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Breckenridge SJ, Chlan L, Savik K. Impact of tracheostomy placement on anxiety in mechanically ventilated adult ICU patients. Heart Lung 2014; 43:392-8. [PMID: 24559754 DOI: 10.1016/j.hrtlng.2014.01.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2012] [Revised: 01/10/2014] [Accepted: 01/12/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To determine if self-reported anxiety levels decreased after tracheostomy placement in a sample of mechanically ventilated intensive care unit patients. BACKGROUND There is limited research regarding the impact of a tracheostomy on patients' anxiety. Elevated anxiety delays healing and contributes to long-term mental health complications. METHODS This was a secondary analysis of data from a large clinical trial conducted in urban Minnesota. Fifty-one of 116 patients received a tracheostomy. Anxiety scores were obtained daily using the Visual Analog Scale-Anxiety. Mixed model analysis was used to compare anxiety ratings pre- and post-tracheostomy. RESULTS There was no significant decrease in anxiety following tracheostomy after controlling for time and gender (all p > .16). Age was the only variable to impact anxiety levels: anxiety scores increased as age increased (p = .02). CONCLUSIONS Prospective studies are needed to more accurately assess the impact of tracheostomy placement on patient anxiety and salient outcomes.
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Affiliation(s)
| | - Linda Chlan
- Symptom Management Research, College of Nursing, Ohio State University, 398 Newton Hall, 1585 Neil Avenue, Columbus, OH 43210, USA
| | - Kay Savik
- School of Nursing, University of Minnesota, 5-140 Weaver-Densford Hall, 308 Harvard Street SE, Minneapolis, MN 55455, USA
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Nilsen ML, Sereika SM, Hoffman LA, Barnato A, Donovan H, Happ MB. Nurse and patient interaction behaviors' effects on nursing care quality for mechanically ventilated older adults in the ICU. Res Gerontol Nurs 2014; 7:113-25. [PMID: 24496114 DOI: 10.3928/19404921-20140127-02] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 12/05/2013] [Indexed: 01/26/2023]
Abstract
The study purposes were to (a) describe interaction behaviors and factors that may effect communication and (b) explore associations between interaction behaviors and nursing care quality indicators among 38 mechanically ventilated patients (age ≥60 years) and their intensive care unit nurses (n = 24). Behaviors were measured by rating videorecorded observations from the Study of Patient-Nurse Effectiveness with Communication Strategies (SPEACS). Characteristics and quality indicators were obtained from the SPEACS dataset and medical chart abstraction. All positive behaviors occurred at least once. Significant (p < 0.05) associations were observed between (a) positive nurse and positive patient behaviors, (b) patient unaided augmentative and alternative communication (AAC) strategies and positive nurse behaviors, (c) individual patient unaided AAC strategies and individual nurse positive behaviors, (d) positive nurse behaviors and pain management, and (e) positive patient behaviors and sedation level. Findings provide evidence that nurse and patient behaviors effect communication and may be associated with nursing care quality.
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Nilsen ML, Sereika S, Happ MB. Nurse and patient characteristics associated with duration of nurse talk during patient encounters in ICU. Heart Lung 2013; 42:5-12. [PMID: 23305914 DOI: 10.1016/j.hrtlng.2012.10.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Revised: 10/08/2012] [Accepted: 10/10/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Communication interactions between nurses and mechanically ventilated patients in the intensive care unit (ICU) are typically brief. Factors associated with length of nurses' communication have not been explored. OBJECTIVE To examine the association between nurse and patient characteristics and duration of nurse talk. METHODS In this secondary analysis, we calculated duration of nurse talk in the first 3-min of video-recorded communication observation sessions for each nurse-patient dyad (n = 89) in the SPEACS study (4 observation sessions/dyad, n = 356). In addition, we explored the association between nurses' characteristics (age, gender, credentials, nursing experience, and critical care experience) and patients' characteristics (age, gender, race, education, delirium, agitation-sedation, severity of illness, level of consciousness, prior intubation history, days intubated prior to study enrollment, and type of intubation) on duration of nurse talk during the 3-min interaction observation. RESULTS Duration of nurse talk ranged from 0-123 s and varied significantly over the 4 observation sessions (p = .007). Averaging the duration of nurse talk over the observation sessions, differences in talk time between the units varied significantly by study group (p < .001). Talk duration was negatively associated with a Glasgow Coma Scale ≤14 (p = .008). Length of intubation prior to study enrollment had a curvilinear relationship with talking duration (linear p = .002, quadratic p = .013); the point of inflection was at 23 days. Nurse characteristics were not significantly related to duration of nurse talk. CONCLUSION Length of time the patient is intubated, and the patient's level of consciousness may influence duration of nurse communication in ICU.
