A Systematic Review of Patient and Caregiver Experiences with a Tracheostomy

Nakarada-Kordic, Ivana; Patterson, Niamh M.; Wrapson, Jill; Reay, Stephen

doi:10.1007/s40271-017-0277-1

Cited by 88 publications

(84 citation statements)

References 66 publications

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“…As noted by Nakarada-Kordic et al, 24 steps to accommodate such paradoxes should include providing proper information and counseling, and formulating patient-specific treatment and care initiatives. Similarly, this review demonstrated that the patients call for individualized and patient-specific counseling and communication plans as key points with regard to appropriate decision making, which indicated this to be a precondition to feel safe and confident with home mechanical ventilation.…”

Section: Discussionmentioning

confidence: 99%

Users' Experiences With Home Mechanical Ventilation: A Review of Qualitative Studies

et al. 2019

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BACKGROUND: Users of home mechanical ventilation encounter major psychological and physiologic challenges. To ensure well-functioning home mechanical ventilation, users' experiences of care and treatment are important knowledge to supplement clinical perspectives. This systematic review aimed to summarize current qualitative evidence regarding experiences of home mechanical ventilation users. METHODS: By following Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines, 9 databases were systematically searched. Seven studies met the inclusion criteria after title and/or abstract screening and full-text assessment. These were appraised by using the Relevance, Appropriateness, Transparency, Soundness checklist. Thematic analysis guided data extraction and identification of the findings. The Confidence in the Evidence for Reviews of Qualitative Research tool was applied to assess the confidence of the findings. RESULTS: The review showed high confidence in 4 findings: an increase in quality of life, feeling forced to accept home mechanical ventilation, collaboration between home-care assistants and users of home mechanical ventilation is challenging, and information about the technology from a user's perspective. The review showed moderate confidence in 2 findings: living at home is pivotal for a normalized everyday life, and home mechanical ventilation causes a life with continued worries and uncertainty. CONCLUSIONS: According to the users, treatment by home mechanical ventilation resulted in increased well-being and facilitated a community-and home-based lifestyle compared with institutional-based treatment. However, the users also expressed difficulties in coming to terms with the necessary extensive surveillance, which gave rise to a sense of undermined autonomy and self-determinism as well as continued worries and uncertainty. The users called this situation dependent independency. As a result of the review we call for an increased focus on a patientcentered treatment and care.

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Section: Discussionmentioning

confidence: 99%

Users' Experiences With Home Mechanical Ventilation: A Review of Qualitative Studies

et al. 2019

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“…This then starts a difficult cycle of tracheostomy-related physical and psychosocial problems for the child and his or her family. [7][8][9][10] Laryngotracheal stenosis has been a major challenge for surgeons due to the complex laryngeal structure and functions. Choosing the optimal surgical intervention is extremely difficult at this age due to the special anatomy of the pediatric airways, the vulnerable tissues and the potential associated congenital malformations.…”

Section: Introductionmentioning

confidence: 99%

“…Severe dyspnea at birth requires urgent intubation followed by tracheotomy to allow adequate ventilation and oxygenation of the newborn. This then starts a difficult cycle of tracheostomy‐related physical and psychosocial problems for the child and his or her family …”

Section: Introductionmentioning

confidence: 99%

Slide laryngotracheoplasty for congenital subglottic stenosis in newborns and infants

et al. 2019

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Objectives Subglottic stenosis is the most common laryngeal anomaly necessitating tracheostomy in early childhood. Crico‐ and laryngotracheal resection and laryngotracheal reconstruction—usually with autologous cartilage graft implantation—are the most effective treatments. These surgical techniques are obviously challenging in neonatal age and infancy. However, a reconstructive surgery performed at early age may prevent the sequel of complications. Methods The authors present their novel surgical method for congenital subglottic stenosis. Seven infants had inspiratory stridor; two of them had to be intubated and one required tracheostomy. Laryngotracheoscopy, CT or MRI revealed subglottic stenosis: Cotton‐Myer grade II in one, and grade III in six cases. Slide laryngotracheoplasty was performed before 5 months of age (10–130 days), with a follow‐up period of average 36 months (4–80 months). Phoniatry and quality of life questionnaire were used for evaluation of postoperative results. Results Slide laryngotracheoplasty in the neonatal age made the temporary tracheostomy unnecessary. All babies remained intubated for 3 to 10 days with an uncuffed tracheal tube. After extubation, no dyspnea or swallowing disorder occurred. A subjective quality of life questionnaire, laryngotracheoscopy, clinical growth charts showed satisfactory functional results. Conclusions Single‐stage slide laryngotracheoplasty might be a favorable solution for subglottic stenosis, even in early childhood. In one step, the airway can be maintained without stenting and tracheostomy. Level of Evidence 4 Laryngoscope, 130:E199–E205, 2020

