Qualitative studies on the patient's experience of weaning from mechanical ventilation.

In contrast to primarily deductive quantitative research, qualitative research aims to interpret data to develop theoretical insights that describe and explain phenomena such as interactions, experiences, roles, perspectives, and organizations. In this review, we summarize qualitative studies that used primarily in-depth personal interviews as a data collection method and a grounded theory analytic approach. The liberal use of illustrative excerpts and interpretive descriptions offer clinicians vicarious accounts of patient experiences of weaning from mechanical ventilation. Important experiences of patients during their weaning from mechanical ventilation included frustration, uncertainty, hopelessness, fear, and lack of mastery. The extent to which, in at least some patients, these experiences were determinants of weaning failure, consequences of weaning failure, or both, was difficult to establish. An assumption of this genre of research is that if clinicians understand the lived experiences of patients, they can better appreciate patient needs during the weaning process, and by inference, their role as clinicians during weaning from mechanical ventilation.

[1]  H. Holman,et al.  Qualitative inquiry in medical research. , 1993, Journal of clinical epidemiology.

[2]  R. Macnaughton Numbers, scales, and qualitative research , 1996, The Lancet.

[3]  F. Bellivier,et al.  Subjective psychological status of severely ill patients discharged from mechanical ventilation. , 1995, Clinical intensive care : international journal of critical & coronary care medicine.

[4]  A. Perry,et al.  Patients' perceptions of uncertainty and stress during weaning from mechanical ventilation. , 1999, Dimensions of critical care nursing : DCCN.

[5]  P. Rosenfield,et al.  The potential of transdisciplinary research for sustaining and extending linkages between the health and social sciences. , 1992, Social science & medicine.

[6]  D. Sargent Using ibutilide to convert atrial fibrillation and flutter. , 1999, Dimensions of critical care nursing : DCCN.

[7]  Trisha Greenhalgh,et al.  How to read a paper: Papers that go beyond numbers (qualitative research) , 1997 .

[8]  Shortell Sm,et al.  The emergence of qualitative methods in health services research. , 1999 .

[9]  D. Cook,et al.  Life support in the intensive care unit: a qualitative investigation of technological purposes. Canadian Critical Care Trials Group. , 1999, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[10]  Caring and comfort metaphors used by patients in critical care. , 1996, Image--the journal of nursing scholarship.

[11]  T. Noseworthy,et al.  Quality of life measures before and one year after admission to an intensive care unit. , 1995, Critical care medicine.

[12]  William A. Knaus,et al.  A controlled trial to improve care for seriously ill hospitalized patients. The study to understand prognoses and preferences for outcomes and risks of treatments (SUPPORT). The SUPPORT Principal Investigators. , 1995, JAMA.

[13]  C. Pope,et al.  Qualitative Research: Reaching the parts other methods cannot reach: an introduction to qualitative methods in health and health services research , 1995 .

[14]  D. Cook,et al.  Users' guides to the medical literature: XXIII. Qualitative research in health care A. Are the results of the study valid? Evidence-Based Medicine Working Group. , 2000, JAMA.

[15]  N. Denzin,et al.  Handbook of Qualitative Research , 1994 .

[16]  Shanyang Zhao Metatheory, Metamethod, Meta-Data-Analysis: What, Why, and How? , 1991 .

[17]  R. Griffiths,et al.  Psychological morbidity following critical illness - the rationale for care after intensive care , 1998 .

[18]  M. Haller,et al.  Sensitivity and specificity of a screening test to document traumatic experiences and to diagnose post-traumatic stress disorder in ARDS patients after intensive care treatment , 1999, Intensive Care Medicine.

[19]  N Black,et al.  Why we need qualitative research. , 1994, Journal of epidemiology and community health.

[20]  D. Cook,et al.  Users' guides to the medical literature: XXIII. Qualitative research in health care B. What are the results and how do they help me care for my patients? Evidence-Based Medicine Working Group. , 2000, JAMA.

[21]  R. Frankel,et al.  Limitation of Medical Care: An Ethnographic Analysis , 1993, The Journal of Clinical Ethics.

[22]  L. Brochard,et al.  Mechanical Ventilation and Weaning , 2002 .

[23]  J. Jenny,et al.  Qualitative analysis of patients' work during mechanical ventilation and weaning. , 1997, Heart & lung : the journal of critical care.

[24]  Rita Seeger Jablonski,et al.  The Experience of Being Mechanically Ventilated , 1994 .

[25]  F. Khan,et al.  Psychological aspects of weaning from mechanical ventilation. , 1980, Psychosomatics.

[26]  G. Noblit,et al.  Meta-Ethnography: Synthesizing Qualitative Studies , 1988 .

[27]  L. Lowry,et al.  Neuman's Framework and Ventilator Dependency: A Pilot Study , 1993, Nursing science quarterly.