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Affiliation(s)
- Marci Lee Nilsen
- University of Pittsburgh, School of Nursing, Department of Acute and Tertiary Care, 336 Victoria Building, 3500 Victoria Street, Pittsburgh, PA 15261, USA.
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Tsay SF, Mu PF, Lin S, Wang KWK, Chen YC. The experiences of adult ventilator-dependent patients: A meta-synthesis review. Nurs Health Sci 2013; 15:525-33. [DOI: 10.1111/nhs.12049] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Revised: 01/13/2013] [Accepted: 01/28/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Shwu-Feng Tsay
- R. O.C., Health Bureau; Taichung City Government; Taichung Taiwan
- Department of Health Service Administration; China Medical University; Taichung Taiwan
| | - Pei-Fan Mu
- Institute of Clinical and Community Health Nursing; National Yang-Ming University; Taipei Taiwan
| | - Shirling Lin
- Nursing Department; Taipei Veterans General Hospital; Taipei Taiwan
| | | | - Yu-Chih Chen
- Nursing Department; Taipei Veterans General Hospital; Taipei Taiwan
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55
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Communication when patients are conscious during respirator treatment—A hermeneutic observation study. Intensive Crit Care Nurs 2012; 28:197-207. [DOI: 10.1016/j.iccn.2011.12.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Revised: 12/12/2011] [Accepted: 12/15/2011] [Indexed: 11/22/2022]
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Karlsson V, Bergbom I, Forsberg A. The lived experiences of adult intensive care patients who were conscious during mechanical ventilation: A phenomenological-hermeneutic study. Intensive Crit Care Nurs 2012; 28:6-15. [DOI: 10.1016/j.iccn.2011.11.002] [Citation(s) in RCA: 100] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2011] [Revised: 11/08/2011] [Accepted: 11/12/2011] [Indexed: 10/14/2022]
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Tembo AC, Parker V, Higgins I. Being in limbo: The experience of critical illness in intensive care and beyond. ACTA ACUST UNITED AC 2012. [DOI: 10.4236/ojn.2012.23041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Zeilani R, Seymour JE. Muslim women's narratives about bodily change and care during critical illness: a qualitative study. J Nurs Scholarsh 2011; 44:99-107. [PMID: 22141404 DOI: 10.1111/j.1547-5069.2011.01427.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE To explore experiences of Jordanian Muslim women in relation to bodily change during critical illness. DESIGN A longitudinal narrative approach was used. A purposive sample of 16 Jordanian women who had spent a minimum of 48 hr in intensive care participated in one to three interviews over a 6-month period. FINDINGS Three main categories emerged from the analysis: the dependent body reflects changes in the women's bodily strength and performance, as they moved from being care providers into those in need of care; this was associated with experiences of a sense of paralysis, shame, and burden. The social body reflects the essential contribution that family help or nurses' support (as a proxy for family) made to women's adjustment to bodily change and their ability to make sense of their illness. The cultural body reflects the effect of cultural norms and Islamic beliefs on the women's interpretation of their experiences and relates to the women's understandings of bodily modesty. CONCLUSIONS This study illustrates, by in-depth focus on Muslim women's narratives, the complex interrelationship between religious beliefs, cultural norms, and the experiences and meanings of bodily changes during critical illness. CLINICAL RELEVANCE This article provides insights into vital aspects of Muslim women's needs and preferences for nursing care. It highlights the importance of including an assessment of culture and spiritual aspects when nursing critically ill patients.
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Affiliation(s)
- Ruqayya Zeilani
- The University of Jordan, Faculty of Nursing, Amman, Jordan.
