Ching-Ju Chen1, Ling-Nu Hsu, Gretl McHugh, Malcolm Campbell, Ya-Ling Tzeng. 1. 1PhD, RN, Head Nurse, Department of Nursing, China Medical University Hospital, Taiwan, ROC 2MSN, RN, Advisor, Department of Nursing, China Medical University Hospital, Taiwan, ROC 3PhD, RN, Senior Lecturer, School of Nursing, Midwifery and Social, Work, University of Manchester, Manchester, England 4PhD, Lecturer in Statistics, School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, England 5PhD, RN, Associate Professor, School of Nursing, China Medical University, and Adjunct Advisor, Department of Nursing, China Medical University Hospital, Taiwan, ROC.
Abstract
BACKGROUND: Poor quality of sleep may result in more problems for patients who undergo weaning from mechanical ventilation because it could result in disabled muscle relaxation and affect the function of the respiratory muscles. Few studies have specifically investigated what factors contributed to quality of sleep and weaning outcomes. PURPOSE: This study investigates the predictors of quality of sleep and successful weaning from mechanical ventilation in patients at respiratory care centers. METHODS: We used a cross-sectional design to recruit 94 patients who were in the process of weaning from ventilation at three respiratory care centers in a medical center in central Taiwan. A structured questionnaire was used to collect data. Disease severity during the first 24 hours after commencing the weaning process was assessed using the Acute Physiology and Chronic Health Evaluation II. Level of consciousness was evaluated using the Glasgow Coma Scale, and quality of sleep was measured using the Verran and Snyder-Halpern Sleep Scale. Stepwise multiple regression and logistic regression were used for multivariate analysis. RESULTS: Fifty-three (56.4%) of the 94 participants successfully completed the weaning process. Participants who successfully weaned within 72 hours were younger (p = .038), had a lower level of disease severity (p < .001), and had a better quality of sleep (p = .004) than their counterparts who failed to wean. Factors including disease severity (B = -1.32), current use of hypnotic drugs (B = -10.71), and having three-to-four coexisting chronic diseases (B = -9.91) contributed negatively to quality of sleep. Factors including level of consciousness (odds ratio [OR] = 1.64), quality of sleep (OR = 1.05), disease severity (OR = 0.81), and alcohol consumption history (OR = 0.21) were found to significantly impact weaning success. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: A strong relationship was identified between disease severity and quality of sleep. Both factors are significant predictors of successful weaning from mechanical ventilation. A better understanding of the related risk factors will help improve the care provided by nurses and medical personnel to patients undergoing the weaning process.
BACKGROUND: Poor quality of sleep may result in more problems for patients who undergo weaning from mechanical ventilation because it could result in disabled muscle relaxation and affect the function of the respiratory muscles. Few studies have specifically investigated what factors contributed to quality of sleep and weaning outcomes. PURPOSE: This study investigates the predictors of quality of sleep and successful weaning from mechanical ventilation in patients at respiratory care centers. METHODS: We used a cross-sectional design to recruit 94 patients who were in the process of weaning from ventilation at three respiratory care centers in a medical center in central Taiwan. A structured questionnaire was used to collect data. Disease severity during the first 24 hours after commencing the weaning process was assessed using the Acute Physiology and Chronic Health Evaluation II. Level of consciousness was evaluated using the Glasgow Coma Scale, and quality of sleep was measured using the Verran and Snyder-Halpern Sleep Scale. Stepwise multiple regression and logistic regression were used for multivariate analysis. RESULTS: Fifty-three (56.4%) of the 94 participants successfully completed the weaning process. Participants who successfully weaned within 72 hours were younger (p = .038), had a lower level of disease severity (p < .001), and had a better quality of sleep (p = .004) than their counterparts who failed to wean. Factors including disease severity (B = -1.32), current use of hypnotic drugs (B = -10.71), and having three-to-four coexisting chronic diseases (B = -9.91) contributed negatively to quality of sleep. Factors including level of consciousness (odds ratio [OR] = 1.64), quality of sleep (OR = 1.05), disease severity (OR = 0.81), and alcohol consumption history (OR = 0.21) were found to significantly impact weaning success. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: A strong relationship was identified between disease severity and quality of sleep. Both factors are significant predictors of successful weaning from mechanical ventilation. A better understanding of the related risk factors will help improve the care provided by nurses and medical personnel to patients undergoing the weaning process.
Authors: Marcus T Altman; Melissa P Knauert; Terrence E Murphy; Amy M Ahasic; Zeeshan Chauhan; Margaret A Pisani Journal: Ann Intensive Care Date: 2018-05-08 Impact factor: 6.925