Bed Bath With Auditory Hypnosis on ICU Patients

Condition(s) studied

Investigational drug(s) / intervention(s)

Bed Bath With Auditory Hypnosis: In the bed bath protocol accompanied by audio suggestion, a 30-60 minute audio recording containing audio suggestions specific to the ICU patient will be prepared with the support of a specialist hypnotherapist. This audio recording will include the following messages: - The purpose of the bed bath, - Procedures to be performed during the bed bath, - The benefits of the bed bath, - Feeling safe during the bed bath, - Improvement in physiological parameters and comfort levels after the bed bath. While it is noted that auditory suggestion typically lasts 30-60 minutes, even a 15-minute auditory suggestion has been reported to provide benefits.

Study summary

Intensive care units (ICUs) are specialized units where complex life-saving treatment and care activities are performed. Due to the treatment procedures performed in these specialized units, a large number of tools/equipment/devices/cables (endotracheal tubes, monitor cables, hemodialysis machines, mechanical ventilation, etc.) are placed on critically ill patients. These treatment devices restrict the movement of patients, creating obstacles to the independent performance of basic human needs such as personal hygiene. One of the individual hygiene practices frequently applied in ICUs is bed bathing. The application of bed bathing in ICUs varies according to institutional and clinical policies. In addition to its beneficial effects such as preventing infection, accelerating blood circulation, providing comfort and relaxation, etc., bed bathing also carries the risk of having a negative effect on physiological parameters. Eliminating or minimizing this risk is one of the primary care objectives of intensive care nurses. In this regard, it is crucial that bed baths, which are considered a routine nursing activity in ICUs, are performed in accordance with specific standards and protocols. In recent years, there has been an increase in the use of certain non-pharmacological care interventions in ICUs. One such intervention is auditory suggestion. Auditory suggestion refers to messages delivered through hearing to facilitate the adoption of specific thoughts, feelings, or behaviors. This method includes music, verbal suggestion, nature sounds, and other auditory stimuli that are believed to have the potential to influence the subconscious. In recent years, auditory suggestion has been integrated into the treatment processes of critically ill patients, particularly in intensive care units. This method is applied to reduce patients' stress, control pain, and support hemodynamic stability. Research has provided strong evidence supporting the physiological and psychological effects of auditory suggestion on both adult and pediatric patients. On the other hand, maintaining the patient's physiological parameters under control and increasing their comfort level while administering bed baths in the ICU are desired outcomes of nursing care. Based on this, the study was designed as a randomized controlled trial to investigate the effects of bed baths administered with auditory suggestion on physiological and comfort parameters in intensive care patients. The study, which will be conducted with a total of 66 ICU patients meeting the sample selection criteria, will apply the "bed bath protocol with auditory suggestion" to the study group and routine bed baths to the control group (only once). The study data will be collected using the "Patient Information Form" and the "Physiological and Comfort Parameters Monitoring Form" (data from the form will be collected and recorded before the bath, immediately after the bath, and 30 minutes after the bath). The study data will be analyzed using appropriate statistical methods.

Eligibility

Primary outcome measure(s)

• Intensive Care Pain Observation Scale — Before bed bath, immediately and 30 minutes after the bed bat
  It is a scale used specifically for the assessment of pain in unconscious patients receiving mechanical ventilation treatment in ICU. The scale consists of four parameters to assess facial expression, body movements, ventilator compliance and muscle tension. Each parameter is scored between 0 and 2. The minimum score is 0 and maximum score is 8. Scores between 0 and 4 show mild to moderate pain and scores between 5 and 8 show severe pain. Since pain is one of the most important markers of comfort, investigators planned to use this scale for criterion-related validity. It is expected that as pain increases, comfort level decreases.
• Comfort Behaviors Checklist — Before bed bath, immediately and 30 minutes after the bed bath
  The Comfort Behaviors Checklist consists of 30 behavioral indicators. In addition, Kolcaba suggests that if the list is the only measurement tool that measures comfort, the individual should give a numerical score to pain and comfort so that comfort can be objectively evaluated. Questions 2, 3, 5, 7, 8, 8, 9, 11, 12, 13, 19, 20, 21, 22, 24, 25, 27 are reverse coded. The list is scored on a 4-point Likert scale. When the list is completed, questions that are not applicable to the individual are given 0 points. The total number of questions answered is multiplied by 4 to obtain the possible score. The scores for all questions are calculated by reversing the questions, and the raw comfort score is obtained. Finally, the possible comfort scores are divided by the raw scores to obtain a decimal number. The decimal part of the obtained score is expressed as a two-digit number. The total score is calculated and then standardized to a scale of 0 (lowest comfort) to 120 (highest comfort).
• Change in Heart Rate — Baseline (pre-bed bath), immediately post-bed bath, and 30 minutes post-bed bath
  Heart rate (beats per minute) will be measured before bed bath, immediately after, and 30 minutes after.
• Change in Systolic and Diastolic Blood Pressure — Baseline, immediately post, and 30 minutes post-intervention
  Systolic and diastolic blood pressure (mmHg) will be measured at three time points: before, immediately after, and 30 minutes after bed bath.
• Change in Respiratory Rate — Baseline, immediately post, 30 minutes post
  Respiratory rate (breaths per minute) will be assessed at baseline, immediately after, and 30 minutes after the bed bath.
• Change in Body Temperature — Baseline, immediately post, 30 minutes post
  Body temperature (in degrees Celsius) will be recorded at three time points: before, immediately after, and 30 minutes after the bed bath.
• Change in Peripheral Oxygen Saturation (SpO₂) — Baseline, immediately post, 30 minutes post
  SpO₂ will be measured using pulse oximetry before and after the bed bath at designated time points.
• Change in Blood pH — Baseline, immediately post, 30 minutes post
  Blood pH will be assessed through arterial blood gas sampling at three time points.
• Change in Partial Pressure of Oxygen (pO₂) — Baseline, immediately post, 30 minutes post
  pO₂ will be measured through arterial blood gas analysis at three time points.
• Change in Partial Pressure of Carbon Dioxide (pCO₂) — Baseline, immediately post, 30 minutes post
  pCO₂ values will be obtained via arterial blood gas analysis at the specified intervals.

Trial sites (1)

Other trials for the same condition