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Freeman-Sanderson A, Togher L, Phipps P, Elkins M. A clinical audit of the management of patients with a tracheostomy in an Australian tertiary hospital intensive care unit: Focus on speech-language pathology. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2011; 13:518-525. [PMID: 21936760 DOI: 10.3109/17549507.2011.582520] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Speech-language pathologists manage communication and swallowing disorders, both of which can occur in patients after tracheostomy insertion. An audit on the incidence and timing of speech-language pathology intervention for adults with tracheostomies has not previously been published. Data were retrospectively extracted from the medical records of all patients who were tracheostomized at Royal Prince Alfred Hospital, NSW, Australia, from October 2007 for 1 year. Extracted data included diagnosis, date and type of tracheostomy, time to speech-language pathologist involvement, time to phonation, and time to oral intake. Among the 140 patients (mean age 58 years, range 16-85), diagnoses were neurological (32%), head and neck (25%), cardiothoracic (24%), respiratory (6%), and other (13%). Speech-language pathology was involved with 78% of patients, with initial assessment on average 14 days after tracheostomy insertion (14 days to 166 days). Median time from tracheostomy insertion to phonation was 12 days (range 1-103). Median time from tracheostomy insertion to oral intake was 15 days (range 1-142). Only 20% of patients returned to verbal communication within 1 week after tracheostomy insertion. Further research into access to and timing of speech-language pathology intervention in the critical care setting is warranted.
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Laakso K, Markström A, Idvall M, Havstam C, Hartelius L. Communication experience of individuals treated with home mechanical ventilation. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2011; 46:686-699. [PMID: 22026570 DOI: 10.1111/j.1460-6984.2011.00040.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Mechanical ventilatory support seriously affects speaking and communication, and earlier studies show that many ventilator-supported patients experience difficulties and frustration with their speech and voice production. Since there is a growing number of individuals who require mechanical ventilatory support and there is a paucity of studies that examine ventilator-supported communication, this research area needs to be developed to ensure adequate health services for this population. The present study focused on ventilator-supported communication from the point of view of individuals receiving home mechanical ventilation (HMV). AIMS The specific aim was to examine the communication experience of individuals receiving HMV. METHODS & PROCEDURES A qualitative approach was adopted for this study, and data were collected by means of semi-structured interviews. Qualitative content analysis was used to structure, condense and interpret the data. The participants were recruited from the National Respiratory Centre (NRC) in Sweden, and included 19 individuals receiving HMV. OUTCOMES & RESULTS The main theme A long and lonely struggle to find a voice and six subthemes detailing different facets of it emerged from data analysis: Managing changed speech conditions, Prioritising voice, A third party supporting communication, Using communication to get things done, Depending on technology, and Facing ignorance. Important aspects influencing the ventilator-supported individuals' communicative performance (speech, support from others and technological solutions) are discussed. CONCLUSIONS & IMPLICATIONS The study revealed that healthcare practitioners involved in the care of individuals receiving HMV need to improve their understanding and knowledge of issues related to ventilator-supported communication. Individuals receiving HMV encounter a needlessly long and lonely struggle to achieve effective communication. They face numerous challenges regarding their communication, and they need to be heard in both literal and figurative senses. To overcome these challenges they need support from competent healthcare practitioners and personal assistants, and continuous follow-up by speech and language therapists tailoring communicative solutions to fit individual needs.
