Nurs Res. 2023;72(6):456-461. doi: 10.1097/NNR.0000000000000688. Epub 2023 Sep 19.
Although a multitude of studies have demonstrated the effectiveness of noninvasive ventilation (NIV) for treatment of respiratory insufficiency, there have been few investigations of patients' experiences while receiving this common treatment. Identification of the presence, intensity, and distress of symptoms during NIV will inform the development and testing of interventions to best manage them and improve patients' intensive care unit (ICU) experiences.
The objectives of this study were (a) to identify the presence, intensity, and distress of symptoms in patients receiving NIV in the ICU using a modified version of the Edmonton Symptom Assessment Scale (MESAS) and (b) to describe the most common and distressing symptoms experienced by patients.
A cross-sectional descriptive design was used with a convenience sample of 114 participants enrolled from three ICUs at one Midwestern medical center. Participants were approached if they were English-speaking, were 18 years old or older, and had an active order for NIV; exclusions included use of personal NIV equipment, severe cognitive impairment, or problems communicating. Demographic and clinical data were obtained from the electronic health record. Presence, intensity, and distress of patient-reported symptoms were obtained once using a modified, 11-item version of the MESAS.
The mean age of participants was 68 years old, and 54.4% were male. The primary type of NIV was bi-level positive airway pressure; a nasal/oral mask was most frequently used. The symptoms experienced by most of the participants were thirst, anxiety, tiredness, and restlessness; these symptoms were rated as moderate or severe in both intensity and distress by most participants experiencing the symptoms.
Patients in the ICU experience both intense and distressful symptoms that can be severe while undergoing treatment with NIV. Future research is warranted to determine these symptoms' interrelatedness and develop interventions to effectively manage patient-reported symptoms.
尽管大量研究表明无创通气(NIV)在治疗呼吸功能不全方面的有效性,但对患者接受这种常见治疗时的体验的研究甚少。识别 NIV 期间症状的存在、强度和困扰程度,将为制定和测试干预措施提供信息,以最佳管理这些症状并改善患者的重症监护病房(ICU)体验。
本研究的目的是(a)使用埃德蒙顿症状评估量表(MESAS)的修改版,确定接受 ICU 中 NIV 的患者的症状存在、强度和困扰程度,(b)描述患者最常见和最困扰的症状。
采用横断面描述性设计,从一家中西部医疗中心的三个 ICU 中方便选择 114 名参与者进行研究。如果患者是英语使用者、年龄在 18 岁或以上、且有 NIV 治疗医嘱,即可参与研究;排除标准包括使用个人 NIV 设备、严重认知障碍或沟通问题。人口统计学和临床数据从电子健康记录中获得。使用修改后的 11 项 MESAS 版本,一次获得患者报告症状的存在、强度和困扰程度。
参与者的平均年龄为 68 岁,54.4%为男性。主要的 NIV 类型是双水平气道正压通气;最常使用鼻/口鼻面罩。大多数参与者经历的症状是口渴、焦虑、疲倦和不安;大多数经历这些症状的患者都将这些症状的强度和困扰程度评为中度或重度。
接受 NIV 治疗的 ICU 患者会经历强烈和困扰的症状,这些症状在治疗过程中可能很严重。需要进一步研究这些症状的相互关系,并开发干预措施来有效管理患者报告的症状。