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Effect of an Intervention Using Voice Recording of a Family Member on Patients Undergoing Mechanical Ventilator Weaning Process

녹음된 목소리를 통한 가족중재가 인공호흡기 이탈 과정 환자에게 미치는 효과

  • Received : 2023.06.07
  • Accepted : 2024.01.22
  • Published : 2024.02.28

Abstract

Purpose: This study aimed to determine the impact of an intervention using voice recording of family members on pain, anxiety, and agitation in patients undergoing weaning from mechanical ventilation. Methods: A randomized control pre-post experimental design was implemented to 53 participants, with 27 and 26 participants in the experimental and control groups, respectively. A 70-second voice recording of a family member, repeated three times at 10-minute intervals was used as an intervention for the experimental group. Meanwhile, participants in the control group used headset for 30 minutes. Structured instruments were utilized to measure pain, anxiety, agitation, and the weaning process. Wilcoxon Signed Ranks test and the Mann-Whitney U test, or χ2 test, were used for data analysis. Results: The experimental group exhibited significant decrease in pain (Z = - 3.53, p < .001), anxiety (t = 5.45, p < .001), and agitation (Z = - 2.99, p = .003) scores compared with those of the control group. However, there was no significant difference between groups in the weaning process' simplification (χ2 = 0.63, p = .727). Conclusion: Intervention using family members' voice recording effectively reduces pain, anxiety, and agitation in patients undergoing weaning from mechanical ventilation. This can be actively utilized to provide a more comfortable process for patients.