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“…Patients reported that they mostly had negative experiences related to tracheostomy, speaking and communication, well-being and life quality, disfigurement and body image, stigmatization and social withdrawal, personal support and management (2).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Clinic Course in Patients Discharged With Tracheostomy

Sarı¹,

Ekinci²

2019

tybd

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ÖZ Amaç: Yoğun bakımda perkütan yolla trakeostomi açılarak spontan solunum veya mekanik ventilatör (MV) desteği ile trakeostomili bir şekilde taburcu edilen hastaların bakımları esnasında yaşanılan problemlerin tespit edilmesi ve elde edilen veriler doğrultusunda hasta bakıcıların eğitiminde bu konulara ağırlık verilerek hastalarda oluşabilecek morbidite ve mortalitenin azaltılması amaçlandı. Gereç ve Yöntem: Yoğun bakım kliniğine 2017 ve 2018 yıllarında yatan ve trakeostomi açılan 90 hastanın dosyaları incelendi. Bu hastaların 29'u taburcu edildi. Hastalar SVH, solunum yetmezliği, nöromüsküler hastalıklar ve diğerleri (Alzheimer, Parkinson) olarak gruplandırıldı. Hastalar ve bakıcıları ile yüz yüze veya telefonla görüşülerek hastalar hakkında bilgi alındı. Hastaların yatış nedenleri, Glasgow koma skorları (GKS), beslenme şekilleri, mekanik ventilatör desteği, evde yaşam süreleri ve yaşanılan sorunlar kaydedildi. Bulgular: Taburcu edilen 29 hastanın 14'ü SVH, 5'i solunum yetmezliği, 6'sı nöromüsküler hastalık, 4'ü diğerleri olarak sınıflandırıldı. Yoğun bakımdan çıkış GKS değerleri (GKS2) yüksek olan hastaların mortalitesi daha düşük olarak tespit edildi. NMH grubunun ex olma oranı (%0), SVH (%64.3) ve SY (%80) gruplarından istatistiksel olarak anlamlı düzeyde düşük bulunmuştur. Yaşayan hastaların7'sinde(%50) kontraktür veya eklem hareket kısıtlılığı gelişmiştir. Evde yaşanılan sorunlar içerisinde en sık solunumsal problemler, bunların içerisinde de 12 hastada yoğun sekresyon (%85,7) görülmüştür. Beslenme problemleri olarak en sık kabızlık 6 hastada (%42,9) görülmüştür.ABSTRACT Objective: The objective of the study was to determine the problems of the patients, who underwent percutaneous tracheostomy opening in intensive care and then were discharged with tracheostomy either with spontaneous respiration or mechanical ventilation (MV) support, and to decrease the morbidity and mortality of the patients by focusing on training the caregivers mostly about problems. Materials and Methods: The files of 90 patients, who were admitted to intensive care unit between 2017 and 2018 with tracheostomy, were analyzed. Twenty-nine patients were discharged. Patients were grouped as CVD, respiratory failure, neuromuscular diseases and others (Alzheimer, Parkinson). Patients and their caregivers were interviewed face-to-face or by telephone to obtain information about the patients. Reasons for hospitalization, Glasgow coma scale score (GCS), feeding patterns, mechanical ventilation support, life expectancy and problems experienced at home, were recorded. Findings: In 29 discharged patients, 14 of them were classified as CVD, five as respiratory failure, six as neuromuscular disease and four as other. The mortality rates of patients with high GCS values (GCS2) from ICU were found to be lower. The rate of fatality for the NMD group (0%) was found to be significantly lower than that of CVD (64.3%) and RF (80%). Seven (50%) of the alive patients developed contracture or limitation of joint motion. Respiratory-related problems were th...

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A Systematic Review of Patient and Caregiver Experiences with a Tracheostomy

Cited by 88 publications

References 66 publications

Users' Experiences With Home Mechanical Ventilation: A Review of Qualitative Studies

Users' Experiences With Home Mechanical Ventilation: A Review of Qualitative Studies

Slide laryngotracheoplasty for congenital subglottic stenosis in newborns and infants

Evaluation of Clinic Course in Patients Discharged With Tracheostomy

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