OBJECTIVE: To describe patients' recollections of their experiences during mechanical ventilation and weaning and to extend an evolving nursing theory of weaning. DESIGN: A qualitative approach that used grounded theory techniques. PATIENTS AND METHODS: We surveyed 20 hospitalized patients who had recently undergone mechanical ventilation and weaning from the ventilator in a critical care unit. Included in the analysis were any thoughts, feelings, or actions recalled by the patients that were related to the weaning experience. RESULTS: During ventilation and weaning, patients were engaged to various degrees in what they called "work," which consisted of their efforts to assist in their adjustment and recovery. This work had four themes: sense making, enduring, preserving self, and controlling responses. These themes represented activities by which patients dealt with their personal concerns and cooperated with the therapeutic plan. CONCLUSIONS: Despite good care during the process, mechanical ventilation and weaning are stressful experiences that require active participation by patients. Patients' work needs to be understood and supported by clinicians to facilitate recovery from mechanical ventilation and weaning.

Adaptation, Psychological↗

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Promoting ventilator independence: a grounded theory perspective.

This qualitative study describes a distinctive nursing perspective on the process of ventilator weaning that is not well documented in current literature. The investigators used interviews with expert critical care nurses to reveal the knowledge, judgments, and actions used by nurses to promote ventilator independence. The authors identify a nursing diagnosis and three themes that offer a theoretical framework for ventilator weaning and suggest nursing interventions that promote successful ventilator weaning.

Activities of Daily Living↗

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Deriving a new nursing diagnosis through qualitative research: dysfunctional ventilatory weaning response.

A secondary analysis was conducted on data originally collected using grounded theory methodology, to study nurses' perceptions of how they wean adult patients from mechanical ventilation. From this secondary analysis, a new nursing diagnosis was derived: dysfunctional ventilatory weaning response. This article discusses the rationale for the diagnostic label and describes salient characteristics and interventions related to the diagnosis.

Clinical Nursing Research↗

PubMedDate not supplied

Consistency of a double PAPNET scan of cervical smears.

OBJECTIVE: To determine the reproducibility and accuracy of the PAPNET system in finding and presenting abnormal and atypical cells. STUDY DESIGN: To assess the potential variation of a double PAPNET scan on the same cervical smear, 516 cervical smears from women with abnormal histologic diagnoses were scanned twice via PAPNET and reviewed by two independent examiners in a double-blind trial. RESULTS: The false negative rate of 5.7% in conventional screening was reduced to 0.4% and 0.8%, respectively, by PAPNET testing. The resulting concurrence of the first and the second PAPNET reviews was 99.2%, indicating the accuracy, sensitivity and consistency of this supplemental test. CONCLUSION: The results obtained demonstrate the reproducibility and accuracy of the system in finding and presenting abnormal and atypical cells.

Automation↗

PubMedDate not supplied