Dyspnea. Other diseases of the respiratory system
Conditions
Interventions
Intervention 1: Intervention group: Includes 51 patients who, after assessing the severity of their respiratory distress, will listen to a nature-based guided imagery audio file for 15 to 20 minutes t
Sponsors
Kerman University of Medical Sciences
Eligibility
Sex/Gender
All
Age
18 Years to 60 Years
Inclusion criteria
Inclusion criteria: Aged between 18 and 60 years Glasgow Coma Scale (GCS) score between 9 and 13 First ICU admission, with a minimum ICU stay of one week Physically stable condition as confirmed by the physician No history of psychiatric illnesses such as bipolar disorder or schizophrenia No hearing impairment or structural damage affecting hearing No underlying cardiopulmonary disease Not receiving high-dose sedatives, anxiolytics, or opioids (defined as >1–2 µg/kg fentanyl, >0.1 mg/kg midazolam, or >0.1 mg/kg morphine) Not receiving neuromuscular blockers such as atracurium Not taking bronchodilators Receiving supplemental oxygen via face mask, nasal cannula, or T-piece Not ventilator-dependent No active seizures or advanced neurologic disorders No history of alcohol or drug abuse Behavioral Pain Scale (BPS) score <6 Richmond Agitation Sedation Scale (RASS) score between -2 and +2 Availability of a competent legal guardian to provide informed consent
Exclusion criteria
Exclusion criteria: Participation in a similar clinical trial within the past month Planned upcoming procedures (e.g., surgery, chemotherapy, or radiotherapy) Change in GCS score outside the 9–13 range Transfer from ICU to general wards New dependence on mechanical ventilation Physician-ordered increase in sedative/opioid dosage causing reduced consciousness or respiratory suppression Hemodynamic instability Patient death Inability to tolerate the intervention (e.g., anxiety, irritability, tachycardia) Family withdrawal of consent Medical contraindication for supine or semi-sitting position
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Respiratory distress score based on the IC-RDOS scale. Timepoint: Assessing the severity of respiratory distress at the beginning of the study and after the intervention. Method of measurement: The Intensive Care Respiratory Distress Scale (IC-RDOS) is used to assess respiratory distress in these patients. This scale was designed in 2008 by Campbell et al. to assess the severity of respiratory distress in patients admitted to the intensive care unit, especially in patients who are unable to express their experiences (such as patients with a low level of consciousness, patients under palliative care, and patients with chronic obstructive pulmonary disease and heart failure). This scale allows the treatment team to objectively and based on observation, assess the severity of respiratory distress and make the necessary decisions. The indicators evaluated in this test include the following: heart rate (Heart Rate/65), breathing pattern (+1 irregular breathing pattern and -1 regular breathing pattern), use of accessory respiratory muscles (+1 accessory muscle use and -1 no accessory muscle use), restlessness or anxiety (+1 anxiety and -1 no anxiety) and use of supplemental oxygen (supplemental oxygen use +0.7 and no use -0.7). A total score of greater than or equal to 2.4 indicates moderate to severe respiratory distress and the need for therapeutic interventions, and scores less than 2.4 indicate no or mild respiratory distress, requiring patient monitoring to determine any changes in status. | — |
Secondary
| Measure | Time frame |
|---|---|
| Dyspnea. Timepoint: At first and after the intervention. Method of measurement: IC-RDOS. | — |
Countries
Iran (Islamic Republic of)
Contacts
Public ContactAtena Shojaie
Kerman University of Medical Sciences
Outcome results
None listed