Symptom Management Theory (SMT)-based thirst management is an effective strategy. The 5 mL cold water spray method significantly reduces thirst intensity and distress in mechanically ventilated patients under fasting and fluid restriction, while also improving sleep quality, enhancing oral mucosa hydration, and reducing the need for additional interventions, thereby reducing the nursing workload. Importantly, this method does not increase the risk of adverse events.

A total of 84 participants were randomly assigned to one of three groups: Group A received a 1.6 mL injection of water at room temperature (20–26 °C), Group B received a 1.6 mL spray of cold water (2–6 °C), and Group C received a 5 mL spray of cold water (2–6 °C).

The improvement in thirst was greatest in Group C, followed by Group B, and then Group A.

In terms of thirst distress, sleep quality, oral mucous wetness, and the number of additional interventions, the cold water spray had the better effect.

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