Evaluation of discomfort in the ICU of a low and middle income country.

Abstract

Objective: To evaluate the frequency and severity of discomfort among intensive care unit (ICU) patients. Study Design: Prospective Observational study. Setting: The ICU of the Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan. Period: July 2024 to December 2024. Methods: A total of 151 adult patients aged ≥18, admitted to the ICU for ≥48 hours, and discharged with a Glasgow Coma Scale (GCS) score of 15 were included. Data were collected within 24 hours of ICU discharge using a validated questionnaire assessing discomfort across eight domains including noise, light, bed comfort, sleep, thirst, hunger, cold, and heat, rated on a 0–10 scale. Demographic and clinical information were documented. Statistical analysis was performed using IBM-SPSS Statistics, version 25.0. Results: Of 151 patients, 102 (67.1%) were male, and the mean age was 39.0±14.6 years. Severe bed discomfort was reported 22 (14.6%) patients. Severe sleep disruption was reported in 20 (13.2%) patients. Severe thirst, and hunger were reported in 5 (3.3%) patients each. Patients requiring mechanical ventilation experienced higher levels of severe discomfort, with 30 (19.9%) reporting severe bed discomfort, and 27 (17.9%) severe sleep disruption. In patients on renal replacement therapy, 29 (19.2%) experienced severe bed discomfort, and 21 (13.9%) severe sleep disruption. Conclusion: Discomfort in the ICU is multifaceted and may be influenced by clinical interventions and duration of stay. Targeted interventions to improve bedding, reduce sleep disruption, and manage invasive procedures are essential for enhancing patient comfort, particularly in low-resource ICU settings.