2.50
Hdl Handle:
http://hdl.handle.net/10755/157495
Type:
Presentation
Title:
COMPARISON OF CHEST PHYSIOTHERAPY METHODS ON PREFERENCE POST-LUNG TRANSPLANT
Abstract:
COMPARISON OF CHEST PHYSIOTHERAPY METHODS ON PREFERENCE POST-LUNG TRANSPLANT
Conference Sponsor:Western Institute of Nursing
Conference Year:2010
Author:Esguerra, Angeli, RN
P.I. Institution Name:University of California, Los Angeles Health System
Title:Clinical Nurse
Contact Address:RRUCLA Medical Center, 7 ICU (Cardiothoracic ICU) West, Los Angeles, CA, 90095, USA
Co-Authors:Stephen Weigt; Kristina Mayol-Ngo; David Ross; Ashley Madsen; Anna Gawlinski; Allison Parker; Zeba Shameem; Aliza Richman; Michelle Mekpongsatorn; Seve Madrona; Paige Redfield; Charles Burchette; Taline Marcarian; Susan Sommer; Julia Porter; Ai Jin Lee; P
PURPOSE: The purpose of this feasibility pilot study is to evaluate the effect of chest physiotherapy (CPT) and high frequency chest wall oscillation (HFCWO) on patient preference among post-lung transplant (LT) patients.
BACKGROUND: Chest physiotherapy and HCFWO are routinely used in LT recipients to facilitate the removal of secretions containing destructive by-products of inflammation and entrapped pathogens. Conventional CPT techniques are most commonly performed by nurses, and are practitioner-dependent in terms of the frequency, duration and effectiveness. Contemporary HFCWO may increase rates of lung recovery as well as or better than CPT, with fewer contraindications and disadvantages. To date, there are no studies that investigate which therapy is more comfortable and preferred by post-LT patients. This is an important clinical question. Patients who have less pain will mobilize secretions more frequently, require fewer medications, and are apt to heal and recover faster.
METHODS: In a 2-group experimental study conducted on post-operative day 3, 37 post-LT patients (21 single [SLT], 16 bilateral [BLT], 70 % male, mean age 57 years) were assigned randomly to either CPT first (10 AM & 2 PM) followed by HFCWO (6 PM & 10 PM; n = 18) or vice versa (n = 19). At the end of the treatment (Tx) sequence, a 4-item patient survey assessed Tx preference and effectiveness. Data were analyzed with Chi-Square, t-tests and repeated measures analysis of variance. Open-ended survey responses were analyzed for meaning and overall themes.
RESULTS: Among BLT, patients favored HFCWO over CPT (75% vs. 25%); while SLTs tended to favor CPT over HFCWO (55% vs. 40%; p=0.073). Most patients reported HFCWO as less painful than CPT (50% vs. 38%); 12% reported the Tx METHODS: as equivalent. Across time points, there was a 3-way interaction between the preferred Tx being less painful by survey, Tx method, and VNPS score (F=3.55, p=0.02). Less painful ratings were consistent with VNPS scores during the preferred Tx method. SLT and BLT patients reported preferences towards HFCWO as an effective Tx due to improved airway clearance, longer length of Tx, and comfort. Those who preferred CPT cited the effectiveness of the Tx as more directed and less technical.
IMPLICATIONS: Findings clearly suggest BLT patients prefer HFCWO over CPT. Overall, HFCWO was perceived as less painful than CPT. HFCWO may provide targeted clinical benefit in the BLT population. Further investigation is warranted in a multicenter, comparative study to elucidate Tx preferences post-LT.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleCOMPARISON OF CHEST PHYSIOTHERAPY METHODS ON PREFERENCE POST-LUNG TRANSPLANTen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157495-
dc.description.abstract<table><tr><td colspan="2" class="item-title">COMPARISON OF CHEST PHYSIOTHERAPY METHODS ON PREFERENCE POST-LUNG TRANSPLANT</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Esguerra, Angeli, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of California, Los Angeles Health System</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Clinical Nurse</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">RRUCLA Medical Center, 7 ICU (Cardiothoracic ICU) West, Los Angeles, CA, 90095, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">aesguerra@mednet.ucla.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Stephen Weigt; Kristina Mayol-Ngo; David Ross; Ashley Madsen; Anna Gawlinski; Allison Parker; Zeba Shameem; Aliza Richman; Michelle Mekpongsatorn; Seve Madrona; Paige Redfield; Charles Burchette; Taline Marcarian; Susan Sommer; Julia Porter; Ai Jin Lee; P</td></tr><tr><td colspan="2" class="item-abstract">PURPOSE: The purpose of this feasibility pilot study is to evaluate the effect of chest physiotherapy (CPT) and high frequency chest wall oscillation (HFCWO) on patient preference among post-lung transplant (LT) patients. <br/>BACKGROUND: Chest physiotherapy and HCFWO are routinely used in LT recipients to facilitate the removal of secretions containing destructive by-products of inflammation and entrapped pathogens. Conventional CPT techniques are most commonly performed by nurses, and are practitioner-dependent in terms of the frequency, duration and effectiveness. Contemporary HFCWO may increase rates of lung recovery as well as or better than CPT, with fewer contraindications and disadvantages. To date, there are no studies that investigate which therapy is more comfortable and preferred by post-LT patients. This is an important clinical question. Patients who have less pain will mobilize secretions more frequently, require fewer medications, and are apt to heal and recover faster.<br/>METHODS: In a 2-group experimental study conducted on post-operative day 3, 37 post-LT patients (21 single [SLT], 16 bilateral [BLT], 70 % male, mean age 57 years) were assigned randomly to either CPT first (10 AM &amp; 2 PM) followed by HFCWO (6 PM &amp; 10 PM; n = 18) or vice versa (n = 19). At the end of the treatment (Tx) sequence, a 4-item patient survey assessed Tx preference and effectiveness. Data were analyzed with Chi-Square, t-tests and repeated measures analysis of variance. Open-ended survey responses were analyzed for meaning and overall themes.<br/>RESULTS: Among BLT, patients favored HFCWO over CPT (75% vs. 25%); while SLTs tended to favor CPT over HFCWO (55% vs. 40%; p=0.073). Most patients reported HFCWO as less painful than CPT (50% vs. 38%); 12% reported the Tx METHODS: as equivalent. Across time points, there was a 3-way interaction between the preferred Tx being less painful by survey, Tx method, and VNPS score (F=3.55, p=0.02). Less painful ratings were consistent with VNPS scores during the preferred Tx method. SLT and BLT patients reported preferences towards HFCWO as an effective Tx due to improved airway clearance, longer length of Tx, and comfort. Those who preferred CPT cited the effectiveness of the Tx as more directed and less technical.<br/>IMPLICATIONS: Findings clearly suggest BLT patients prefer HFCWO over CPT. Overall, HFCWO was perceived as less painful than CPT. HFCWO may provide targeted clinical benefit in the BLT population. Further investigation is warranted in a multicenter, comparative study to elucidate Tx preferences post-LT.<br/></td></tr></table>en_GB
dc.date.available2011-10-26T19:55:28Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T19:55:28Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.