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Affiliation(s)
- Katja Laakso
- Division of Speech and Language Pathology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, SwedenKarolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, National Respiratory Centre, Stockholm, SwedenLund University, The Swedish Institute for Health Sciences (Vårdal Institute), Lund, Sweden
| | - Agneta Markström
- Division of Speech and Language Pathology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, SwedenKarolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, National Respiratory Centre, Stockholm, SwedenLund University, The Swedish Institute for Health Sciences (Vårdal Institute), Lund, Sweden
| | - Markus Idvall
- Division of Speech and Language Pathology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, SwedenKarolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, National Respiratory Centre, Stockholm, SwedenLund University, The Swedish Institute for Health Sciences (Vårdal Institute), Lund, Sweden
| | - Christina Havstam
- Division of Speech and Language Pathology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, SwedenKarolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, National Respiratory Centre, Stockholm, SwedenLund University, The Swedish Institute for Health Sciences (Vårdal Institute), Lund, Sweden
| | - Lena Hartelius
- Division of Speech and Language Pathology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, SwedenKarolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, National Respiratory Centre, Stockholm, SwedenLund University, The Swedish Institute for Health Sciences (Vårdal Institute), Lund, Sweden
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Myhren H, Ekeberg Ø, Stokland O. Satisfaction with communication in ICU patients and relatives: comparisons with medical staffs' expectations and the relationship with psychological distress. PATIENT EDUCATION AND COUNSELING 2011; 85:237-44. [PMID: 21167672 DOI: 10.1016/j.pec.2010.11.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2010] [Revised: 11/11/2010] [Accepted: 11/21/2010] [Indexed: 05/12/2023]
Abstract
OBJECTIVE To study intensive care unit (ICU) patients' and relatives' satisfaction in regard to communication with medical staff (nurses and physicians), perceived support, environmental strain and their psychological distress. Further, to compare this with expectations of the medical staff. METHODS Cross-sectional study, 4-6 weeks post-ICU discharge. Respondents to the questionnaire were: 255 (63%) patients, 354 (82%) relatives and 145 (74%) medical staff. Degree of satisfaction and distress were measured on a five-point Likert-scale (0=low to 4=high). RESULTS The mean score for patient satisfaction with communication was 3.0 (95%CI 2.9-3.1) and for relatives 3.4 (3.3-3.5). This was significantly higher than expected by the staff for patients 2.5 (2.4-2.6) and relatives 2.8 (2.7-2.9), both p<0.001. Relatives' degree of psychological distress, 2.5 (2.4-2.6) was significantly higher than for patients', 1.6 (1.5-1.7), but was significantly lower than expected by the staff, 2.9 (2.8-3.0) and 2.7 (2.6-2.8) respectively, both p<0.001. CONCLUSION Patients and relatives were more satisfied with the communication than expected by the staff. The staff overestimated the patients' and relatives' psychological distress. Relatives report more psychological distress symptoms post-ICU discharge compared to the patients. PRACTICE IMPLICATIONS Medical staff is aware of psychological distress in ICU patients and relatives and effort to reduce this during ICU stay and afterwards should be implemented.
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Affiliation(s)
- Hilde Myhren
- Intensive Care Unit, Oslo University Hospital, Ullevål, Norway.
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Happ MB, Garrett K, Thomas DD, Tate J, George E, Houze M, Radtke J, Sereika S. Nurse-patient communication interactions in the intensive care unit. Am J Crit Care 2011; 20:e28-40. [PMID: 21362711 PMCID: PMC3222584 DOI: 10.4037/ajcc2011433] [Citation(s) in RCA: 131] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND The inability to speak during critical illness is a source of distress for patients, yet nurse-patient communication in the intensive care unit has not been systematically studied or measured. OBJECTIVES To describe communication interactions, methods, and assistive techniques between nurses and nonspeaking critically ill patients in the intensive care unit. METHODS Descriptive observational study of the nonintervention/usual care cohort from a larger clinical trial of nurse-patient communication in a medical and a cardiothoracic surgical intensive care unit. Videorecorded interactions between 10 randomly selected nurses (5 per unit) and a convenience sample of 30 critically ill adults (15 per unit) who were awake, responsive, and unable to speak because of respiratory tract intubation were rated for frequency, success, quality, communication methods, and assistive communication techniques. Patients self-rated ease of communication. RESULTS Nurses initiated most (86.2%) of the communication exchanges. Mean rate of completed communication exchange was 2.62 exchanges per minute. The most common positive nurse act was making eye contact with the patient. Although communication exchanges were generally (>70%) successful, more than one-third (37.7%) of communications about pain were unsuccessful. Patients rated 40% of the communication sessions with nurses as somewhat difficult to extremely difficult. Assistive communication strategies were uncommon, with little to no use of assistive communication materials (eg, writing supplies, alphabet or word boards). CONCLUSIONS Study results highlight specific areas for improvement in communication between nurses and nonspeaking patients in the intensive care unit, particularly in communication about pain and in the use of assistive communication strategies and communication materials.
