TY - JOUR
T1 - Experience of acute noninvasive ventilation - Insights from 'Behind the Mask'
T2 - A qualitative study
AU - Smith, Tracy A.
AU - Agar, Meera
AU - Jenkins, Christine R.
AU - Ingham, Jane M.
AU - Davidson, Patricia M.
N1 - Funding Information:
Funding JMI’s research work on this paper was undertaken, in part, with funding support from the Cancer Institute New South Wales Academic Chairs Program.
Publisher Copyright:
© Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
PY - 2019/3/1
Y1 - 2019/3/1
N2 - Objective Non-invasive ventilation (NIV) is widely used in the management of acute and acute-on-chronic respiratory failure. Understanding the experiences of patients treated with NIV is critical to person-centred care. We describe the subjective experiences of individuals treated with NIV for acute hypercapnic respiratory failure. Design Qualitative face-to-face interviews analysed using thematic analysis. Setting Australian tertiary teaching hospital. Participants Individuals with acute hypercapnic respiratory failure treated with NIV outside the intensive care unit. Individuals who did not speak English or were unable or unwilling to consent were excluded. Results 13 participants were interviewed. Thematic saturation was achieved. Participants described NIV providing substantial relief from symptoms and causing discomfort. They described enduring NIV to facilitate another chance at life. Although participants sometimes appeared passive, others expressed a strong conviction that they knew which behaviours and treatments relieved their distress. Most participants described gaps in their recollection of acute hospitalisation and placed a great amount of trust in healthcare providers. All participants indicated that they would accept NIV in the future, if clinically indicated, and often expressed a sense of compulsion to accept NIV. Participants' description of their experience of NIV was intertwined with their experience of chronic disease. Conclusions Participants described balancing the benefits and burdens of NIV, with the goal of achieving another chance at life. Gaps in recall of their treatment with NIV were frequent, potentially suggesting underlying delirium. The findings of this study inform patient-centred care, have implications for the care of patients requiring NIV and for advance care planning discussions.
AB - Objective Non-invasive ventilation (NIV) is widely used in the management of acute and acute-on-chronic respiratory failure. Understanding the experiences of patients treated with NIV is critical to person-centred care. We describe the subjective experiences of individuals treated with NIV for acute hypercapnic respiratory failure. Design Qualitative face-to-face interviews analysed using thematic analysis. Setting Australian tertiary teaching hospital. Participants Individuals with acute hypercapnic respiratory failure treated with NIV outside the intensive care unit. Individuals who did not speak English or were unable or unwilling to consent were excluded. Results 13 participants were interviewed. Thematic saturation was achieved. Participants described NIV providing substantial relief from symptoms and causing discomfort. They described enduring NIV to facilitate another chance at life. Although participants sometimes appeared passive, others expressed a strong conviction that they knew which behaviours and treatments relieved their distress. Most participants described gaps in their recollection of acute hospitalisation and placed a great amount of trust in healthcare providers. All participants indicated that they would accept NIV in the future, if clinically indicated, and often expressed a sense of compulsion to accept NIV. Participants' description of their experience of NIV was intertwined with their experience of chronic disease. Conclusions Participants described balancing the benefits and burdens of NIV, with the goal of achieving another chance at life. Gaps in recall of their treatment with NIV were frequent, potentially suggesting underlying delirium. The findings of this study inform patient-centred care, have implications for the care of patients requiring NIV and for advance care planning discussions.
KW - Advance care planning
KW - Chronic obstructive pulmonary disease
KW - Heart failure
KW - Respiratory conditions
KW - noninvasive ventilation
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U2 - 10.1136/bmjspcare-2015-000908
DO - 10.1136/bmjspcare-2015-000908
M3 - Article
C2 - 27566721
AN - SCOPUS:85061864890
SN - 2045-435X
VL - 9
JO - BMJ Supportive and Palliative Care
JF - BMJ Supportive and Palliative Care
IS - 1
M1 - e11
ER -