Clinical Skills Development Service, Metro North Hospital and Health Service, Brisbane, Qld, Australia.
School of Psychology, The University of Queensland, Brisbane, Qld, Australia.
J Clin Nurs. 2018 Feb;27(3-4):546-554. doi: 10.1111/jocn.13861. Epub 2017 Jun 28.
To investigate whether awareness of manual respiratory rate monitoring affects respiratory rate in adults, and whether count duration influences respiratory rate estimates.
Nursing textbooks typically suggest that the patient should ideally be unaware of respiratory rate observations; however, there is little published evidence of the effect of awareness on respiratory rate, and none specific to manual measurement. In addition, recommendations about the length of the respiratory rate count vary from text to text, and the relevant empirical evidence is scant, inconsistent and subject to substantial methodological limitations.
Experimental study with awareness of respiration monitoring (aware, unaware; randomised between-subjects) and count duration (60 s, 30 s, 15 s; within-subjects) as the independent variables. Respiratory rate (breaths/minute) was the dependent variable.
Eighty-two adult volunteers were randomly assigned to aware and unaware conditions. In the baseline block, no live monitoring occurred. In the subsequent experimental block, the researcher informed aware participants that their respiratory rate would be counted, and did so. Respirations were captured throughout via video recording, and counted by blind raters viewing 60-, 30- and 15-s extracts. The data were collected in 2015.
There was no baseline difference between the groups. During the experimental block, the respiratory rates of participants in the aware condition were an average of 2.13 breaths/minute lower compared to unaware participants. Reducing the count duration from 1 min to 15 s caused respiratory rate to be underestimated by an average of 2.19 breaths/minute (and 0.95 breaths/minute for 30-s counts). The awareness effect did not depend on count duration.
Awareness of monitoring appears to reduce respiratory rate, and shorter monitoring durations yield systematically lower respiratory rate estimates.
When interpreting and acting upon respiratory rate data, clinicians should consider the potential influence of these factors, including cumulative effects.
调查成人对手动呼吸频率监测的意识是否会影响呼吸频率，以及计数持续时间是否会影响呼吸频率估计。
护理教科书通常建议患者最好不知道呼吸频率观察结果；然而，关于意识对呼吸频率的影响的证据很少，并且没有专门针对手动测量的证据。此外，关于呼吸频率计数的长度的建议因文本而异，相关的实证证据很少、不一致且存在重大方法学限制。
具有呼吸监测意识（意识、无意识；随机分组）和计数持续时间（60 秒、30 秒、15 秒；组内）的实验研究作为自变量。呼吸频率（每分钟呼吸次数）是因变量。
82 名成年志愿者被随机分配到意识和无意识条件下。在基线块中，没有进行实时监测。在随后的实验块中，研究人员告知有意识的参与者他们的呼吸频率将被计数，并进行了计数。通过视频记录捕获整个呼吸过程，并由盲法评分者查看 60 秒、30 秒和 15 秒的提取物进行计数。数据于 2015 年收集。
两组在基线时没有差异。在实验块期间，有意识条件下的参与者的呼吸频率比无意识参与者平均低 2.13 次/分钟。将计数持续时间从 1 分钟减少到 15 秒，会导致呼吸频率平均低估 2.19 次/分钟（30 秒计数时为 0.95 次/分钟）。意识效应不依赖于计数持续时间。
监测意识似乎会降低呼吸频率，并且较短的监测持续时间会导致呼吸频率估计值系统降低。
在解释和根据呼吸频率数据采取行动时，临床医生应考虑这些因素的潜在影响，包括累积效应。
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