistant, Department of Fundamentals of Nursing, Atatürk University, Erzurum, Turkey
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Ma F, He H, Xu B, Zhou J, Pu K. Effect of sterile ice water versus menthol spray on thirst symptoms of fasted children in the intensive care unit: A prospective cohort study. Medicine (Baltimore) 2023; 102:e33315. [PMID: 36961147 PMCID: PMC10036011 DOI: 10.1097/md.0000000000033315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 02/27/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Thirst is a very common symptom in fasted children in intensive care unit (ICU). This study aimed to evaluate the effect of sterile ice water versus menthol spray in ICU fasted children, to provide insights to the clinical care of fasted children. METHODS The children admitted to the ICU of our hospital from June 1, 2021 to August 31, 2022 and needed to fast were included. Children were randomly assigned to the ice water group or menthol group. We evaluated and compared the thirst distress scale (TDS), oral mucosa wetness scale (OMWS), children medical fear scale (CMFS), numerical rating scale (NRS), unstimulated whole saliva (UWS) flow rate between 2 groups. RESULTS A total of 139 children were included, involving 69 children in ice water group and 70 children in menthol group. There were no significant differences in the baseline characteristics, TDS, OMWS, OMWS, CMFS, and NRS score, UWS flow rate before intervention between ice water group and menthol group (all P > .05). After intervention, the TDS, OMWS, NRS score of menthol group was statistically less than that of ice water group (all P < .05), the UWS flow rate of menthol group was statistically higher than that of ice water group (P = .034). CONCLUSIONS Compared with ice water spray, menthol spray may be more beneficial to relieve the thirst and increase the comfort in ICU fasted children. Future studies with larger sample size and rigorous design are needed to evaluate the effects and safety of ice water and menthol spray in the nursing care of children.
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Affiliation(s)
- Fangyan Ma
- Department of Cardiothoracic Surgery, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Haiting He
- Department of Cardiothoracic Surgery, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Banghong Xu
- Department of Cardiothoracic Surgery, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Jing Zhou
- Department of Nursing, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Kai Pu
- Department of Nursing, Children’s Hospital of Nanjing Medical University, Nanjing, China
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Kim Y, Ku HM, Jun MK. Knowledge Evaluation of Oral Diseases and Perception of Cooperation with Dental Experts for Oral Care of Nurses in Intensive Care Units in Korea: A Preliminary Study. NURSING REPORTS 2023; 13:528-538. [PMID: 36976700 PMCID: PMC10051949 DOI: 10.3390/nursrep13010048] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/12/2023] [Accepted: 03/16/2023] [Indexed: 03/29/2023] Open
Abstract
The aim of this study was to identify the status of education and knowledge concerning oral diseases for oral care as they relate to intensive care unit (ICU) nurses, as well as to investigate the perception of oral care education and practice, as led by dental experts. This study conducted a self-report survey consisting of 33 questions on education and knowledge about oral diseases, as well as perception of dental expert-led education and practice, targeting 240 nurses in the ICU. Finally, 227 questionnaires were analyzed, and 75.3% of the participants were staff nurses, and 41.4% were in the medical ICU. In the area of education and knowledge of major oral diseases, more than 50% of the respondents treating gingivitis, periodontitis, and dental caries did not complete dental education, and it was found that more than half of the respondents were unable to distinguish diseases of the mouth. It was recognized that more than half of nurses required dental expert-led education and practice. In this study, the education and knowledge of oral diseases of ICU nurses were found to be insufficient, and the need for the cooperation of dental experts was high. Therefore, collaboration to improve oral care practical guidelines for realistically applicable ICU patients will be needed.
