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.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-12162004-120129 |
| Date | 17 December 2004 |
| Creators | Guentner, Kathleen |
| Contributors | Lakshmipathi Chelluri, MD, Mary Beth Happ, RN, PhD, Annette DeVito Dabbs, RN, PhD, Yookyung Kim, PhD, Leslie A. Hoffman, RN, PhD |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-12162004-120129/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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