Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark.
J Clin Nurs. 2018 Jan;27(1-2):e61-e69. doi: 10.1111/jocn.13847. Epub 2017 Jul 5.
To clarify chronic obstructive pulmonary disease patients' perspectives on treatment with noninvasive ventilation and develop management strategies for the treatment based on these perspectives.
The effect of treating chronic obstructive pulmonary disease patients with noninvasive ventilation is well-documented, as is the problem of patient difficulties in tolerating the treatment. Knowledge of how patients with chronic obstructive pulmonary disease experience and evaluate treatment with noninvasive ventilation is limited; therefore, more information of patient perspectives is needed to develop treatment practices in respiratory medicine.
This study is based on critical psychological practice research.
A co-researcher group comprising diverse health professionals was set up and headed by the principal researcher. The group convened seven times over 12 months to develop new management strategies based on patients' perspectives on noninvasive ventilation. Health professionals contributed with experience-based perspectives, and the researcher contributed with data from participant observation in the department and semi-structured interviews with 16 patients and four relatives.
Interviews revealed that patients with chronic obstructive pulmonary disease regarded noninvasive ventilation treatment positively even though they experienced discomfort and anxiety. Patients' perspectives revealed that patients with chronic obstructive pulmonary disease conduct their everyday lives with chronic obstructive pulmonary disease looking at chronic obstructive pulmonary disease as a basic life condition rather than an illness. This approach had a major impact on chronic obstructive pulmonary disease patients' attitudes to noninvasive ventilation treatment and hospitalisation.
Investigation of patient perspectives generated results that were highly productive in facilitating multidisciplinary collaboration and in developing and sustaining new management strategies. Critical psychological practice research facilitated ongoing development of clinical practice related to noninvasive ventilation treatment.
Focus on patients' perspectives in treatment with noninvasive ventilation resulted in the development of new management strategies regarding patient care, joint ward rounds, and in addition, one room at the ward, to which a nurse was assigned, was designated for chronic obstructive pulmonary disease patients treated with noninvasive ventilation.
阐明慢性阻塞性肺疾病患者对无创通气治疗的看法，并根据这些观点制定无创通气治疗的管理策略。
无创通气治疗慢性阻塞性肺疾病患者的效果已有充分记录，患者难以耐受治疗的问题也同样存在。关于慢性阻塞性肺疾病患者对无创通气治疗的体验和评价，我们知之甚少；因此，为了制定呼吸医学领域的治疗实践，我们需要更多患者观点的信息。
本研究基于批判性心理实践研究。
成立了一个由不同卫生专业人员组成的共同研究小组，由首席研究员领导。该小组在 12 个月内召开了 7 次会议，根据患者对无创通气的看法制定新的管理策略。卫生专业人员提供了基于经验的观点，而研究人员则提供了参与者在科室的观察数据以及对 16 名患者和 4 名家属的半结构化访谈数据。
访谈揭示了慢性阻塞性肺疾病患者对无创通气治疗持积极态度，尽管他们感到不适和焦虑。患者的观点表明，慢性阻塞性肺疾病患者将慢性阻塞性肺疾病视为一种基本生活条件，而不是一种疾病，他们以这种方式过着日常生活。这种方法对慢性阻塞性肺疾病患者对无创通气治疗和住院的态度产生了重大影响。
对患者观点的调查产生了富有成效的结果，促进了多学科合作，并制定和维持了新的管理策略。批判性心理实践研究促进了与无创通气治疗相关的临床实践的不断发展。
关注无创通气治疗中的患者观点导致了新的管理策略的制定，这些策略涉及患者护理、联合查房，此外，病房还指定了一个房间，专门为接受无创通气治疗的慢性阻塞性肺疾病患者提供服务。
