Person-centred care during prolonged weaning from mechanical ventilation, nurses' views: an interview study

Intensive Crit Care Nurs. 2018 Jun:46:32-37. doi: 10.1016/j.iccn.2017.11.004. Epub 2018 Mar 19.

Abstract

Objective: To determine: 1) if the three elements of person-centred care (initiating, working and safeguarding the partnership) were present, and 2) to identify evidence of barriers to person-centred care during prolonged weaning from mechanical ventilation.

Research methodology: Secondary analysis of semi structured interviews with 19 critical care nurses using theoretical thematic analysis.

Setting: This study was conducted in three Swedish intensive care units, one in a regional hospital and two in a university hospital.

Findings: Three themes and nine subthemes related to person-centred care were identified. The three themes included: 1) 'finding a person behind the patient' related to the 'initiating the partnership' phase, 2) 'striving to restore patient́s sense of control' related to 'working the partnership' phase and 3) 'impact of patient involvement' related to 'safeguarding the partnership' phase of person-centred care'. Additionally a further theme 'barriers to person-centred care' was identified.

Conclusion: We found evidence of all three person-centred care routines. Barriers to person-centred care comprised of lack team collaboration and resources. Facilitating patients to actively participate in decision-making during the weaning process may optimise weaning outcomes and warrants further research.

Keywords: Intensive care units; Interview; Mechanical ventilation; Person-centred care; Prolonged weaning; Qualitative research; Weaning.

MeSH terms

  • Adult
  • Decision Making
  • Female
  • Hospitals, University / organization & administration
  • Humans
  • Interviews as Topic / methods
  • Male
  • Middle Aged
  • Nurses / psychology*
  • Patient-Centered Care / methods
  • Qualitative Research
  • Respiration, Artificial / nursing
  • Self Care / methods
  • Sweden
  • Ventilator Weaning / nursing
  • Ventilator Weaning / standards*