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Affiliation(s)
- Yesel Kim
- Department of Dental Hygiene, Jeonju Kijeon College, Jeonju 54989, Republic of Korea
| | - Hye-Min Ku
- Department of Preventive Dentistry & Public Oral Health, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul 03722, Republic of Korea
| | - Mi-Kyoung Jun
- Department of Dental Hygiene, Dongnam Health University, Suwon 16328, Republic of Korea
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Wiriyakijja P, Niklander S, Santos-Silva AR, Shorrer MK, Simms ML, Villa A, Sankar V, Kerr AR, Riordain RN, Jensen SB, Delli K. World Workshop on Oral Medicine VIII: Development of a Core Outcome Set for Dry Mouth: A Systematic Review of Outcome Domains for Xerostomia. Oral Surg Oral Med Oral Pathol Oral Radiol 2023:S2212-4403(23)00068-8. [PMID: 37198047 DOI: 10.1016/j.oooo.2023.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/11/2022] [Accepted: 01/25/2023] [Indexed: 03/08/2023]
Abstract
OBJECTIVE The purpose of this study was to identify all outcome domains used in clinical studies of xerostomia, that is, subjective sensation of dry mouth. This study is part of the extended project "World Workshop on Oral Medicine Outcomes Initiative for the Direction of Research" to develop a core outcome set for dry mouth. STUDY DESIGN A systematic review was performed on MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials databases. All clinical and observational studies that assessed xerostomia in human participants from 2001 to 2021 were included. Information on outcome domains was extracted and mapped to the Core Outcome Measures in Effectiveness Trials taxonomy. Corresponding outcome measures were summarized. RESULTS From a total of 34,922 records retrieved, 688 articles involving 122,151 persons with xerostomia were included. There were 16 unique outcome domains and 166 outcome measures extracted. None of these domains or measures were consistently used across all the studies. The severity of xerostomia and physical functioning were the 2 most frequently assessed domains. CONCLUSION There is considerable heterogeneity in outcome domains and measures reported in clinical studies of xerostomia. This highlights the need for harmonization of dry mouth assessment to enhance comparability across studies and facilitate the synthesis of robust evidence for managing patients with xerostomia.
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Effect of menthol lozenges after extubation on thirst, nausea, physiological parameters, and comfort in cardiovascular surgery patients: A randomized controlled trial. Intensive Crit Care Nurs 2023; 76:103415. [PMID: 36812765 DOI: 10.1016/j.iccn.2023.103415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/30/2023] [Accepted: 02/04/2023] [Indexed: 02/22/2023]
Abstract
OBJECTIVES To determine the effect of post-extubation oral menthol lozenges on thirst, nausea, physiological parameters, and comfort level in patients undergoing cardiovascular surgery. RESEARCH METHODOLOGY/DESIGN The study was a single-centre, randomized controlled trial. SETTING This study included 119 patients undergoing coronary artery bypass graft surgery in a training and research hospital. Patients in the intervention group (n = 59) received menthol lozenges at 30, 60, and 90 min after extubation. Patients in the control group (n = 60) received standard care and treatment. MAIN OUTCOME MEASURES The primary outcome of the study was the change in post-extubation thirst assessed by Visual Analogue Scale after using menthol lozenges compared to baseline. Secondary outcomes were changes in post-extubation physiological parameters and nausea severity assessed by Visual Analogue Scale compared to baseline, and comfort level assessed with Shortened General Comfort Questionnaire. RESULTS Between-group comparisons showed that the intervention group had significantly lower thirst scores at all time points and nausea at the first assessment (p < 0.05) and significantly higher comfort scores (p < 0.05) than the control group. There were no significant differences between the groups in physiological parameters at baseline or any of the postoperative assessments (p > 0.05). CONCLUSION In patients undergoing coronary artery bypass graft surgery, the use of menthol lozenges effectively increased comfort level by reducing post-extubation thirst and nausea, but had no effect on physiological parameters. IMPLICATIONS FOR CLINICAL PRACTICE Nurses should be vigilant for complaints such as thirst, nausea, and discomfort in patients after extubation. Nurses' administration of menthol lozenges to patients may help reduce post-extubation thirst, nausea, and discomfort.
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Study on the Efficacy and Safety of Oral Care in ICU Patients Based on Meta-Analysis. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:5337181. [PMID: 36277596 PMCID: PMC9568354 DOI: 10.1155/2022/5337181] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 09/14/2022] [Accepted: 09/23/2022] [Indexed: 01/26/2023]
Abstract
The effectiveness and safety of oral care in Intensive Care Unit (ICU) patients by meta-analysis are explored. According to the research direction of the effectiveness and safety of oral nursing in ICU patients, the corresponding literature studies are retrieved in literature databases and meta-analysis is performed. A total of 17 Chinese and English literature studies are included, and the literature has no obvious publication bias. The experimental results show that the improvement effect of dry mouth and halitosis in the improved group is significantly higher than that in the traditional group, and the dry mouth score, plaque index, and complications such as oral mucosa infection, oral mucosa damage, and halitosis are significantly reduced in the improved group, and the differences are statistically significant (P < 0.05). Improved oral care can significantly improve the symptoms of dry mouth and halitosis in ICU patients, quickly remove dental plaque and effectively reduce the incidence of complications such as halitosis, oral mucosal infection, and oral mucosal damage. Improved oral care is an effective and safe ICU nursing program.
