No abstract available.
Critical Care

No abstract available.
Critical Care*

No abstract available.
Critical Care*

No abstract available.
Critical Care*

No abstract available.
Critical Care*

Background: The needs of intensive care patient’s family members are often neglected. Many healthcare practitioners do not realize that meeting the family needs in the intensive care settings actually may improve outcome for their patients and enable the family members to cope and deal with the patient’s hospitalization period effectively. With this in mind, the present study aimed to address the needs of Malaysian family members of intensive care unit patients. Methods: This cross-sectional survey was conducted among family members of Intensive Care Unit of Hospital Universiti Sains Malaysia, Malaysia. A total of 60 family members were recruited using a convenience sampling manner. A Malay validated Critical Care Family Needs Inventory was used to identify the family needs among the respondents. Descriptive statistics as well as mean comparison analyses were employed to achieve the study. Results: The findings showed that family members ranked Assurance items as the most important needs. In terms of subscales scores, Assurance and Information evidenced higher mean scores compared to other dimensions. All the family need dimensions had positive and significant associations with one another. The highest correlation was noted among Comfort – Support pair, r(58) = 0.73, p < 0.001. No significant differences in the mean values found across gender, history of admission and types of relationships. In contrast, significant mean difference was observed across level of education. Conclusion: Identifying the needs of family members in the intensive care unit is imperative as it raises awareness and contributes knowledge in terms of family needs to healthcare providers, policy makers, medical social workers and general public.
Critical Care

Background: Surgical Apgar Score (SAS) is a simple, inexpensive, and readily available ten-point scoring system using patient's parameters which include surgical blood loss, lowest recorded mean arterial pressure (MAP) and lowest intraoperative heart rate in predicting 30-day post-operative morbidities. This study determined the reliability of SAS in predicting immediate post-operative extubation and immediate intensive care unit (ICU) admission among patients who underwent major abdominal surgeries in a tertiary hospital in Iloilo City. Methods: A descriptive retrospective cross- sectional study conducted in a tertiary hospital in Iloilo City included patients aged 19 and above who underwent major abdominal surgery from January 1, 2017 to December 31, 2019, and met the study's inclusion criteria. Purposive sampling was utilized. Demographics, clinical data, intraoperative data, management as well as treatment course, post- operative course and patient outcome were extracted, and data collected were utilized for data processing and analysis. Frequency count, mean and standard deviation were utilized for descriptive statistics; T-test and One-way Analysis of Variance (ANOVA) were utilized to determine statistical difference among groups. Logistic regression analysis was employed to assess association between SAS and immediate extubation and post- op ICU admission. Statistical Package of the Social Sciences (SPSS) software version 23.0 was utilized for statistical computations. A probability level of p<0.05 was utilized to determine statistical significance. Results: The study consisted of 221 patients predominantly female 64.3 % (n=142) with the mean age of 55.80 17.53. Mean SAS was 6.79 $ 1.3 with a total of 13 (5.9%) patients who were classified as high risk (SAS 0-4), 152 (68.8%) patients as medium risk (SAS 5-7) and 56 (25.3%) patients as low risk with SAS 8-10. On logistic regression analysis, mean arterial pressure (MAP), lowest heart rate and estimated blood loss were significantly associated with decision to do immediate post-operative extubation and immediate ICU admission (p<0.001). Those with higher MAP were 1.19 times more likely to be extubated (OR 1.199, CI: 1.078-1.334, p<0.001) and higher estimated blood loss more likely to be admitted in the ICU (OR 1.006, CI: 1.004-1.009, p<0.001). Lastly, those with higher heart rates were 1.2 times more likely to be admitted in the ICU post-operatively. Low-Risk SAS (Score of 8-10) is predictive of immediate post-operative extubation with 97.7% sensitivity and 75.6% specificity. High Risk SAS (score of 0-4) is predictive of immediate post-operative ICU admission with a sensitivity of 76.1% and 98.3% specificity. Conclusion SAS is a reliable and valid predictive tool in determining immediate post- operative extubation and ICU admission among patients undergoing major abdominal surgeries. Multicentric, longitudinal and prospective studies are further required to confirm results.Keywords: Surgical Apgar Score (SAS), extubation, intensive care, critical care, abdominal surgery
Critical Care

PURPOSE: The purpose of this study was to investigate the influence of perceptions of death, end-of-life (EOL) care stress, and emotional intelligence on attitudes toward EOL care among nurses in the neonatal intensive care unit (NICU). METHODS: The participants were 111 nurses working in a NICU who had experienced EOL care at least once. Data were analyzed using the t-test, Pearson correlation coefficient, and stepwise multiple regression analysis in SPSS for Windows. RESULTS: The mean score for perceptions of death was 3.16 out of 5, the mean score for EOL care stress was 3.61 out of 5, the mean emotional intelligence score was 4.66 out of 7, and the average score for EOL care attitudes was 2.77 out of 4. The factors affecting attitudes towards EOL care were academic degree, anxiety regarding death, negativity towards death, experiences of patient death, and emotional intelligence. The explanatory power of these variables for attitudes towards EOL care was 24.7%. CONCLUSION: The results of this study are expected to serve as a basic reference for the development of nursing education programs and EOL care protocols to improve attitudes toward EOL care among NICU nurses.
Anxiety ; Critical Care ; Education, Nursing ; Emotional Intelligence* ; Humans ; Infant, Newborn ; Intensive Care, Neonatal* ; Terminal Care

Neonatal intensive care in Korea has improved remarkably since the 1990's, but there is still a shortage of facilities and equipments in neonatal intensive care units (NICUs). Only 61.7% of hospital beds needed for neonatal intensive care are available, the given area per bed is limited, and other facilities such as on-call rooms, interview rooms, closets are insufficient. Mechanical ventilators are not appropriately distributed to NICUs that are equipped to handle neonatal intensive care. The number of physicians for neonatal intensive care is by far too small, with the number of patients per physician being very high. The number of patients per nurse, too, is as high as 5.3 to 7.3, making it very difficult to provide adequate intensive care. All these are caused by the insufficient investment by the hospitals, which is due to the inadequate reimbursement from the health insurance. Therefore, government-driven efforts are necessary to bring the level of neonatal intensive care service up to par.
Critical Care ; Humans ; Infant, Newborn ; Insurance, Health ; Intensive Care Units, Neonatal* ; Intensive Care, Neonatal* ; Investments ; Korea ; Ventilators, Mechanical

Neonatal intensive care in Korea has improved remarkably since the 1990s, but there is still a shortage of facilities and equipment in NICUs. Only 71.1% of the beds needed for neonatal intensive care are available. Mechanical ventilators are not appropriately distributed to the NICUs that are equipped to handle neonatal intensive care. The number of doctors is far too small, making the number of patients per doctor very high. Nurses, too, need to take care of 7.7 patients per nurse, making it very difficult to provide adequate intensive care. All this is caused by insufficient investment by the hospitals, which, in turn, is caused by inadequate reimbursement from health insurance. Therefore, a government-sponsored effort is necessary to bring the level of neonatal intensive care up to par.
Humans ; Infant, Newborn ; Insurance, Health ; Critical Care ; Intensive Care Units, Neonatal ; Intensive Care, Neonatal ; Investments ; Korea ; Ventilators, Mechanical