Experiencias del paciente durante la retirada de la ventilación mecánica invasiva: una revisión de la literatura / Patients’ experience during weaning of invasive mechanical ventilation: A review of the literature

Objetivo: La retirada de la ventilación mecánica invasiva (VMI) es un procedimiento en el que influyen factores fisiológicos y psicológicos, siendo estos últimos los menos estudiados. El objetivo fue identificar en la literatura, las experiencias de los pacientes durante la retirada de la VMI y cómo intervienen en dicho proceso. Método: Se realizó una búsqueda bibliográfica en las bases de datos Pubmed, CINAHL y PsycINFO. Los términos de búsqueda fueron: «patient», «experience» y «ventilator weaning». Los límites fueron la edad (> 19 años) y el idioma (inglés, español y finlandés). Resultados: Se analizaron 15 publicaciones. Los principales resultados se agruparon en tres grandes temas según las percepciones, sentimientos y experiencias del paciente, la influencia de la atención de los profesionales y los factores determinantes para la retirada exitosa de la VMI. Los pacientes recuerdan la retirada de la VMI como un proceso estresante y experimentan ansiedad, frustración, desesperación o incertidumbre. Las enfermeras tienen un papel fundamental en la mejora de la comunicación con el paciente y en la anticipación a sus necesidades. El soporte familiar y el cuidado proporcionado por los profesionales se destacan como fundamentales durante el proceso. Para conseguir una retirada exitosa de la VMI se identifica la importancia de la autodeterminación, la automotivación y la confianza de los pacientes. Conclusiones: La atención psicológica, además de la física y la tecnológica, es importante durante la retirada de la VMI para proporcionar un cuidado holístico. Son necesarios estudios de intervención para lograr mejorar la atención a los pacientes durante dicho proceso

Objective: Weaning from invasive mechanical ventilation (IMV) is influenced by physiological and psychological factors, the latter being the least studied. The aim was to identify, through the literature, patients’ experiences during weaning from IMV and report its influencing factors. Method: The literature search was conducted using the Pubmed, CINAHL and PsycINFO databases. The search terms were: ‘patient’, ‘experience’ and ‘ventilator weaning’. The research limits were: age (> 19 years) and language (English, Spanish and Finnish). Results: Fifteen publications were analysed. The main results were grouped into three main categories according to patient's perceptions, feelings and experiences, influence of professionals’ attention and determinants for successful weaning. Patients remember IMV weaning as a stressful process where they experience anxiety, frustration, despair or uncertainty. Nurses have a key role in improving communication with patients and foreseeing their needs. Family support and the care provided by the caregivers were shown as essential during the process. The patient's self-determination, self-motivation and confidence are identified as important factors to achieve successful IMV weaning. Conclusions: Psychological care, in addition to physical and technical care, is important at providing holistic care. Interventional studies are needed to improve the care during the weaning experience

Patients' experience during weaning of invasive mechanical ventilation: A review of the literature. / Experiencias del paciente durante la retirada de la ventilación mecánica invasiva: una revisión de la literatura.

OBJECTIVE: Weaning from invasive mechanical ventilation (IMV) is influenced by physiological and psychological factors, the latter being the least studied. The aim was to identify, through the literature, patients' experiences during weaning from IMV and report its influencing factors. METHOD: The literature search was conducted using the Pubmed, CINAHL and PsycINFO databases. The search terms were: "patient", "experience" and "ventilator weaning". The research limits were: age (>19years) and language (English, Spanish and Finnish). RESULTS: Fifteen publications were analysed. The main results were grouped into three main categories according to patient's perceptions, feelings and experiences, influence of professionals' attention and determinants for successful weaning. Patients remember IMV weaning as a stressful process where they experience anxiety, frustration, despair or uncertainty. Nurses have a key role in improving communication with patients and foreseeing their needs. Family support and the care provided by the caregivers were shown as essential during the process. The patient's self-determination, self-motivation and confidence are identified as important factors to achieve successful IMV weaning. CONCLUSIONS: Psychological care, in addition to physical and technical care, is important at providing holistic care. Interventional studies are needed to improve the care during the weaning experience.