title: Patients' and Health Care Providers' Perception of Stressors in the Intensive Care Units.
abstract: OBJECTIVE
  The purposes of this study is first, to investigate intensive care patients' perceptions of stressors; second, to investigate the health care provider's perception of what constitutes a stressor from the patient's perspective; and third, to describe how health care providers manage their patients' stressors. This was a mixed-methods study; the quantitative section replicated Cornock's 1998 study of stress in the intensive care unit (ICU), with difference in sampling to include all health care providers in the ICU, in addition to nurses. The qualitative section added information to the current literature by describing how health care providers manage their patient's stressors. This article reports the quantitative findings of this study, as the qualitative section is presented in a separate article.
  
  
  BACKGROUND
  It is important to describe ICU patients' stressful experiences to assess patient's stressors, provide holistic care to eliminate stressors, and provide feedback to health care providers. There is a need to describe the clinical practice related to stress perception and management of stressors in the critical care environment.
  
  
  METHODS
  A mixed-methods comparative descriptive design was used for the quantitative section, and a phenomenological approach guided the qualitative section. Lazarus and Folkman's theory formed the bases for integrating all variables investigated in this study. The sample included 70 ICU patients and 70 ICU health care providers. After consenting to participate in this study, subjects were given a demographic form and a paper-based tool, the Environmental Stressors graphic data form Questionnaire. Questionnaires were filled out by subjects anonymously in the ICU and returned to the researcher in the same setting.
  
  
  RESULTS
  Descriptive statistics were analyzed using SPSS data analysis software. The top 3 most stressful items ranked by the patients included "being in pain," followed by "not being able to sleep" and "financial worries"; on the other hand, health care providers perceived "being in pain" followed by "not being able to communicate" and "not being in control of yourself" as the top 3 stressors perceived by their patients.
  
  
  CONCLUSIONS
  The findings of this study are crucial and may inform nursing assessments and care of the ICU patient. In addition, this information may encourage the ICU staff to manipulate and redesign the ICU environment to be less stressful. Also, the findings of this study guided the development of an ICU stressor control policy.
authors.affiliation: Alham Abuatiq, PhD, MSN, RN, is a tenure track assistant professor in California State University, San Bernardino. Dr Abuatiq is a PhD degree holder from the University of San Diego in 2013 and has a master's degree in critical care nursing from the University of Jordan in 2006 and BSN from the University of Jordan in 2004. Active researcher in the 2 major fields: first, research interest in critical care nursing, patient's perception of stress, and the effects of technology on a patient's stress perception; and second, research interest includes the effectiveness of using virtual laboratories and E-learning in nursing.
authors.forename: Alham
authors.initials: A
authors.lastname: Abuatiq
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009730:Nursing Assessment; D010361:Patients / Q000523:psychology*; D011594:Psychometrics; D012307:Risk Factors; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires