Journal of Advanced Nursing, 1989, 14, 1038-1043 A comparison of nurses' and patients' perceptions of intensive care unit stressors Jane Cochran MS(N) RN Instructor, School of Nursing, University of Missouri-Columbia and Lawrence H. Ganong PhD Associate Professor, School of Nursing and Department of Human Development and Family Studies, University of Missouri-Columbia, USA Accepted for publication 5 December 1988 COCHRAN J.& GANONG L.H. (1989) Journal of Advanced Nursing 14, 1038-1043 A comparison of nurses' and patients' perceptions of intensive care unit stressors This study was designed to compare intensive care unit (ICU) nurses' and patients' perceptions of the stressfulness of items in the environment for patients in an ICU. The sample consisted of 20 ICU patients and 23 registered nurses employed in the medical and surgical ICUs at a large midwestem university hospital. The patients were contacted 1 to 2 days after transfer from an ICU and asked to complete the Intensive Care Unit Environmental Stressor Scale (ICUESS), a Likert-type questionnaire designed to measure the stressfulness of commonly occurring items in the ICU environment. The nurses were asked to complete the same questionnaire as they believed an ICU patient would complete it. They were asked to complete the questionnaire after the completion of a shift worked in an ICU. A series of one-way ANOVAs were done to compare the patients' and nurses' responses. In every comparison, nurses rated the items as being significantly more stressful than did the patients. Items with the highest mean ratings by patients were: (I) having tubes in your nose or mouth; (2) being stuck with needles; (3) being in pain; (4) not being able to sleep; and (5) being thirsty. Patients and nurses also were asked to list the three most stressful items from the ICUESS. These responses were compared using chi- square tests for homogeneity. Nurses mentioned 'being tied down by tubes' and 'not being in control of oneself significantly more times than did patients. The items 'being in pain', 'having tubes in your nose or mouth', and 'not being able to sleep' were listed most often by both nurses and patients. INTENSIVE CARE UNIT lack of privacy, separation from family, and immobility contribute to making this a stressful environment (Gowa The intensive care unit (ICU) environment is a stressful one 1979, Harris 1984, Kleck 1984, Noble 1982, Stephenson for patients. The presence of strange machinery, flashing 1983). The ICU environment deprives patients of norma lights, loud and unfamiliar noises, noxious smells, and sensory stimuli while bombarding them continuously with lights on 24 hours a day, coupled with invasive procedures, strange sensory stimuli (MacKinnon-Kessler 1983). This , ^ , r. I rM ,, •• r,^ • ^ 1 1. situation may elicit the stress response and trigger IC Correspondence: ]. Cochran, School of Nursing, llnwersity of Missoun-Coltimbia, •' "^ 5343 Nursing School Building, Columbia, Missouri 652 H, USA. Syndrome. 1038