Improving Clinical Outcomes and Psychological Well-being in Critical Care for Adult Patients: Efficacy of an Integrated Nursing Care Model After Complex Surgical Procedures

Abstract

Background: Patients in surgical intensive care units (SICUs) face a high risk of adverse clinical outcomes (e.g., complications, prolonged length of stay) and psychological distress (e.g., anxiety, depression, delirium). Traditional nursing care often prioritizes physiological stabilization over proactive psychological support. This study aims to evaluate a novel integrated nursing care model designed to address both physical and mental health needs concurrently. Aim : To compare the incidence of postoperative complications and length of ICU/hospital stay between patients receiving integrated care versus standard care and to assess differences in psychological outcomes (delirium, anxiety, depression, patient satisfaction) between the two groups.  Design: Quasi-experimental design was utilized to achieve the aim of the current study . Setting: Surgical Intensive Care Units at Sohag university hospitals. Tools:Tool (1): Patients’ structured interviewing questionnaire, it included two parts;demographic and clinical baseline characteristics, Tool (2):  Patients’ clinical outcomes, Tool (3): Confusion Assessment Method for the ICU (CAM-ICU), Tool (4): Richmond Agitation-Sedation Scale (RASS), Tool (5): Hospital Anxiety and Depression Scale (HADS), Tool (6): Numeric Rating Scale (NRS), Tool (7): Customized ICU Patient Satisfaction Questionnaire. The implementation of the integrated nursing care model was associated with a significant reduction in the mean length of the ICU stay for the intervention group compared to the control group . There was the significant improvement in patient psychological well-being. Patients in the integrated care group reported significantly lower anxiety.The results also showed a reduced incidence and duration of delirium in the integrated nursing care group as measured by the CAM-ICU. Interestingly, while anxiety scores were lower. The data from the Customized ICU Patient Satisfaction Questionnaire revealed high levels of satisfaction in the integrated care group. Specifically, satisfaction regarding communication clarity and perceived quality of nursing care was significantly higher in the intervention group. Conclusion: An Integrated Nursing Care Model effectively improves outcomes for adult patients after complex surgical procedures by addressing both physical and psychological needs concurrently. Recommendations: Focus on implementing a standardized integrated nursing care model should include early mobilization and rehabilitation, prioritized pain and sedation management, enhanced communication, and comprehensive psychosocial support for patients and families.