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15
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Halm MA. Managing Thirst in the Critically Ill. Am J Crit Care 2022; 31:161-165. [PMID: 35229147 DOI: 10.4037/ajcc2022475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Margo A. Halm
- Margo A. Halm is associate chief nurse executive, nursing research and evidence-based practice, VA Portland HealthCare System, Portland, Oregon
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Effects of a spray-based oropharyngeal moisturising programme for patients following endotracheal extubation after cardiac surgery: A randomised, controlled three-arm trial. Int J Nurs Stud 2022; 130:104214. [DOI: 10.1016/j.ijnurstu.2022.104214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 01/18/2023]
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Zhang W, Gu Q, Gu Y, Zhao Y, Zhu L. Symptom management to alleviate thirst and dry mouth in critically ill patients: A randomised controlled trial. Aust Crit Care 2022; 35:123-129. [PMID: 34119409 DOI: 10.1016/j.aucc.2021.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 03/22/2021] [Accepted: 04/17/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Critically ill patients often experience coexisting symptoms. Thirst, in particular, appears to be an important symptom, having the highest prevalence, intensity, and induction of distress, and is significantly correlated with other symptoms. However, thirst and dry mouth are not usually assessed or treated. OBJECTIVES The aim of the study was to demonstrate the effectiveness of an intervention bundle to relieve thirst and dry mouth. METHODS The present study was a randomised controlled trial in which critically ill patients were allocated to an experimental or control group. The intervention bundles, including vitamin C sprays, peppermint water mouthwash, and a lip moisturiser, were provided to the experimental group for 3 days, whereas patients in the control group were exposed to the placebo interventions, including saline sprays, 40 °C water mouthwash, and wetting the lips with water. RESULTS A total of 61 patients were recruited to the study; 65.6% (n = 41) were men, and the average age was 64.2 ± 16.8 years. The average decrease in thirst intensity and oral mucosa situation scores after the interventions was larger in the experimental group patients relative to controls (1.27 and 0.36 vs. 0.19 and 0.1 points, respectively; p < 0.05). Being male, scoring highly on the Acute Physiology and Chronic Health Evaluation II scale, not receiving diuretics, and having higher serum sodium levels were potential predictors of thirst and oral dryness. CONCLUSIONS The interventional bundle used in this study was shown to be a promising approach that can relieve thirst intensity and dry mouth, which are pervasively distressful to critically ill patients. CLINICAL TRIAL REGISTRATION NUMBERS The study was registered on the www.Chictr.org.cn under the identification number ChiCTR1900022873.
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Affiliation(s)
- Weiqing Zhang
- Department of Critical Care Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiuying Gu
- Department of Critical Care Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Yanting Gu
- Department of Critical Care Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yujin Zhao
- Department of Critical Care Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lin Zhu
- Department of Critical Care Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Thirst Interventions in Adult Acute Care-What Are the Recommended Management Options and How Effective Are They?: A Systematic Review. Dimens Crit Care Nurs 2022; 41:91-102. [PMID: 35099156 DOI: 10.1097/dcc.0000000000000511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE The aim of this study was to review the scope and quality of evidence for thirst treatment in adult acute care. METHODS A systematic review was completed by 2 independent reviewers using MEDLINE, PubMed, BNI, EMBASE, EMCARE, and CINAHL databases and additional hand searching in June 2020. Interventions to relieve thirst for inpatients receiving acute care were included. Evidence was appraised against the levels of evidence for therapeutic studies, and a risk-of-bias assessment was completed for included studies. Outcomes are presented via narrative synthesis. Meta-analysis was planned. RESULTS Four studies (out of 844) were eligible reporting thirst outcomes from 611 critical care patients. Meta-analysis could not be completed because a priori criteria were not met. Two randomized controlled trials represented the highest level of evidence. Thirst assessment was completed via a self-reported scale in all reviewed works. Interventions included cold water sprays or swabs, menthol lip moisturizer, and use of humidification. Three works demonstrate reduced thirst scores; all interventions in these studies exploit cooling effects to the oropharynx with the aim of preabsorptive satiation of thirst. A humidified oxygen circuit showed a neutral response when compared with a nonhumidified circuit. CONCLUSIONS There is a limited but growing evidence base related to thirst treatment in the acute setting. Studies using a "bundle" of topical interventions incorporating cooling and menthol treatments showed positive effects in reducing symptom burden. Work to explore the scope of application for thirst treatment for patients unable to self-report, consideration of sustained effects, and a study of individual versus combined effects of bundle elements would be welcomed as the evidence base continues to develop.
