Schou Lone, Egerod Ingrid
The Heart Centre, Rigshospitalet, Department 4142, Blegdamsvej 9, DK-2100 Copenhagen O, Denmark.
Intensive Crit Care Nurs. 2008 Jun;24(3):171-9. doi: 10.1016/j.iccn.2007.12.004. Epub 2008 Feb 15.
Research into mechanical ventilator weaning has predominantly been devoted to analysis and evaluation of predictors of weaning success. Few studies have examined the patient experience of weaning. The aim of this study was to provide a contemporary description of the patient experience of weaning, in order to up-date this aspect of knowledge in the context of newer modalities of mechanical ventilation and sedation.
The study had a descriptive qualitative design focusing on the lived experience of post-CABG (coronary artery bypass graft) patients ventilated > or = 24h (n=10). Data were generated using semi-structured depth interviews conducted 2-5 months after hospital discharge. A hermeneutic phenomenological approach was used to analyze the data.
The article presents selected themes that emerged during the process of analysis. The main findings relate to general phenomena such as discomfort and impaired communication, psychological phenomena such as loss of control and loneliness, and existential phenomena such as temporality and human interaction.
Newer modalities of sedation and mechanical ventilation have not entirely eliminated the discomforts of critical illness; the human aspects of suffering remain. In order to address some of the general, psychological, and existential patient experiences, care should be taken to acknowledge the patient and to respect the patient domain and individual time frames. In nurse-patient communication, it is recommended that caregivers give accurate and unambiguous information.
对机械通气撤机的研究主要致力于分析和评估撤机成功的预测因素。很少有研究考察患者的撤机体验。本研究的目的是对患者的撤机体验进行当代描述,以便在机械通气和镇静的新模式背景下更新这方面的知识。
本研究采用描述性定性设计,聚焦于冠状动脉搭桥术(CABG)后机械通气≥24小时的患者(n = 10)的实际体验。数据通过出院后2 - 5个月进行的半结构化深度访谈收集。采用诠释现象学方法分析数据。
本文呈现了分析过程中出现的选定主题。主要发现涉及不适和沟通障碍等一般现象、失去控制和孤独等心理现象以及时间性和人际互动等存在现象。
镇静和机械通气的新模式并未完全消除危重病的不适;痛苦的人文方面依然存在。为了应对患者的一些一般、心理和存在体验,应注意认识到患者并尊重患者领域和个人时间框架。在护患沟通中,建议护理人员提供准确、明确的信息。