The experiences of adult ventilator‐dependent patients: A meta‐synthesis review

Abstract

Studies exploring the perceptions of patients whose lives are maintained by mechanical ventilation highlight the stressful nature of this type of experience. The objective of this meta-synthesis study was to describe the nature of the experience of adult ventilator-dependent patients. A systematic literature search of English and Chinese databases was undertaken, covering the period between 1970 and 2012. Qualitative research findings were extracted and pooled using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. A total of 1004 papers were identified from various database and hand searches. Nineteen papers were critically appraised and 16 met inclusion criteria. Five meta-synthesis themes emerged from the analysis: (1) the feelings of fear due to being dependent on a ventilator and the loss of control of life; (2) disconnection with reality; (3) impaired embodiment; (4) construction of coping patterns; (5) trust and caring relationship. Suggested implications for practice include enhancing the trust relationship with health professionals, as well as nursing actions throughout the suction procedure relating to release of patient's psychological distress and empowering their resilience factors.

Nurses' communication with mechanically ventilated patients in the intensive care unit: Umbrella review

“…Patients' experiences of voicelessness during mechanical ventilation were a central theme (Dithole, Sibanda, Moleki, & Thupayagale‐Tshweneagae, 2016; Karlsen, Ølnes, & Heyn, 2018; Tsay, Mu, Lin, Wang, & Chen, 2013; Yang, 2016). Words used to depict the experiences were dependency, vulnerability, isolation, helplessness, uncertainty, distress, and powerlessness; as well as loss of personality, identity, control, and freedom (Karlsen et al., 2018; Tsay et al., 2013; Yang, 2016). Frustration was the word most used to describe the voicelessness: ‘Being voiceless is perhaps the most frustrating experience of mechanically ventilated patients’ (Yang, 2016).…”

“…It was even suggested that ‘many patients died without fully expressing their needs and wishes about end‐of‐life care or final message to loved ones’ (Yang, 2016). Another research synthesis pointed out that the voicelessness contributed to disorientation (Tsay et al., 2013).…”

“…The research syntheses described patients' spontaneous and unaided communication attempts (Dithole et al., 2016; Karlsen et al., 2018; Salem & Ahmad, 2018; Tsay et al., 2013). Karlsen et al wrote that ‘patients used a variety of communication techniques’, but these were not itemized.…”

“Pain relieved, but still struggling”—Critically ill patients experiences of pain and other discomforts during analgosedation

“…A further finding was the many descriptions of discomforts other than pain, possibly dominating because descriptions of actual pain were rare. The majority of these discomforts have been reported on and presented in reviews of the qualitative literature (Cutler et al., ; Egerod et al., ; Tsay, Mu, Lin, Wang, & Chen, ). We found that well‐known discomforts relating to MV, communication difficulties, comprehension and experiencing delusions were often triggered or aggravated by how the patients fluctuated between states of wakefulness.…”

Health-related quality of life and nursing-sensitive outcomes in mechanically ventilated patients in an Intensive Care Unit: a study protocol

“…Some authors have studied factors that have a stressful effect on mechanically ventilated patients [ 15 – 18 ] and have found that one of the worst remembered and most stressful experiences, aside from thirst and pain, is endotracheal tube discomfort [ 19 ]. There are several tools to assess stressors within ICU, and all of them allow us to assess the degree of stress or nuisance experienced by the patient for each factor.…”