Keywords

References

  1. Boles JM, Bion J, Connors A, Herridge M, Marsh B, Melot C, et al. Weaning from mechanical ventilation. European Respiratory Journal. 2007;29(5):1033-1056. https://doi.org/10.1183/09031936.00010206
  2. MacIntyre NR, Cook DJ, Ely EW Jr, Epstein SK, Fink JB, Heffner JE, et al. Evidence-based guidelines for weaning and discontinuing ventilatory support: A collective task force facilitated by the American College of Chest Physicians; the American Association for Respiratory Care; and the American College of Critical Care Medicine. Chest. 2001;120(6 Suppl):375S-395S. https://doi.org/10.1378/chest.120.6_suppl.375s
  3. Chanques G, Jaber S, Barbotte E, Violet S, Sebbane M, Perrigault PF, et al. Impact of systematic evaluation of pain and agitation in an intensive care unit. Critical Care Medicine. 2006;34(6):1691-1699. https://doi.org/10.1097/01.CCM.0000218416.62457.56
  4. Payen JF, Bosson JL, Chanques G, Mantz J, Labarere J. Pain assessment is associated with decreased duration of mechanical ventilation in the intensive care unit: A post Hoc analysis of the DOLOREA study. Anesthesiology. 2009;111(6):1308-1316. https://doi.org/10.1097/ALN.0b013e3181c0d4f0
  5. Haugdahl HS, Dahlberg H, Klepstad P, Storli SL. The breath of life. Patients' experiences of breathing during and after mechanical ventilation. Intensive and Critical Care Nursing. 2017;40:85-93. https://doi.org/10.1016/j.iccn.2017.01.007
  6. Mofredj A, Alaya S, Tassaioust K, Bahloul H, Mrabet A. Music therapy, a review of the potential therapeutic benefits for the critically ill. Journal of Critical Care. 2016;35:195-199. https://doi.org/10.1016/j.jcrc.2016.05.021
  7. Burk RS, Grap MJ, Munro CL, Schubert CM, Sessler CN. Agitation onset, frequency, and associated temporal factors in critically ill adults. American Journal of Critical Care. 2014;23(4):296-304. https://doi.org/10.4037/ajcc2014186
  8. Chevrolet JC, Jolliet P. Clinical review: Agitation and delirium in the critically ill-significance and management. Critical Care. 2007;11(3):214. https://doi.org/10.1186/cc5787
  9. Woods JC, Mion LC, Connor JT, Viray F, Jahan L, Huber C, et al. Severe agitation among ventilated medical intensive care unit patients: Frequency, characteristics and outcomes. Intensive Care Medicine. 2004;30(6):1066-1072. https://doi.org/10.1007/s00134-004-2193-9
  10. Funk GC, Anders S, Breyer MK, Burghuber OC, Edelmann G, Heindl W, et al. Incidence and outcome of weaning from mechanical ventilation according to new categories. European Respiratory Journal. 2010;35(1):88-94. https://doi.org/10.1183/09031936.00056909
  11. Hetland B, Lindquist R, Chlan LL. The influence of music during mechanical ventilation and weaning from mechanical ventilation: A review. Heart & Lung. 2015;44(5):416-425. https://doi.org/10.1016/j.hrtlng.2015.06.010
  12. Amidei C, Sole ML. Physiological responses to passive exercise in adults receiving mechanical ventilation. American Journal of Critical Care. 2013;22(4):337-348. https://doi.org/10.4037/ajcc2013284
  13. Berning JN, Poor AD, Buckley SM, Patel KR, Lederer DJ, Goldstein NE, et al. A novel picture guide to improve spiritual care and reduce anxiety in mechanically ventilated adults in the intensive care unit. Annals of the American Thoracic Society. 2016;13(8):1333-1342. https://doi.org/10.1513/AnnalsATS.201512-831OC
  14. Twiss E, Seaver J, McCaffrey R. The effect of music listening on older adults undergoing cardiovascular surgery. Nursing in Critical Care. 2006;11(5):224-231. https://doi.org/10.1111/j.1478-5153.2006.00174.x
  15. Bausewein C, Booth S, Gysels M, Higginson I. Non-pharmacological interventions for breathlessness in advanced stages of malignant and non-malignant diseases. Cochrane Database of Systematic Reviews. 2008;(2):CD005623. https://doi.org/10.1002/14651858.CD005623.pub2
  16. Devlin JW, Skrobik Y, Gelinas C, Needham DM, Slooter AJC, Pandharipande PP, et al. Clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Critical Care Medicine. 2018;46(9):e825-e873. https://doi.org/10.1097/CCM.0000000000003299