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A qualitative study of nurses' perception on patients' thirst in intensive care units. Intensive Crit Care Nurs 2021; 69:103184. [PMID: 34893396 DOI: 10.1016/j.iccn.2021.103184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 11/20/2021] [Accepted: 11/22/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Thirst is a prevalent and intense symptom among patients in intensive care units. Occurrence of thirst in the intensive care unit cannot be avoided because of the nature of critical illnesses and their treatments like the side effects of administered medication or dehydration. In the intensive care unit, nurses have the opportunity and responsibility to prevent and reduce thirst by recognizing the different types of thirst. Thus, knowing nurses' perception on patients' thirst is crucial. OBJECTIVES Exploration of intensive care nurses' perception on patients' thirst. RESEARCH DESIGN A qualitative descriptive study. METHODS Data were collected from December 2020 to January 2021 and analyzed by using a phenomenographic methodology. Data were transcribed verbatim and thematic analysis was performed. RESULTS Sixteen nurses, in Chongqing, China, aged 25-48 years, were interviewed. Four themes emerged: (1) perceived barriers for thirst; (2) perceived signs of thirst; (3) perceived reasons of thirst; (4) perceived consequences for thirst. Overall nurses' perception of patients' thirst is poor. Nurses give a low priority and insufficient attention to the issue of thirst in intensive care patients. CONCLUSION Intensive care nurses' perception on thirst in patients should be evaluated and, if necessary, this issue should be given more attention in training in order to create sufficient awareness about the topic.
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20
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Negro A, Villa G, Greco M, Ciriolo E, Luraschi EL, Scaramuzzi J, Manara DF, Zangrillo A. Thirst in patients admitted to intensive care units: an observational study. Ir J Med Sci 2021; 191:2283-2289. [PMID: 34668107 PMCID: PMC8526093 DOI: 10.1007/s11845-021-02817-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 10/13/2021] [Indexed: 12/02/2022]
Abstract
Background Despite various studies reporting a high prevalence, reaching 71%, the sensation of thirst in intensive care unit (ICU) patients, its prevention, detection, and management, is not well known nor considered. Limited research has examined the causes of thirst in ICU patients, while it has been examined in other patient populations. Aim To determine the incidence and intensity of thirst in patients admitted to ICU and its association with airway devices (endotracheal tube, tracheostomy, oxygen mask), airway humidification, patients’ characteristics, and therapy (serum sodium concentration, hematocrit, fluid balance, possibility of oral hydration, and dosage of diuretics). Methods Patients were interviewed daily to report the presence of thirst and rate its intensity on a Numeric Rating Scale (NRS) from 0 (no thirst) –10 (intolerable thirst). Other data were obtained through direct evaluation or by consulting medical records. Patients admitted to three ICUs from May to August 2014 in a university hospital in Italy were included. Results A total of 220 Patients were enrolled. Thirst was found in 76.1% of patients’ observations, with a mean thirst score of 5.37. Thirst intensity was predicted by high doses of diuretics (> 100 mg/die), increasing serum sodium concentration, absence of oral hydration and the presence of xerostomia. Thirst was associated with the use of humidified Venturi mask. Conclusions Thirst is highly prevalent among patients in this population of intensive care patients. It would be desirable to evaluate this stressor at least daily, to eliminate or relieve this sensation.
