Intensive care patients' perceptions of the experience of mechanical ventilation

The purpose of this phenomenological study was to describe intensive care patients' perceptions of the experience of mechanical ventilation. A purposeful sample of 11 post-extubation mechanically ventilated patients was interviewed using a semi-structured interview guide, and the interviews were audiotaped and transcribed. Data were analyzed for common themes and descriptive elements using the phenomenological method. A core phase, spiritual resource connection, and four process phases: life before, lost power, in sync, and life after emerged.

Spiritual resource connection gave patients the courage, trust, and hope needed to survive the life stress and challenges, including the ventilator experience. Connection with spiritual resources empowered patients to draw on past coping strategies (life before) and to have hope for the future beyond the ventilator experience. This connection enabled patients to willingly synchronize with the ventilatoes preset patterns, which allowed them greater energy to attempt self-transcendence through thinking about the past, future, and human relationships and methods of communication with staff (in sync). Disconnection from spiritual resources (lost power) occurred with fear of the unknown or perceived mistreatment by staff, and caused patients to focus further on their own needs, pain, and inadequate communication.

As patients were told of impending extubation they experienced relief and dread at the thought of reclaiming their breathing patterns (life after). They began to put the ventilator experience into perspective, and began to feel gratitude at being alive. After extubation patients described times of physical discomfort associated with the endotracheal tube.

Findings indicated that humane, compassionate, competent care promoted spiritual resource connection, which helped patients perceive the experience less negatively and enabled them to better manage the experience. Further research is needed to determine additional methods of promoting spiritual resource connection during the ventilator experience.