  17. Islekdemir B, Kaya N. Effect of family presence on pain and anxiety during invasive nursing procedures in an emergency department: A randomized controlled experimental study. International Emergency Nursing. 2016;24:39-45. https://doi.org/10.1016/j.ienj.2015.05.008
  18. Rose L, Yu L, Casey J, Cook A, Metaxa V, Pattison N, et al. Communication and virtual visiting for families of patients in intensive care during the COVID-19 pandemic: A UK national survey. Annals of the American Thoracic Society. 2021;18(10):1685-1692. https://doi.org/10.1513/AnnalsATS.202012-1500OC
  19. Haugdahl HS, Eide R, Alexandersen I, Paulsby TE, Stjern B, Lund SB, et al. From breaking point to breakthrough during the ICU stay: A qualitative study of family members' experiences of long-term intensive care patients' pathways towards survival. Journal of Clinical Nursing. 2018;27(19-20):3630-3640. https://doi.org/10.1111/jocn.14523
  20. Rosa RG, Falavigna M, da Silva DB, Sganzerla D, Santos MMS, Kochhann R, et al. Effect of flexible family visitation on delirium among patients in the intensive care unit: The ICU visits randomized clinical trial. JAMA. 2019;322(3):216-228. https://doi.org/10.1001/jama.2019.8766
  21. Lee YO, Kang JY. The effects of extended family visiting hours in the intensive care unit. Journal of Korean Critical Care Nursing. 2011;4(1):51-63.
  22. Dan SY, Park SH, Lee S, Park HY, Yi YH. Experience of patients and families about flexible visiting. Journal of Korean Critical Care Nursing. 2017;10(1):51-62.
  23. Hajiabadi F, Heydari A, Manzari ZS. The elixir of visiting: A qualitative study on the experiences of conscious mechanically ventilated patients in intensive care units regarding visiting family members. Evidence Based Care Journal. 2017;7(2):46-58. https://doi.org/10.22038/EBCJ.2017.25177.1560
  24. Alireza ZF, Ali AJ, Tayebeh NB. Comparison the effect of trained and untrained family presence on their anxiety during invasive procedures in an emergency department: A randomized controlled trial. Turkish Journal of Emergency Medicine. 2019;19(3):100-105. https://doi.org/10.1016/j.tjem.2019.05.001
  25. Hart JL, Taylor SP. Family presence for critically ill patients during a pandemic. Chest. 2021;160(2):549-557. https://doi.org/10.1016/j.chest.2021.05.003
  26. Dou H, Dai Y, Qiu Y, Lei Y. Attachment voices promote safety learning in humans: A critical role for P2. Psychophysiology. 2022;59(6):e13997. https://doi.org/10.1111/psyp.13997
  27. Black P, Boore JR, Parahoo K. The effect of nurse-facilitated family participation in the psychological care of the critically ill patient. Journal of Advanced Nursing. 2011;67(5):1091-1101. https://doi.org/10.1111/j.1365-2648.2010.05558.x
  28. Gelinas C, Arbour C, Michaud C, Robar L, Cote J. Patients and ICU nurses' perspectives of non-pharmacological interventions for pain management. Nursing in Critical Care. 2013;18(6):307-318. https://doi.org/10.1111/j.1478-5153.2012.00531.x
  29. Haas CF, Loik PS. Ventilator discontinuation protocols. Respiratory Care. 2012;57(10):1649-1662. https://doi.org/10.4187/respcare.01895
  30. Wu SJ, Chou FH. [The effectiveness of music therapy in reducing physiological and psychological anxiety in mechanically ventilated patients]. Hu Li Za Zhi. 2008;55(5):35-44. Chinese.
  31. Kwak EM, Oh H. Validation of a Korean translated version of the Critical Care Pain Observation Tool (CPOT) for ICU patients. Journal of Korean Academy of Nursing. 2012;42(1):76-84. https://doi.org/10.4040/jkan.2012.42.1.76
  32. Spielberger CD, Gonzalez-Reigosa F, Martinez-Urrutia A, Natalicio LF, Natalicio DS. Development of the Spanish edition of the State-Trait Anxiety Inventory. Revista Interamericana de Psicologia. 1971;5(3-4):145-158.
  33. Kim JT, Shin DK. A study based on the standardization of the STAI for Korea. New Medical Journal. 1978;21(11):69-75.
  34. Chlan L, Savik K, Weinert C. Development of a shortened state anxiety scale from the Spielberger State-Trait Anxiety Inventory (STAI) for patients receiving mechanical ventilatory support. Journal of Nursing Measurement. 2003;11(3):283-293. https://doi.org/10.1891/jnum.11.3.283.61269
