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慢性高碳酸血症呼吸衰竭患者对长期家庭无创通气的适应:一项定性研究

Adaptation to Long-Term Home Non-Invasive Ventilation for People with Chronic Hypercapnic Respiratory Failure: A Qualitative Study.

作者信息

Yacob Hussain Nur Zahrah Yuko, Hassan Norasyikin, Wong Hang Siang, Mok Yingjuan, Klainin-Yobas Piyanee

机构信息

Division of Nursing, Changi General Hospital, Singapore 529889, Singapore.

Alice Lee Centre for Nursing Studies Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore.

出版信息

Nurs Rep. 2025 May 20;15(5):176. doi: 10.3390/nursrep15050176.

Abstract

Home non-invasive ventilation use is the primary treatment for improving respiratory function in people with chronic hypercapnic respiratory failure. Non-invasive ventilation has also been studied to understand users' perspectives. However, no studies have been conducted on how users adapt to non-invasive ventilation in their homes from the early phase of their diagnosis as a long-term utility. The study employed a descriptive qualitative design guided by Roy's adaptation model. A purposive sample was used. People with chronic hypercapnic respiratory failure who had used NIV at home for a minimum of six months would be eligible. They were interviewed at a sleep and assisted ventilation centre. Their interviews were audio recorded before proceeding with transcription. Each transcript was thematically analysed. Twenty participants were included in the study, from which six themes emerged. They experienced a common transition, from denying the need for non-invasive ventilation to integrating them into their daily lives at home. Throughout this process, they had emotional turmoil, faced difficulties in keeping their masks on, and improved sleep quality. They also adjusted their social interactions before fully accepting the use of non-invasive ventilation. Their coping strategies in their role functions at home and social interaction were also narrated. Their family members were pivotal in their adaptation period. : Gaining insight into individuals' adaptation experiences can facilitate early identification of potential challenges faced by new users of non-invasive ventilation. This study calls for healthcare professionals to assess users' understanding of long-term commitment and their living conditions early for a successful NIV adaptation.

摘要

家庭无创通气的使用是改善慢性高碳酸血症呼吸衰竭患者呼吸功能的主要治疗方法。人们也对无创通气进行了研究,以了解使用者的观点。然而,尚未有关于使用者如何从诊断初期就将无创通气作为一种长期实用设备在家中适应的研究。该研究采用了以罗伊适应模型为指导的描述性定性设计。采用了目的抽样法。在家中使用无创通气至少六个月的慢性高碳酸血症呼吸衰竭患者符合条件。他们在睡眠与辅助通气中心接受了访谈。访谈在进行转录之前进行了录音。对每份转录本进行了主题分析。该研究纳入了20名参与者,从中出现了六个主题。他们经历了一个共同的转变,从否认需要无创通气到将其融入家庭日常生活中。在这个过程中,他们经历了情绪波动,戴着面罩遇到困难,睡眠质量得到改善。他们还在完全接受使用无创通气之前调整了社交互动。他们在家中角色功能和社交互动中的应对策略也被叙述。他们的家庭成员在适应期起着关键作用。深入了解个人的适应经历有助于早期识别无创通气新使用者面临的潜在挑战。这项研究呼吁医疗保健专业人员尽早评估使用者对长期使用的理解及其生活状况,以实现无创通气的成功适应。

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本文引用的文献

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Assessment of Chronic Hypercapnic Respiratory Failure.慢性高碳酸血症性呼吸衰竭评估。
Sleep Med Clin. 2024 Sep;19(3):391-403. doi: 10.1016/j.jsmc.2024.04.002. Epub 2024 Jun 4.

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