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Affiliation(s)
- Mary Beth Happ
- School of Nursing, University of Pittsburgh, Pennsylvania, USA.
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63
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Abstract
Ascertaining the symptom experience of chronically critically ill (CCI) patients is difficult because of communication impairment and fluctuations in patient cognition and physiologic conditions. The use of checklist self-report ratings is hampered by the inability of most CCI patients to respond verbally to symptom queries. In addition to the communication problems caused by mechanical ventilation, the apparently diverse idioms of symptom expression add to the potential for miscommunication regarding symptom experience. Although patient communication impairment is a major barrier to symptom identification, symptom assessment and treatment are fundamental components of nursing care for CCI. This article reviews and describes the unique constellation of symptoms experienced by many critically ill patients. We report our observations of symptom communication among CCI patients and nurses and discuss inconsistency in the language of symptom expression among nurses and patients. Clinically applicable strategies to improve nurse-patient symptom communication and suggestions for refinement of symptom assessment in chronic critical illness are provided.
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Samuelson KA. Adult intensive care patients' perception of endotracheal tube-related discomforts: A prospective evaluation. Heart Lung 2011; 40:49-55. [DOI: 10.1016/j.hrtlng.2009.12.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2009] [Revised: 12/29/2009] [Accepted: 12/29/2009] [Indexed: 10/19/2022]
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Muslim women's experiences of suffering in Jordanian intensive care units: a narrative study. Intensive Crit Care Nurs 2010; 26:175-84. [PMID: 20434344 DOI: 10.1016/j.iccn.2010.02.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2009] [Revised: 02/08/2010] [Accepted: 02/09/2010] [Indexed: 11/20/2022]
Abstract
This paper explores Muslim women's experiences of suffering in Jordanian intensive care units. A narrative approach was employed to access women's stories of their critical illness. Sixteen women who had spent at least 48 hours in intensive care were recruited from two hospitals in a Jordanian city and took part in between one and three interviews over a six-month period. Women's accounts of suffering were pervaded with physical, social, spiritual and technological themes. Pain was a central strand in the women's accounts and was experienced often as severe, overwhelming and disturbing to their sleep. The sudden onset of illness, the unfamiliar ICU environment and feeling of uncertainty made it difficult for the women to interpret their experiences. Religious beliefs and cultural norms helped the women make sense of their suffering. Social support, especially from the family, was reported by the women to be essential: a lack of social support was seen as a symbol of death. This study emphasises the importance of looking at a patient who is critically ill as a whole person within the context of their cultural, spiritual and biographical milieu.
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Abstract
The purpose of this study was to uncover the structure of the lived experience of feeling misunderstood. Parse’s phenomenological-hermeneutic research method was used to answer the research question: What is the structure of the lived experience of feeling misunderstood? Extraction-synthesis revealed four core concepts. The structure is the lived experience of feeling misunderstood is disheartening insignificance surfacing with discordant affiliations, as resignation with resiliency emerges with inventive endeavors. Implications for nursing research and practice are presented.
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Mu PF, Wang KWK, Chen YC, Tsay SF. A systematic review of the experiences of adult ventilator-dependent patients. ACTA ACUST UNITED AC 2010. [DOI: 10.11124/jbisrir-2010-117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Briscoe WP, Woodgate RL. Sustaining self: the lived experience of transition to long-term ventilation. QUALITATIVE HEALTH RESEARCH 2010; 20:57-67. [PMID: 20019349 DOI: 10.1177/1049732309356096] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Long-term mechanical ventilation (LTMV) is used to support growing numbers of children and adults who develop chronic respiratory failure. The purpose of this hermeneutic phenomenological study was to explore the subjective meaning of the experience of transition from spontaneous breathing to reliance on LTMV. In-depth, audiorecorded interviews of 11 ventilated individuals living in a western Canadian province were transcribed and analyzed. The transition journey was revealed to be a time of psychological, physical, and spiritual challenge. "Sustaining self " was revealed as the essence of ventilator users' transition experience. Findings underscore the complex nature of transition to technological reliance, illuminating the need for increased health professional knowledge and understanding of the symptom experience and management options for individuals living with chronic respiratory failure. Strategies to support individuals' sense of self as they journey to a life reliant on LTMV are required.
