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Resuscitation Preferences in Survivors of Prolonged Mechanical Ventilation (PMV)/Tracheostomy

Guentner, Kathleen (2004) Resuscitation Preferences in Survivors of Prolonged Mechanical Ventilation (PMV)/Tracheostomy. Doctoral Dissertation, University of Pittsburgh.

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    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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    Details

    Item Type: University of Pittsburgh ETD
    ETD Committee:
    ETD Committee TypeCommittee MemberEmail
    Committee ChairHoffman, Leslie Alhof@pitt.edu
    Committee MemberDabbs, Annette DeVitoajdst42@pitt.edu
    Committee MemberChelluri, Lakshmipathichelluril@ccm.upmc.edu
    Committee MemberHapp, Mary Bethmhapp@pitt.edu
    Committee MemberKim, Yookyungykk@pitt.edu
    Title: Resuscitation Preferences in Survivors of Prolonged Mechanical Ventilation (PMV)/Tracheostomy
    Status: 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.
    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.
    Patent pending: No
    Institution: University of Pittsburgh
    Thesis Type: Doctoral Dissertation
    Refereed: Yes
    Degree: PhD - Doctor of Philosophy
    URN: etd-12162004-120129
    Uncontrolled Keywords: communication; mechanical ventilation; patient’s treatment decision-making; preference; preference; prolonged; quality of life; resuscitation
    Schools and Programs: School of Nursing > Nursing
    Date Deposited: 10 Nov 2011 15:11
    Last Modified: 29 May 2012 13:33
    Other ID: http://etd.library.pitt.edu/ETD/available/etd-12162004-120129/, etd-12162004-120129

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