Factors Associated With Time to Decannulation in Patients With Tracheostomy Following Severe Traumatic Brain Injury.

BACKGROUND: Prolonged tracheal tube placement following severe traumatic brain injury (TBI) can cause serious complications. Safe removal requires sufficient ability for independent breathing and airway protection. Thus, identifying important factors for time to removal of the tracheal tube (decannulation) is essential for safe and efficient weaning. This study aimed to identify significant factors for time to decannulation in a Danish population of subjects with tracheostomy after TBI. METHODS: This was a retrospective register-based cohort study. Subjects with moderate and severe TBI and a tracheal tube were selected from the Danish Head Trauma Database between 2011-2021. Time to decannulation was calculated as time from injury to decannulation. Associations between selected explanatory variables representing demographic and clinical characteristics and time to decannulation were analyzed using linear regression models. RESULTS: A total 324 subjects were included with a median of 44 d to decannulation. Primary analysis found that an improvement in swallowing ability during the initial 4 weeks of rehabilitation was associated with an 8.2 d reduction in time to decannulation (95% CI -12.3 to -4.2, P < .001). Change in overall sensorimotor ability reduced time to decannulation by 0.94 (95% CI -0.78 to -0.10, P = .03) d. Change in cognitive abilities from rehab admission to 4-week follow-up did not significantly affect the number of days to decannulation (P = .66). Secondary analysis showed pneumonia was associated with the largest estimated increase of 24.4 (95% CI 15.9-32.9, P < .001) d and that increased cognitive functioning at rehabilitation admission was associated with a significant reduction in time to decannulation. CONCLUSIONS: This study found that a change in swallowing ability is a potentially significant factor for reducing time to decannulation. Identifying factors that could explain differences in time to decannulation is essential for patient outcomes, especially if these factors are modifiable and could be targeted in rehabilitation and treatment.

Women's lived experiences of learning to live with osteoporosis: a longitudinal qualitative study.

BACKGROUND: A vast amount of literature exists concerning pharmaceutical adherence in osteoporosis. However, the process of learning to live with osteoporosis over time remains largely unknown. The purpose of this study was to gain a deeper understanding of the continued process of how women learn to live with osteoporosis. Our objective was to explore what characterizes women's experiences of living with osteoporosis during the first year after diagnosis, when patients are prescribed anti-osteoporotic treatment, without having experienced an osteoporotic fracture. METHODS: Forty-two narrative qualitative interviews were conducted with fifteen recently diagnosed Danish women. A longitudinal design was chosen since this allows an investigation of the perspective over time. The interviews were conducted in the period of March 2011 to August 2012. Data were analyzed using a phenomenological-hermeneutic interpretation of text. No medical records were available for the researchers. All information with the exception of T-score was self-reported. RESULTS: The participants' experiences could be described in two key themes developed through the analysis: 1) "To become influenced by the medical treatment" which consisted of two sub-themes "taking the medication", and "discontinuing the medication". 2) "Daily life with osteoporosis", which was characterized by three sub-themes: "interpretation of symptoms", "interpretation of the scan results" and "lifestyle reflections". The results highlighted that learning to live with osteoporosis is a multifaceted process that is highly influenced by the medical treatment. In some cases, this is a prolonged process that can take around one year. CONCLUSIONS: The results suggest a need for improved support for individual women during the complex process of learning to live with osteoporosis. The study adds new knowledge that can be useful for healthcare professionals taking a health-oriented stance when supporting women in self-management of their illness. Further investigations of lived experiences over time in the field of osteoporosis research are therefore needed.

The effect of involving significant others in chronic pain programs for adult patients with chronic non-malignant pain: a systematic review protocol.

REVIEW QUESTION/OBJECTIVE: The objective of this review is to identify the effect of the involvement of significant others in chronic pain management programs for adult patients with chronic non-malignant pain on function, self-efficacy and pain.More specifically, the objectives are to identify the effect of involving significant others in chronic management programs for adults with chronic non-malignant pain in primary, secondary or tertiary health care. This is compared to those receiving usual care or other self-management interventions.

Perceptions of patients, significant others and health professionals of the role of significant others in programs for chronic non-malignant pain patients: a systematic review protocol.

REVIEW QUESTION/OBJECTIVE: The objective of this review is to identify and synthesize the perceptions of patients, significant others and health professionals regarding the role of significant others in chronic pain programs or healthcare regimens that target patients with chronic non-malignant pain. More specifically, the objective is to identify the role of significant others in chronic pain programs and healthcare regimens for adult patients with chronic non-malignant pain in primary, secondary or tertiary healthcare settings.