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Affiliation(s)
- Winnifred P Briscoe
- Red River College of Applied Arts, Science and Technology, Winnipeg, Manitoba, Canada.
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Mu PF, Wang KWK, Chen YC, Tsay SF. A systematic review of the experiences of adult ventilator-dependent patients. ACTA ACUST UNITED AC 2010; 8:344-381. [PMID: 27820005 DOI: 10.11124/01938924-201008080-00001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES The objective of this meta-synthesis study was to describe the nature of the experience of adult ventilator-dependent patients. INCLUSION CRITERIA This review considered studies utilized qualitative methods to examine the experience of adult with ventilator. The phenomena of interest were experiences of patients who were treated with ventilator for both short term and long term in ICU settings or home settings. The research was limited to studies published in Chinese or in English language. SEARCH STRATEGY The searching strategy sought to find both published and unpublished studies. The CINAHL, PubMed, MEDLINE, Cochrane Library, Chinese Periodicals Index and JIB website were used to search the articles. The preliminary keywords were drawn from the natural language terms of the topic, in the title, abstract and subject descriptors. METHODOLOGICAL QUALITY Each paper was assessed independently by two reviewers for methodological quality. The Joanna Briggs Institute's Qualitative Assessment and Review Instrument were used to appraisal the methodological quality of the articles. Any disagreements that arose between the reviewers were resolved through discussion with a third reviewer. DATA SYNTHESIS Qualitative research findings were pooled and the data analysis process involved synthesizing findings to generate a set of statements that represent the nature of the experiences of ventilator-dependent adult patients. The categories and themes/meta-syntheses were emerged from the analysis process. RESULTS A total of 997 papers were identified from various database and hand searches. Nineteen papers were critically appraised and 15 met inclusion criteria. Four papers were excluded because they did not meet the inclusion criteria. Five themes/meta-syntheses emerged from the analysis: 1). The feelings of fear due to being dependent on ventilator and the loss of control of life, 2). Disconnection with reality, 3). Impaired embodiment (body image and body boundary), 4). Construction of coping patterns, 5). Trust and caring relationship. CONCLUSION The five themes/meta-syntheses derived from the review represent the patients' experiences in regarding the threatening of the integrity of self, self-other and self-environment relationships, the coping patterns and resilient resources to maintain their self-identify and the meaning of life. These findings also illustrate the resiliency factors for those patients to cope with this stressful situation.The implications to practice include enhancing the trust relationship with health professionals, as well as the nursing actions prior to suction, during the suction procedure and post suction in related to release their psychological distress and empower their resilience factors was suggested.Furthermore, the further research could focus on the development and implementation of support programs for the patients, families, and health professionals, as well as the research regarding the reduction of psychological distress and empower the coping patterns.
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Affiliation(s)
- Pei-Fan Mu
- 1. Taiwan Joanna Briggs Institute Collaborating Centre, Taiwan. 2. School of Nursing, National Yang-Ming University, Taipei, Taiwan, R. O. C. 3. Director of Department of Nursing, Veteran General Hospital, Taipei, Taiwan R. O. C. 4. Deputy Director of Bureau of Nursing and Health Services Development, R. O. C
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Laakso K, Markström A, Hartelius L. Communication and quality of life in individuals receiving home mechanical ventilation. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2009. [DOI: 10.12968/ijtr.2009.16.12.45421] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Katja Laakso
- Institute of Neuroscience and Physiology, Division of Speech and Language Pathology, University of Gothenburg, Gothenburg, and The Swedish Institute for Health Sciences (Vårdalinstitutet), Lund University, Lund, Sweden
| | - Agneta Markström
- Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, National Respiratory Centre, Stockholm, Sweden
| | - Lena Hartelius
- Institute of Neuroscience and Physiology, Division of Speech and Language Pathology, University of Gothenburg, Gothenburg, Sweden
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