• Shelly Ashkenazy, Charles Weissman, and DeKeyser GanzFredaFHadassah Hebrew University School of Nursing, Hadassah Medical Center, Jerusalem, Israel; Hadassah Hebrew University School of Nursing and Jerusalem College of Technology, Jerusalem, Israel..
• Hadassah Hebrew University School of Nursing, Hadassah Medical Center, Jerusalem, Israel. Electronic address: shelly.ashkenazy@mail.huji.ac.il.
• Pain Manag Nurs. 2022 Dec 1; 23 (6): 711719711-719.

BackgroundBeing hospitalized in an intensive care unit ICU often involves pain and discomfort. While pain is commonly alleviated with analgesics, discomfort is more difficult to diagnose and treat, thus potentially leading to incorrect analgesic administration.AimTo describe intensive care unit practitioners' perceptions of discomfort in the ICU, and their methods to discern between pain and non-pain discomfort.MethodsTwenty-five intensive care unit practitioners (7 doctors and 18 nurses) were interviewed from medical and general intensive care units at one institution in Jerusalem, Israel. Data collection was performed using semi-structured interviews. Interviews were audio-recorded and transcribed. Transcriptions were coded and categorized by two researchers independently. Content analysis identified common themes.ResultsTwo main discomfort themes were identified: unpleasant physical sensations and unpleasant psychologic feelings, with further subcategories. Physiologic and non-physiologic signs such as facial expression and motor activity helped to diagnose discomfort. Trial and error and cause and effect were used to differentiate pain from other sources of discomfort.ConclusionsPractitioners saw pain as a dominant source of discomfort. Treating overall discomfort should focus on improving the quality of the total intensive care unit experience. Strategies to diagnose non-pain discomfort and pain were similar. Differentiating pain from non-pain discomfort is essential in order to provide appropriate treatment for pain and non-pain-related discomfort.Copyright © 2022 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

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