  35. Yousefi H, Toghyani F, Yazdannik AR, Fazel K. Effect of using Richmond Agitation Sedation Scale on duration of mechanical ventilation, type and dosage of sedation on hospitalized patients in intensive care units. Iranian Journal of Nursing and Midwifery Research. 2015;20(6):700-704. https://doi.org/10.4103/1735-9066.170008
  36. Sessler CN, Gosnell MS, Grap MJ, Brophy GM, O'Neal PV, Keane KA, et al. The Richmond Agitation-Sedation Scale: Validity and reliability in adult intensive care unit patients. American Journal of Respiratory and Critical Care Medicine. 2002;166(10):1338-1344. https://doi.org/10.1164/rccm.2107138
  37. Ely EW, Truman B, Shintani A, Thomason JW, Wheeler AP, Gordon S, et al. Monitoring sedation status over time in ICU patients: Reliability and validity of the Richmond Agitation-Sedation Scale (RASS). JAMA. 2003;289(22):2983-2991. https://doi.org/10.1001/jama.289.22.2983
  38. Saadatmand V, Rejeh N, Heravi-Karimooi M, Tadrisi SD, Vaismoradi M, Jordan S. Effects of natural sounds on pain: A randomized controlled trial with patients receiving mechanical ventilation support. Pain Management Nursing. 2015;16(4):483-492. https://doi.org/10.1016/j.pmn.2014.09.006
  39. Saglik DS, Caglar S. The effect of parental presence on pain and anxiety levels during invasive procedures in the pediatric emergency department. Journal of Emergency Nursing. 2019;45(3):278-285. https://doi.org/10.1016/j.jen.2018.07.003
  40. Ahn MN, Ahn HY. The effects of music intervention on pain among critically ill patients with ventilatory support. Journal of Korean Biological Nursing Science. 2013;15(4):247-256. https://doi.org/10.7586/jkbns.2013.15.4.247
  41. Kunz M, Lautenbacher S, LeBlanc N, Rainville P. Are both the sensory and the affective dimensions of pain encoded in the face? Pain. 2012;153(2):350-358. https://doi.org/10.1016/j.pain.2011.10.027
  42. Nordness MF, Hayhurst CJ, Pandharipande P. Current perspectives on the assessment and management of pain in the intensive care unit. Journal of Pain Research. 2021;14:1733-1744. https://doi.org/10.2147/JPR.S256406
  43. Gheshlaghi PA, Farahani ZB, Anboohi SZ, Nasiri M, Ziapour A, Garosi VH. Effect of family presence on pain and anxiety levels among patients during invasive nursing procedures in an emergency department at a public hospital in Western Iran. African Journal of Emergency Medicine. 2021;11(1):31-36. https://doi.org/10.1016/j.afjem.2020.11.003
  44. Kamali SH, Imanipour M, Emamzadeh Ghasemi HS, Razaghi Z. Effect of programmed family presence in coronary care units on patients' and families' anxiety. Journal of Caring Sciences. 2020;9(2):104-112. https://doi.org/10.34172/JCS.2020.016
  45. Nouri JM, Safaeipour L, Vafadar Z, Moradian ST. The effect of the family presence on anxiety and agitation of patients under mechanical ventilation after open heart surgery: A randomized clinical trial. Perioperative Medicine. 2021;10(1):40. https://doi.org/10.1186/s13741-021-00207-2
  46. Engstrom A, Nystrom N, Sundelin G, Rattray J. People's experiences of being mechanically ventilated in an ICU: A qualitative study. Intensive and Critical Care Nursing. 2013;29(2):88-95. https://doi.org/10.1016/j.iccn.2012.07.003
  47. Blair GJ, Mehmood T, Rudnick M, Kuschner WG, Barr J. Nonpharmacologic and medication minimization strategies for the prevention and treatment of ICU delirium: A narrative review. Journal of Intensive Care Medicine. 2019;34(3):183-190. https://doi.org/10.1177/0885066618771528
  48. Van Rompaey B, Elseviers MM, Schuurmans MJ, Shortridge-Baggett LM, Truijen S, Bossaert L. Risk factors for delirium in intensive care patients: A prospective cohort study. Critical Care. 2009;13(3):R77. https://doi.org/10.1186/cc7892
  49. Thille AW, Cortes-Puch I, Esteban A. Weaning from the ventilator and extubation in ICU. Current Opinion in Critical Care. 2013;19(1):57-64. https://doi.org/10.1097/MCC.0b013e32835c5095
  50. Sellares J, Ferrer M, Cano E, Loureiro H, Valencia M, Torres A. Predictors of prolonged weaning and survival during ventilator weaning in a respiratory ICU. Intensive Care Medicine. 2011;37(5):775-784. https://doi.org/10.1007/s00134-011-2179-3