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“我和机器”:使用无创通气的神经肌肉疾病患者的生活体验。

"Me and ' machine": the lived experiences of people with neuromuscular disorders using non-invasive ventilation.

机构信息

Centre for Health, Activity and Rehabilitation Research (CHARR), School of Physiotherapy, University of Otago, Dunedin, New Zealand.

Department of Medicine, University of Otago, Wellington, New Zealand.

出版信息

Disabil Rehabil. 2023 Jun;45(11):1847-1856. doi: 10.1080/09638288.2022.2076939. Epub 2022 Jun 1.

Abstract

PURPOSE

Neuromuscular disorders (NMD) encompasses a wide range of conditions, with respiratory weakness a common feature. Respiratory care can involve non-invasive ventilation (NIV) resulting in fewer hospital admissions, a lower mortality rate and improved quality of life. The aim of this study was to explore the 'lived experience' of NIV by people with NMD.

METHODS

Interpretive Phenomenological Analysis (IPA) with semi-structured, face to face interviews with 11 people with NMD, using bi-level positive airway pressure for NIV for more than 12 months.

RESULTS

Three themes were interpreted: (i) Alive, with a life; (ii) Me and ' machine; and (iii) Precariousness of this life. NIV enabled hope, independence and the opportunity to explore previously perceived unattainable life experiences. Yet, participants felt dependent on the machine. Furthermore, practical considerations and fear of NIV failure created a sense of precariousness to life and a reframing of personal identity.

CONCLUSION

The findings highlight the broad ranging positive and negative effects that may occur for people with NMD when using this important therapy. Ongoing non-judgemental support and empathy are required from health professionals as the use of NIV challenged concepts such as 'living life well' for people with NMD. IMPLICATIONS FOR REHABILITATIONNeuromuscular disorders may result in respiratory weakness requiring non-invasive ventilation (NIV).When prescribed early, NIV can results in fewer hospital admissions, a lower mortality rate and improved quality of life.The relationship of people with NMD with their NIV machine is complex and impacts on and requires adjustment to their identity.NIV users acknowledged that NIV provided hope but simultaneously recognised the precariousness of NIV on their life.In order to better support people with NMD healthcare professionals need to better understand how the physical, psychological and social implications of NIV affect an individual's life.

摘要

目的

神经肌肉疾病(NMD)涵盖了广泛的病症,呼吸无力是常见特征。呼吸护理可能包括无创通气(NIV),从而减少住院次数、降低死亡率和提高生活质量。本研究旨在探讨 NMD 患者对 NIV 的“生活体验”。

方法

采用解释现象学分析(IPA)方法,对 11 名使用双水平气道正压通气(BiPAP)进行 NIV 治疗超过 12 个月的 NMD 患者进行半结构化、面对面访谈。

结果

解释了三个主题:(i)活着,有生活;(ii)我和“机器”;以及(iii)生活的脆弱性。NIV 使患者充满希望、获得独立,并能探索以前认为无法实现的生活体验。然而,参与者感到依赖于机器。此外,实际考虑因素和对 NIV 失败的恐惧导致对生活的脆弱性和对个人身份的重新定义。

结论

研究结果强调了在使用这种重要治疗方法时,NMD 患者可能会产生广泛的积极和消极影响。健康专业人员需要给予持续的、非评判性的支持和同理心,因为 NIV 的使用挑战了 NMD 患者“生活得好”的概念。

对康复的影响

神经肌肉疾病可能导致呼吸无力,需要使用无创通气(NIV)。

如果早期处方,NIV 可以减少住院次数、降低死亡率和提高生活质量。

NMD 患者与他们的 NIV 机器之间的关系是复杂的,这会影响并需要调整他们的身份。

NIV 用户承认 NIV 提供了希望,但同时也认识到 NIV 对他们生活的脆弱性。

为了更好地支持 NMD 患者,医疗保健专业人员需要更好地理解 NIV 的身体、心理和社会影响如何影响个人的生活。

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