Allergy and Airway |

Noninvasive Ventilation: Better Than You Think; Insights From Behind the Mask FREE TO VIEW

Tracy Smith; Meera Agar, MBBS; Patricia Davidson; Christine Jenkins, MBBS; Jane Ingham
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University of New South Wales, Sydney, NSW, Australia

Chest. 2014;146(4_MeetingAbstracts):26A. doi:10.1378/chest.1990862
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SESSION TITLE: COPD Diagnosis and Evaluation Posters I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Non-invasive ventilation (NIV) is increasingly used in the management of acute respiratory failure due to decompensated chronic cardiorespiratory disease. The increasing burden of chronic disease and focus on person-centred care, necessitates frank discussions of the benefits and burdens of treatment and an understanding of the patients’ perspective. We aimed to describe the subjective experience of individuals undergoing NIV for acute hypercapnic respiratory failure.

METHODS: Face-to-face interviews, analysed using qualitative thematic analysis

RESULTS: Thirteen participants were interviewed. Six interrelated themes emerged: A passenger on a journey dominated by chronic illness; Balancing benefits and burdens of NIV; Looking to another chance; Knowing what alleviates my distress; Struggling and suffering; Feeling vulnerable and trusting staff. Participants viewed NIV as a two-edged sword; providing substantial relief from symptoms, but engendering discomfort and burden. No participant would forgo this treatment in the future. While participants sometimes appeared passive, they often had significant insight into what relieved their subjective distress. Participants expressed both a sense of compulsion to accept NIV and gratitude for NIV as it facilitated another chance at life. Many participants described minimal recollection of their acute hospitalisation, and placed a great amount of trust in health care providers.

CONCLUSIONS: Participants described balancing benefits and burdens of NIV, with the goal of achieving ‘another chance’ at life. This goal was highly valued despite their description of their life as one of struggle and suffering. While many knew what might alleviate their distress they often appeared passive, like passengers on a journey dominated by their chronic illness.

CLINICAL IMPLICATIONS: Enhancing health care providers’ understanding of the complex subjective physical and emotional experience of treatment with NIV may facilitate frank discussions of treatment, enhance patient centred decision making and improve providers’ capacity to relieve patient distress. Leveraging patients’ unique self-knowledge may lead to novel self-management strategies.

DISCLOSURE: The following authors have nothing to disclose: Tracy Smith, Meera Agar, Patricia Davidson, Christine Jenkins, Jane Ingham

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