Guentner, Kathleen
(2004)
Resuscitation Preferences in Survivors of Prolonged Mechanical Ventilation (PMV)/Tracheostomy.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
Abstract
Background: Resuscitation preferences regarding prolonged mechanical ventilation (PMV) have rarely been explored. Objectives: To determine preferences of PMV survivors and influencing factors. Methods: Subjects were 29 (57% male) survivors of PMV ( 7 days) and tracheostomy interviewed > 6 weeks after MV was initiated. Subjects were asked to: 1) indicate if they would choose MV again; 2) rate present health, pain/discomfort in ICU and from MV, perceived family financial burden and emotional/physical stress using a Likert scale (0=positive, 4=negative); 3) identify change changes that might alter this preference; and 4) complete questionnaires assessing quality of life (QoL) (SF-36), functional status (Health Assessment Questionnaire), depressive symptoms (Center for Epidemiological Studies Depression Scale) and communication (Patient Communication Survey). Results: Most (76%) would undergo PMV again. Median MV days were greater for those who would undergo MV again (98.5 vs. 70, p=NS), as were median tracheostomy days (102 vs. 64, p=NS). Those who would not undergo MV again were more likely to have depressive symptoms (p=0.051) and Medicare coverage (p=0.023). No other variables differed between groups, including age, ICU length-of-stay, QoL, functional status, or communication status. Individuals who preferred MV stated their preference would change if their health and/or the family s emotional/physical stress were worse. Those who did not prefer MV would change if family s financial burden and emotional/physical stress were reduced. Conclusions: Most patients would undergo PMV again despite substantial time on MV. Preferences were most likely to change based on present health and family s financial burden and stress.
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| Item Type: |
University of Pittsburgh ETD
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| Status: |
Unpublished |
| Creators/Authors: |
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| ETD Committee: |
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| Date: |
17 December 2004 |
| Date Type: |
Completion |
| Defense Date: |
29 November 2004 |
| Approval Date: |
17 December 2004 |
| Submission Date: |
16 December 2004 |
| Access Restriction: |
No restriction; Release the ETD for access worldwide immediately. |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Nursing > Nursing |
| Degree: |
PhD - Doctor of Philosophy |
| Thesis Type: |
Doctoral Dissertation |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
communication; mechanical ventilation; patient’s treatment decision-making; preference; preference; prolonged; quality of life; resuscitation |
| Other ID: |
http://etd.library.pitt.edu/ETD/available/etd-12162004-120129/, etd-12162004-120129 |
| Date Deposited: |
10 Nov 2011 20:11 |
| Last Modified: |
15 Nov 2016 13:54 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/10389 |
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