Exploration of Physiological and Perceptual Variables During Weaning from Mechanical Ventilation

2.50
Hdl Handle:
http://hdl.handle.net/10755/148291
Type:
Presentation
Title:
Exploration of Physiological and Perceptual Variables During Weaning from Mechanical Ventilation
Abstract:
Exploration of Physiological and Perceptual Variables During Weaning from Mechanical Ventilation
Conference Sponsor:Sigma Theta Tau International
Conference Year:2001
Conference Date:November 10 - 14, 2001
Author:Twibell, Renee, DNS/DNSc/DSN
P.I. Institution Name:Ball State University
Title:Associate Professor
OBJECTIVE: This study explored selected variables in patients who were initially weaning from mechanical ventilation. DESIGN: The design was exploratory and correlational. SAMPLE: Patients (n = 68) were predominately female, Caucasian, and most often admitted for COPD or respiratory failure. Forty-five (66%) participants were mechanically ventilated for three days or less. SETTING: Data were collected in a 17-bed intensive care unit in one Midwestern hospital. VARIABLES: Physiological variables from Burns’ (1991) Weaning Assessment Plan (BWAP) included 12 general assessments and 14 respiratory assessments. Perceptual variables were fatigue, dyspnea, and weaning self-efficacy. INSTRUMENTS: The BWAP was completed by chart review. Participants responded to three vertical VAS scales that measured fatigue, dyspnea, and weaning self-efficacy. FINDINGS: Participants reported moderate dyspnea, moderate fatigue, and high weaning self-efficacy. Dyspnea correlated significantly with fatigue and self-efficacy. High PaO2, low PaCO2, hemodynamic stability, thin secretions, adequate cough, and absence of abdominal problems were associated with complete weaning (p < .05). Perceptual variables were not associated with weaning outcomes. In contrast to previous research, perceptual variables were correlated with physiologic variables. Weaning self-efficacy was associated with normal electrolytes, eupnea, pain control, adequate nutrition, improving body strength, improving chest x-ray, and stable metabolism. Fatigue was associated with improving chest x-ray, high PaO2, and adequate sleep. Dyspnea was associated with high PaO2 and low PaCO2. CONCLUSIONS: Consensus on physiologic correlates of complete weaning is increasing. Perceptual variables may mediate between physiologic variables and weaning outcomes. Further study may address the predictive value of abdominal problems, cough reflex, secretions, and nurse-patient interaction variables. IMPLICATIONS: Nurses can assess physiologic weaning variables and can influence perceptions of dypsnea, fatigue, and weaning self-efficacy through emotional support, positioning, assistance with activities, touch, and environmental control.
Repository Posting Date:
26-Oct-2011
Date of Publication:
10-Nov-2001
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleExploration of Physiological and Perceptual Variables During Weaning from Mechanical Ventilationen_GB
dc.identifier.urihttp://hdl.handle.net/10755/148291-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Exploration of Physiological and Perceptual Variables During Weaning from Mechanical Ventilation</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2001</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">November 10 - 14, 2001</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Twibell, Renee, DNS/DNSc/DSN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Ball State University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Associate Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">rtwibell@bsu.edu</td></tr><tr><td colspan="2" class="item-abstract">OBJECTIVE: This study explored selected variables in patients who were initially weaning from mechanical ventilation. DESIGN: The design was exploratory and correlational. SAMPLE: Patients (n = 68) were predominately female, Caucasian, and most often admitted for COPD or respiratory failure. Forty-five (66%) participants were mechanically ventilated for three days or less. SETTING: Data were collected in a 17-bed intensive care unit in one Midwestern hospital. VARIABLES: Physiological variables from Burns&rsquo; (1991) Weaning Assessment Plan (BWAP) included 12 general assessments and 14 respiratory assessments. Perceptual variables were fatigue, dyspnea, and weaning self-efficacy. INSTRUMENTS: The BWAP was completed by chart review. Participants responded to three vertical VAS scales that measured fatigue, dyspnea, and weaning self-efficacy. FINDINGS: Participants reported moderate dyspnea, moderate fatigue, and high weaning self-efficacy. Dyspnea correlated significantly with fatigue and self-efficacy. High PaO2, low PaCO2, hemodynamic stability, thin secretions, adequate cough, and absence of abdominal problems were associated with complete weaning (p &lt; .05). Perceptual variables were not associated with weaning outcomes. In contrast to previous research, perceptual variables were correlated with physiologic variables. Weaning self-efficacy was associated with normal electrolytes, eupnea, pain control, adequate nutrition, improving body strength, improving chest x-ray, and stable metabolism. Fatigue was associated with improving chest x-ray, high PaO2, and adequate sleep. Dyspnea was associated with high PaO2 and low PaCO2. CONCLUSIONS: Consensus on physiologic correlates of complete weaning is increasing. Perceptual variables may mediate between physiologic variables and weaning outcomes. Further study may address the predictive value of abdominal problems, cough reflex, secretions, and nurse-patient interaction variables. IMPLICATIONS: Nurses can assess physiologic weaning variables and can influence perceptions of dypsnea, fatigue, and weaning self-efficacy through emotional support, positioning, assistance with activities, touch, and environmental control. </td></tr></table>en_GB
dc.date.available2011-10-26T09:43:01Z-
dc.date.issued2001-11-10en_GB
dc.date.accessioned2011-10-26T09:43:01Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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