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Affiliation(s)
| | - Giulia Villa
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, Via Olgettina, 58, 20132, Milan, Italy.
| | | | | | | | | | - Duilio Fiorenzo Manara
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, Via Olgettina, 58, 20132, Milan, Italy
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21
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Flim M, Hofhuis J, Spronk P, Jaarsma T. Measuring thirst distress of patients in the intensive care unit. Nurs Crit Care 2021; 27:576-582. [PMID: 34612559 DOI: 10.1111/nicc.12719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 08/17/2021] [Accepted: 09/15/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Thirst is one of the most intense and distressing symptoms experienced by patients in the intensive care unit (ICU), and no validated measurement tools exist. Validating a thirst measurement tool for the ICU population could be a first step in gaining a better understanding of thirst in ICU patients and aid the development and implementation of strategies regarding the prevention and control of thirst. AIM The objective of this study was to determine the validity and reliability of the "Thirst distress scale for patients with heart failure (TDS-HF)" in measuring thirst distress in adult ICU patients. METHODS Content validity was established by an expert panel consisting of ICU nurses, intensivists and five ICU patients. Concurrent validity, known-groups validity and internal consistency were determined in a consecutive sample of 56 awake and oriented ICU patients with a median age of 70 years (IQR: 57-74). RESULTS Content validity of the TDS-HF in the ICU population was low, with item-content validity indexes between 0.25 and 0.75. Concurrent validity was high as Spearman's correlation between TDS-HF and the numeric rating score (0-10) for thirst distress was 0.71. Internal consistency was high (Cronbach's alpha 0.78). When comparing groups, only higher blood urea nitrogen was significantly related to higher scores on the TDS-HF (P = .003). CONCLUSION The TDS-HF has high concurrent validity and reliability in measuring thirst distress in ICU patients. Nevertheless, questions remain regarding the applicability and content validity of the scale, which should be further explored before the TDS-HF can be used in the ICU. RELEVANCE FOR CLINICAL PRACTICE The TDS-HF can be used to explore thirst distress and to evaluate interventions. Individual items of the scale can be used to explore the nature of thirst distress in individual patients.
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Affiliation(s)
- Marleen Flim
- Department of Intensive Care Medicine, Gelre Hospitals, Apeldoorn, The Netherlands.,Expertise center for Intensive care Rehabilitation Apeldoorn, Apeldoorn, The Netherlands
| | - José Hofhuis
- Department of Intensive Care Medicine, Gelre Hospitals, Apeldoorn, The Netherlands.,Expertise center for Intensive care Rehabilitation Apeldoorn, Apeldoorn, The Netherlands
| | - Peter Spronk
- Department of Intensive Care Medicine, Gelre Hospitals, Apeldoorn, The Netherlands.,Expertise center for Intensive care Rehabilitation Apeldoorn, Apeldoorn, The Netherlands
| | - Tiny Jaarsma
- Utrecht University, Utrecht, The Netherlands.,Clinical Health Sciences, Nursing Sciences, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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22
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Assy Z, Bikker FJ, Picauly O, Brand HS. The association between oral dryness and use of dry-mouth interventions in Sjögren's syndrome patients. Clin Oral Investig 2021; 26:1465-1475. [PMID: 34374853 PMCID: PMC8816756 DOI: 10.1007/s00784-021-04120-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 07/30/2021] [Indexed: 12/20/2022]
Abstract
Objective Sjögren’s syndrome patients use different dry-mouth interventions for the relieve of their oral dryness. Recently, it was shown that patients with dry-mouth complaints have regional differences in perceived intra-oral dryness. Therefore, the aim of the present study was to investigate whether the use of dry-mouth interventions is related to the perceived regional oral dryness. Materials and methods A cross-sectional study was performed among Sjögren’s patients. Volunteers could anonymously administer various questionnaires, including the Regional Oral Dryness Inventory (RODI), Xerostomia Inventory (XI), Bother Index (BI) and a list of dry-mouth interventions. Results Sjögren’s syndrome patients use a wide variety for the relieve of oral dryness. “Drinking water’’ and “moistening the lips’’ were used most frequently. Dry-mouth interventions, “drinking water’’, “rinsing of the mouth”, and “drinking small volumes” had significant associations with the RODI-scores of the posterior palate, and anterior and posterior tongue, respectively. On the other hand, “using mouth gel’’ had a significant association with the RODI-scores of the inside cheeks. Conclusion Sjögren’s syndrome patients are more likely to use mouth gels when their inside cheeks were experienced as most dry, while they drank water, rinsed their mouth or drank small volumes if the posterior palate, and anterior and posterior tongue were considered as dry. It can be concluded that intra-oral dryness affects dry-mouth perception and thereby also the use of the various dry-mouth interventions. Clinical relevance The therapeutic choice of dry-mouth interventions by Sjögren’s syndrome patients seems to some extent to be related to dryness at specific intra-oral regions.
