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Aim: The aim was to qualitatively and quantitatively clarify the stress experiences of patients who were mechanically ventilated in an intensive care unit (ICU) for more than 12 hr. Methods: The participants were adult patients without cognitive impairment who were mechanically ventilated in a general ICU for more than 12 hr. The Japanese version of the ICU Stressful Experiences Questionnaire (ICU‐SEQJ) survey was performed before subjects were discharged from the ICU to collect narratives about how they felt and what they thought during their ICU stay. The results were analyzed in a collective and complementary way by dividing ICU‐SEQJ scores into quartiles and comparing the first (low stress experience group) and third quartiles (high stress experience group). Results: A total of 96 subjects were enrolled in the study, with 25 scoring in the high stress experience group and 24 in the low stress experience group. The high stress experience group had significantly longer duration of intubation, higher amounts of analgesics and sedative drugs, higher C‐reactive protein, lower level of deepest sedation and greater absence of medical history than the low stress experience group. Analysis of the subjects' narratives revealed "Unbearable holistic discomfort", "Pain of being unable to control myself as before" in the high stress experience group and "Responding by giving meaning" in the low stress experience group. Conclusions: Nurses must recognize that long intubation hours and invasive procedures are subjective stress experiences that may cause patients to suffer holistic discomfort and lose their sense of control. [ABSTRACT FROM AUTHOR]

Objectives: Seeking consent for minimal risk research in the ICU poses challenges, especially when the research is time-sensitive. Our aim was to determine the extent to which ICU patients or surrogates support a deferred consent process for a minimal risk study without the potential for direct benefit.Design: Prospective cohort study.Setting: Five ICUs within a tertiary care hospital.Patients: Newly admitted ICU patients 18 years old or older.Interventions: We administered an eight-item verbal survey to patients or surrogates approached for consent to participate in a minimal risk, ICU-based study. The parent study involved noninvasive collection of biosamples and clinical data at the time of ICU admission and again 3 days later. If patients had capacity at the time of ICU admission, or if a surrogate was readily available, consent was sought prior to initial sample collection; otherwise, a waiver of consent was granted, and deferred consent was sought 3 days later. Quantitative and qualitative data were analyzed.Measurements and Main Results: One hundred fifty-seven individuals were approached for consent to participate in the parent study; none objected to the consent process. One hundred thirty-five of 157 (86%) competed the survey, including 94 who consented to the parent study and 41 who declined. Forty-four of 60 individuals (73%) approached for deferred consent responded positively to the question "Did we make the right choice in waiting until now to ask your consent?" three of 60 (5%) responded negatively, and 13 of 60 (22%) made a neutral or unrelated response. The most common reason given for endorsing the deferred consent process was the stress of the early ICU experience 25 of 44 (61%).Conclusions: Most patients and surrogates accept a deferred consent process for minimal risk research in the ICU. For appropriate ICU-based research, investigators and Institutional Review Boards should consider a deferred consent process if the subject lacks capacity and an appropriate surrogate is not readily available. [ABSTRACT FROM AUTHOR]