Background

Noninvasive ventilation (NIV) is the application of mechanical ventilation through a mask. It is used to treat certain forms of acute respiratory failure in intensive care units (ICU). NIV has clinical benefits but can be anxiogenic for the patients. This study aimed at describing cognitive and affective attitudes toward NIV among patients experiencing NIV for the first time in the context of an ICU stay.

Methods

Semi-structured interviews were conducted in 10 patients during their ICU stay and soon after their first NIV experience. None of the patients had ever received NIV previously. Evaluative assertion analysis and thematic analysis were used to investigate cognitive and affective attitudes toward NIV before, during, and after the first NIV experience, as well as patient attitudes toward caregivers and relatives.

Results

Before their first NIV session, the cognitive attitudes of the patients were generally positive. They became less so and more ambiguous during and after NIV, as the patients discovered the actual barriers associated with NIV. Affective attitudes during NIV were more negative than affective attitudes before and after NIV, with reports of dyspnea, anxiety, fear, claustrophobic feelings, and reactivation of past traumatic experiences. The patients had more positive attitudes toward the presence of a caregiver during NIV, compared to the presence of a family member.

Conclusion

This study corroborates the possibly negative—or even traumatic—nature of the NIV experience, with emphasis on the role of affective attitudes. This is a rationale for evaluating the impact of NIV-targeted psychological interventions in ICU patients with acute respiratory failure.

中文翻译：

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“我有被困的感觉”：对急性呼吸衰竭患者对无创通气的认知和情感态度的床边定性研究。

背景

无创通气（NIV）是通过面罩进行机械通气的方法。它用于治疗重症监护病房（ICU）中的某些形式的急性呼吸衰竭。NIV具有临床益处，但可能会给患者带来焦虑。这项研究旨在描述在ICU住院期间首次经历NIV的患者对NIV的认知和情感态度。

方法

在ICU住院期间以及首次NIV经历后不久，对10名患者进行了半结构式访谈。以前没有患者曾接受过NIV。评估断言分析和主题分析用于调查在第一次NIV经历之前，期间和之后对NIV的认知和情感态度，以及患者对看护者和亲戚的态度。

结果

在他们的第一次NIV会议之前，患者的认知态度通常是积极的。随着患者发现与NIV相关的实际障碍，它们在NIV期间和之后变得越来越模糊。NIV期间的情感态度比NIV之前和之后的情感态度更为消极，据报道有呼吸困难，焦虑，恐惧，幽闭恐惧感和过去创伤经历的恢复。与家庭成员的存在相比，患者在NIV期间对看护者的存在抱有更积极的态度。

结论

这项研究证实了NIV经验可能具有消极性质甚至是创伤性质，并着重强调了情感态度的作用。这是评估针对NIV的心理干预措施对ICU急性呼吸衰竭患者的影响的基本原理。