General Adult and Pediatric Intensive Care Unit, Emergency Department - Fondazione IRCCS San Gerardo dei Tintori, University of Milano-Bicocca, Monza, Italy.
Critical care nursing master degree student, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
Nurs Crit Care. 2024 Jan;29(1):49-57. doi: 10.1111/nicc.12951. Epub 2023 Jul 24.
During the pandemic outbreak, helmet continuous positive airway pressure (CPAP) was widely used as respiratory support for COVID-19 patients, inside and outside of intensive care units. The available literature suggests specific interventions to improve the comfort of patients treated with helmet-CPAP. Few reports are available on the experiences of patients undergoing this treatment.
This qualitative study aimed to explore the views and recollections of COVID-19 patients undergoing helmet-CPAP.
We conducted semi-structured interviews with thematic analysis. Participants were recruited from the follow-up programme for COVID-19 patients discharged from an Italian general intensive care unit. Participants were interviewed by telephone. Data analysis followed the principles of thematic synthesis approach.
We conducted 29 phone calls in patients eligible for the study. Five participants declared that they did not remember the time spent in hospital on helmet-CPAP. Twenty-four patients were then included. Two themes and six subthemes were generated from their interview data: (1) The helmet-CPAP as a life-saving treatment (subthemes: recognition of the usefulness of treatment and resilience); (2) the negative feelings related to helmet-CPAP application (subthemes: communication problems, entrapment, mental confusion, fear of dying). Each patient's experience was unique, but some discomfort elements such as noise, gas flow turbulence, choking sensation and thirst were found to be very common.
The application of helmet-CPAP treatment generated positive and negative memories and feelings in COVID-19 patients during the pandemic. The patients' experience has provided an overview of the main factors of discomfort. This can be a starting point for taking corrective measures to promote greater helmet tolerance and subsequent treatment success.
This study has provided an insight into the patient's recollections about helmet-CPAP treatment during a worldwide pandemic. The findings suggested strict applications of interventions aimed to reduce some issues that participants reported, to improve their compliance to treatment. Results from this study could help nurses in understanding the needs of patients treated with helmet-CPAP and may foster a care focused on patient-centred outcomes.
在大流行期间，头盔持续气道正压通气（CPAP）在重症监护病房内外被广泛用作 COVID-19 患者的呼吸支持。现有文献表明，需要采取特定干预措施来提高接受头盔-CPAP 治疗的患者的舒适度。有关接受这种治疗的患者的经验的报告很少。
本定性研究旨在探讨接受头盔-CPAP 治疗的 COVID-19 患者的观点和回忆。
我们对从意大利综合重症监护病房出院的 COVID-19 患者的随访计划进行了半结构式访谈和主题分析。通过电话采访参与者。数据分析遵循主题综合方法的原则。
我们对符合研究条件的 29 名患者进行了电话采访。5 名参与者表示他们不记得在医院接受头盔-CPAP 治疗的时间。然后包括 24 名患者。从他们的访谈数据中生成了两个主题和六个子主题：（1）头盔-CPAP 作为救命治疗（子主题：认识到治疗的有用性和韧性）；（2）与头盔-CPAP 应用相关的负面感受（子主题：沟通问题、被困、精神混乱、对死亡的恐惧）。每位患者的经历都是独特的，但发现一些不适因素，如噪音、气流湍流、窒息感和口渴感非常普遍。
在大流行期间，COVID-19 患者对头盔-CPAP 治疗产生了积极和消极的记忆和感受。患者的经历概述了不适的主要因素。这可以作为采取纠正措施的起点，以提高头盔耐受性和随后的治疗成功率。
本研究深入了解了患者在全球大流行期间对头盔-CPAP 治疗的回忆。研究结果表明，应严格实施旨在减少参与者报告的一些问题的干预措施，以提高他们对治疗的依从性。本研究的结果可以帮助护士了解接受头盔-CPAP 治疗的患者的需求，并促进以患者为中心的护理成果为重点的护理。
