ผลของโปรแกรมการหย่าเครื่องช่วยหายใจแบบบูรณาการเพื่อลดความรู้สึกไม่แน่นอนในผู้ป่วยสูงอายุและผู้ดูแล

Abstract

This quasi experimental research aimed to examine the effect of integrated ventilator weaning program on the reduction of uncertainty feeling in elderly patients at a university hospital in Southern Thailand. Fifty patients were purposively selected and assigned equally into the experimental group and the control group. Participants in the control group received usual care while those in the experimental group received the integrated ventilator weaning program. This program was developed by the researcher based on the uncertainty in illness framework of Mishel. The program included assessing need of patients during weaning of respirator and providing related information, promoting pulmonary rehabilitation, and promoting family participation. Instruments used for data collection included (1) the Demographic and Illness Questionnaire (DIQ), (2) the Uncertainty for Weaning Assessment (UWA), and (3) The Weaning Flow Sheet (WFS). Instruments included the Need Assessment of Patients during Weaning of Respirator and integrated ventilator weaning program with providing related information, promoting pulmonary rehabilitation, and promoting family participation. The content validity of the program and all instruments was examined by three experts, and the reliability was evaluated using test-retest, which yielded values of .96 and .86respectively. Demographic data were analyzed by using descriptive statistics and Chi-Square test. The uncertainty scores were analyzed by using paired t-test and independent t-test. The results revealed that: 1. After intervention completion, mean scores of uncertainty of the Elderly patients and Caregivers in the intervention group were statistically lower than before receiving the intervention (p <.05). 2. After intervention completion, mean scores of uncertainty of the Elderly patients and Caregivers in the intervention group were statistically lower than those in the control group (p <.05). 3. When comparing mean times in weaning practice of the patients in the intervention group and those in the control group at days 1, 2, and 3, there were no statically significant differences (p > .05). The findings indicate that the integrated ventilator weaning program could reduce uncertainty feeling in elderly patients. However, the program could not extend time the tolerated of weaning practice of the patients.