Our study had several limitations. First, the results of
a questionnaire reflect the respondents’ perceptions
of their personal professional assessments and not
necessarily their actual practice. Second, the nurses’
estimates of the occurrence of unpleasant symptoms
and signs will not reflect their actual practices or
patients’ experiences. Obtaining informed consent
from sedated and mechanically ventilated ICUpatients
is problematic. Therefore, to explore the subject area,
we decided to examine the nurses’ perceptions as a first
step before developing and implementing a similar
study involving patients. Third, signs such as body
movements and those reflecting the patient’s cognitive
state should have been included in the questionnaire
to provide a more complete picture of the crucial
signs that nurses should evaluate before the titration
of analgesics and sedatives or other interventions.
Finally, the small number of respondents and the
response rate of 47% compromised our ability to
generalize these findings to all intensive care nurses.