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Affiliation(s)
- Z Assy
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan, 3004, Amsterdam, 1081 LA, the Netherlands.
| | - F J Bikker
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan, 3004, Amsterdam, 1081 LA, the Netherlands
| | - O Picauly
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan, 3004, Amsterdam, 1081 LA, the Netherlands
| | - H S Brand
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan, 3004, Amsterdam, 1081 LA, the Netherlands
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Doi S, Nakanishi N, Kawahara Y, Nakayama S. Impact of oral care on thirst perception and dry mouth assessments in intensive care patients: An observational study. Intensive Crit Care Nurs 2021; 66:103073. [PMID: 34059413 DOI: 10.1016/j.iccn.2021.103073] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/06/2021] [Accepted: 04/09/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To investigate the impact of oral care on thirst perception and dry mouth assessments. RESEARCH DESIGN Single-centre observational study. SETTING Intensive care unit in a university hospital. MAIN OUTCOME We assessed thirst perception and dry mouth in adult patients before and after oral care. Thirst perception was assessed using a numerical rating scale and dry mouth was assessed using an oral moisture checking device and the modified Revised Oral Assessment Guide including tongue, mucous membranes and saliva. RESULTS Eighty-six patients were included. After oral care, thirst scores decreased by 1 (0 to 3, p < 0.01) and remained low only for one hour. Oral moisture was maintained at a normal level ≥ 27.0%, and mROAG was at a low level ≤ 4 before and after the oral care. The numerical rating score did not correlate with oral moisture (ρ = -0.01, p = 0.96) or the modified revised oral assessment guide (ρ = 0.09, p = 0.42). Among patients with thirst, 60 (70%) patients complained of thirst at the assessment timepoints, but only 17 (20%) patients complained independently. CONCLUSION Thirst perception was dissociated from dry mouth before and after oral care. Thirst must be frequently assessed and treated.
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Affiliation(s)
- Satoshi Doi
- Department of Nursing, Tokushima University Hospital, Tokushima, Japan
| | - Nobuto Nakanishi
- Emergency and Critical Care Medicine, Tokushima University Hospital, Tokushima, Japan; Department of Disaster and Emergency Medicine, Graduate School of Medicine, Kobe University, Japan.
| | - Yoshimi Kawahara
- Department of Nursing, Tokushima University Hospital, Tokushima, Japan
| | - Shizu Nakayama
- Department of Nursing, Tokushima University Hospital, Tokushima, Japan
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Lee CW, Liu ST, Cheng YJ, Chiu CT, Hsu YF, Chao A. Prevalence, risk factors, and optimized management of moderate-to-severe thirst in the post-anesthesia care unit. Sci Rep 2020; 10:16183. [PMID: 32999369 PMCID: PMC7527446 DOI: 10.1038/s41598-020-73235-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 09/12/2020] [Indexed: 11/12/2022] Open
Abstract
Post-operative thirst is common and may cause intense patient discomfort. The aims of this retrospective study conducted in a high-volume post-anesthesia care unit (PACU) were as follows: (1) to examine the prevalence of moderate-to-severe post-operative thirst—defined as a numerical rating scale (NRS) score of 4 or higher, (2) to identify the main risk factors for moderate-to-severe post-operative thirst, and (3) to maximize the efficacy and safety of thirst management through a quality improvement program. During a 1-month quality improvement program conducted in August 2018, a total of 1211 adult patients admitted to our PACU were examined. Moderate-to-severe thirst was identified in 675 cases (55.8%). The use of glycopyrrolate during anesthesia was associated with moderate-to-severe thirst (71.7% versus 66.4%, respectively, p = 0.047; adjusted odds ratio: 1.46, p = 0.013). Following a safety assessment, ice cubes, room temperature water, or an oral moisturizer were offered to patients. A generalized estimating equation model revealed that ice cubes were the most effective means for thirst management—resulting in an estimated thirst intensity reduction of 0.93 NRS points at each 15-min interval assessment (p < 0.001)—followed by room temperature water (− 0.92/time-point, p < 0.001) and the oral moisturizer (− 0.60/time-point; p < 0.001). Patient satisfaction (rated from 1 [definitely dissatisfied] to 5 [very satisfied]) followed a similar pattern (ice cubes: 4.22 ± 0.58; room temperature water: 4.08 ± 0.55; oral moisturizer: 3.90 ± 0.55, p < 0.001). The use of glycopyrrolate—an anticholinergic agent that reduces salivary secretion—was the main independent risk factor for moderate-to-severe post-operative thirst. Our findings may provide clues towards an optimized management of thirst in the immediate post-operative period.
