Study On Influence Factors And Intervention Of Thirst In Intensive Care Unit Patients

Objective:1.To assess the incidence,intensity and distribution of thirst in ICU patients and identify influence factors of thirst in ICU patients.2.To evaluate the effects of thirsty management strategy based on Symptom Management Theory.Methods:1.The incidence,intensity,distribution and influence factors of thirst were investigated in a total of 301 patients selected by convenient sampling method from ICUs(including MICU,SICU,ECU and CCU)in a general hospital in Fujian Province during the time period from March 2016 to December 2016.2.A randomized controlled trial was conducted in a sample of 100 fasting patients after cardiovascular surgery from a general hospital in Fujian Province which was divided into experimental and control groups,each containing 50 patients.The experimental group was administrated with thirst management strategy and the control group was treated with usual care.The numeric rating scale(NRS)and cost-effect analysis was used to evaluate the effect of thirsty management strategy.Results:1.The incidence of thirst in the 301 ICU patients was 69.8%.Of all the subjects,the percentage of mild thirst was 30.9%,and about 70% of ICU patients felt severe thirst.The results of univariate analysis showed that: surgery,mechanical ventilation,fasting,non-oral feeding,nebulizer therapy,diuretics,opioids,high sodium level,high glucose level and plasma osmolality,APACHE ? score were the influence factors of thirst presence in ICU patients.Logistic stepwise regression analysis showed that fasting(OR 4.096,95%CI: 1.435-11.690),surgery(OR 2.960,95%CI: 1.105-7.933),high glucose level(OR 2.357,95%CI:1.156-4.807)and APACHE ? score(OR 1.128,95%CI: 1.024-1.242),were the independent influence factors of thirst presence in ICU patients,the difference was statistically significant(P<0.05).2.The baseline data of patients,such as gender,age,operating time etc.,were similar between two groups(P(29)0.05).This study demonstrated no significant difference(P(29)0.05)between experimental and control group in the scores of NRS at baseline.There was a significant difference(P(29)0.05)between experimental and control group at post-test.The scores of NRS in the experimental group before and after the intervention were decreased from(7.68±1.596)to(4.17±1.465),the difference was statistically significant(P<0.05).The scores of NRS in the control group were increased from(6.08±1.536)to(7.68±1.596),the difference was statistically significant(P<0.05).Before and after the intervention,the difference of thirst score between two groups was statistically significant(P<0.05).At the same time,the cost-effectiveness analysis showed that the cost-effectiveness ratio of the intervention group was 0.770 and the control group was 1.350 The efficiency of thirsty management strategy in the intervention group was better than that in the control group.Conclusion:1.The incidence of thirst was high in ICU patients,and patients with moderate to severe thirst accounted for a larger proportion.Surgery,mechanical ventilation,fasting,non-oral feeding,nebulizer therapy,diuretics,opioids,high sodium level,high glucose level and plasma osmolality,APACHE ? score were the influence factors of thirst in ICU patients.Excluding confounding factors,APACHE ?score,surgery,fasting,high glucose level were independent factors of thirst in ICU patients.2.The thirst management strategy based on symptom management theory can effectively reduce the thirst of ICU fasting patients,alleviate the thirst of patients,and the its application process is relatively feasible,safe,economical and convenient.