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Affiliation(s)
- Chia-Wei Lee
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, 10002, Taiwan
| | - Shih-Ting Liu
- Department of Nursing, National Taiwan University Cancer Center, Taipei, 10672, Taiwan
| | - Ya-Jung Cheng
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, 10002, Taiwan
| | - Ching-Tang Chiu
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, 10002, Taiwan
| | - Yu-Fen Hsu
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, 10002, Taiwan
| | - Anne Chao
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, 10002, Taiwan.
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Abstract
With the major scale up of critical care services to respond to the increasing numbers of patients with severe COVID-19 infection, nurses need to be able to rapidly assess patients. While many patients present with signs of viral pneumonia and may develop respiratory failure, it is essential that the subsequent systemic complications are also recognized. Due to the unprecedented numbers of patients requiring critical care, many of them will initially have to be managed in emergency departments and acute wards until a critical care bed becomes available. In this article, the assessment of a patient with suspected or confirmed severe COVID-19 has been presented initially from a ward perspective, followed by that of critical care, using the Airway, Breathing, Circulation, Disability and Exposure (ABCDE) approach. This article has been specifically designed to enable nurses to systematically assess patients and prioritise care.
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Sugizaki CSDA, Braga CC, Freitas ATVDS, Peixoto MDRG. Transcultural adaptation of the Thirst Distress Scale (TDS) into Brazilian Portuguese and an analysis of the psychometric properties of the scale for patients on hemodialysis. J Bras Nefrol 2020; 42:153-162. [PMID: 32187260 PMCID: PMC7427644 DOI: 10.1590/2175-8239-jbn-2019-0151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 11/18/2019] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To produce a transcultural adaptation of the Thirst Distress Scale (TDS) into Brazilian Portuguese and analyze the scale's psychometric properties for patients on hemodialysis (HD). METHODS The original scale was translated, back translated, and discussed with psychometric assessment experts. The final version was tested with 126 patients on HD and retested with 70 individuals from the original patient population. Cronbach's alpha was used to measure the scale's internal consistency. Reliability of thirst intensity evaluated via the visual analogue scale (VAS) was tested with Kappa statistic and the Bland-Altman plot. Reproducibility was assessed based on the intraclass correlation coefficient (ICC). RESULTS The wording of three items and the verb tenses of six had to be adjusted in the final version of the Brazilian Portuguese TDS. Comprehension of the scale by patients on HD was good, the scale's internal consistency was satisfactory (0.84; p<0.001), agreement with a visual analogue scale (VAS) was moderate (kappa=0.44; p<0.001), and reproducibility neared perfection (ICC=0.87; p<0.001). CONCLUSION Our results showed that the Brazilian Portuguese version of the scale might be used reliably. The Brazilian Portuguese version of the TDS is a practical, affordable, accessible and well-accepted tool that has a lot to offer for the management of patients with HD.
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Affiliation(s)
| | - Clarice Carneiro Braga
- Universidade Federal de Goiás, Faculdade de Nutrição, Programa
de Pós-Graduação em Nutrição e Saúde, Goiânia, GO, Brasil
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Leemhuis A, Shichishima Y, Puntillo K. Palliation of Thirst in Intensive Care Unit Patients: Translating Research Into Practice. Crit Care Nurse 2020; 39:21-28. [PMID: 31575591 DOI: 10.4037/ccn2019544] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Thirst is prevalent among patients in intensive care units. A research-based "thirst bundle" was shown to significantly decrease thirst in these patients. OBJECTIVE To implement a research-based thirst intervention performed by intensive care unit nurses and patients' family members. METHODS Nurses and family members were taught the thirst intervention through video training and project team reinforcement. The intervention was performed by nurses for 123 patients and by family members for 13 patients. Thirst was measured with a numeric rating scale of 0 to 10, a word scale of 0 to 3, or "yes/no" answers, whichever was easiest for the patient. Inferential statistics were used to assess changes in thirst scores over time. Also assessed were nurse and family member burden levels, family level of satisfaction, and patient enjoyment. RESULTS Thirst scores on the numeric rating scale decreased significantly: from a mean (SD) of 7.9 (2.0) before to 3.9 (2.7) after the intervention for nurses (P < .001); and from 9.2 (1.5) to 5.3 (2.6) for family members (n = 13; P = .002). Word scale scores also decreased significantly, from a median (interquartile range) of 3 (3-3) before to 2 (1-2) after the intervention for nurses (P < .001). Most patients (96%) reported enjoying the procedure. Median burden levels were less than 2 on a numeric rating scale of 0 to 10. CONCLUSIONS The palliative "thirst bundle" significantly alleviated patients' thirst and resulted in little caregiver burden. Further efforts are warranted to incorporate this intervention into intensive care unit practice.
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Affiliation(s)
- Ann Leemhuis
- Ann Leemhuis is clinical nurse III, adult medical-surgical intensive care unit, University of California San Francisco Medical Center, San Francisco, California. Yuriko Shichishima is a clinical nurse II and a clinical nurse educator, Department of Community Health Systems, School of Nursing, University of California San Francisco Medical Center. Kathleen Puntillo is professor emeritus, Department of Physiological Nursing, University of California San Francisco School of Nursing
| | - Yuriko Shichishima
- Ann Leemhuis is clinical nurse III, adult medical-surgical intensive care unit, University of California San Francisco Medical Center, San Francisco, California. Yuriko Shichishima is a clinical nurse II and a clinical nurse educator, Department of Community Health Systems, School of Nursing, University of California San Francisco Medical Center. Kathleen Puntillo is professor emeritus, Department of Physiological Nursing, University of California San Francisco School of Nursing
| | - Kathleen Puntillo
- Ann Leemhuis is clinical nurse III, adult medical-surgical intensive care unit, University of California San Francisco Medical Center, San Francisco, California. Yuriko Shichishima is a clinical nurse II and a clinical nurse educator, Department of Community Health Systems, School of Nursing, University of California San Francisco Medical Center. Kathleen Puntillo is professor emeritus, Department of Physiological Nursing, University of California San Francisco School of Nursing
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Karimian M, Khalighi E, Salimi E, Borji M, Tarjoman A, Mahmoudi Y. The effect of educational intervention on the knowledge and attitude of intensive care nurses in the prevention of pressure ulcers. INTERNATIONAL JOURNAL OF RISK & SAFETY IN MEDICINE 2020; 31:89-95. [PMID: 32039864 DOI: 10.3233/jrs-191038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Pressure ulcers can cause disability, which can lead to a default in patients' safety and results in frequent complications for patients. OBJECTIVES This study aimed to determine the effect of educational intervention on nurses' knowledge and attitude in preventing pressure ulcers. METHODS In this study, 67 nurses of ICU wards at Ilam University of Medical Sciences were randomly assigned to the experimental or control group. Data collection tools included the demographic characteristics questionnaire, the Pieper Pressure Ulcer Knowledge test (PUKT) and the Attitude toward Pressure Ulcer tool (APuP). In the experimental group, the nurses were allocated into groups of four-five persons and for each group four face-to-face training sessions and two virtual training sessions by means of educational videos on bed sores were performed. Gathered data were analyzed using SPSS software version 16, and descriptive and analytical tests were performed. RESULTS PUKT questionnaire score in the experimental group improved from 15.68 (3.42) to 29.75 (12.33) (P = 0.000), while in the control group it was 16.40 (3.13) and 17.54 (6.62) before intervention, which was not significant (P > 0.05). Furthermore, the APUP questionnaire score in the experimental group improved from 27.12 (2.13) to 39.37 (3.21) (P = 0.000), while in the control group it was 27.65 (1.71) and 28.37 (5.00) before intervention, which was not significant (P > 0.05). CONCLUSIONS Since educational intervention improved the knowledge and attitude of nurses in preventing pressure ulcers, it is required to conduct appropriate educational interventions to improve their knowledge and attitude.
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Affiliation(s)
- Mohamad Karimian
- Assistant Professor of Vascular Surgery, Ilam University of Medical Sciences, Ilam, Iran
| | - Ebrahim Khalighi
- Department of Anaesthesiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Ebrahim Salimi
- Department of Nursing, Faculty of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran
| | - Milad Borji
- Department of Nursing, Faculty of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Asma Tarjoman
- Student Research Committee, Department of Nursing, Faculty of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran
| | - Yosof Mahmoudi
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
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