Scientific Publications Database

Article Title: Transitions to Home Mechanical Ventilation The Experiences of Canadian Ventilator-assisted Adults and Their Family Caregivers
Authors: Dale, Craig M.; King, Judy; Nonoyama, Mika; Carbone, Sarah; Mckim, Douglas; Road, Jeremy; Rose, Louise
Journal: ANNALS OF THE AMERICAN THORACIC SOCIETY Volume 15 Issue 3
Date of Publication:2018
Abstract:
Rationale: Several studies have explored the experiences of ventilator-assisted individuals living at home with family caregivers. However, few explore the experiences of these individuals as they transition from a hospital setting to living at home with a view to identifying modifiable processes that could optimize transition.Objectives: This descriptive, qualitative study sought to elucidate barriers to, and facilitators of, transition to home mechanical ventilation from the perspective of Canadian ventilator-assisted individuals and their family caregivers.Methods: Participant recruitment occurred through hospital and community respiratory clinicians based in the four Canadian provinces of Alberta, British Columbia, Ontario, and Saskatchewan. Semistructured telephone or face-to-face interviews at home were undertaken with 33 individuals, including 19 ventilator-assisted individuals and 14 family caregivers, after 3 to 24 months of transitioning to home mechanical ventilation. Interview data were analyzed by content analysis.Results: Formal teaching of knowledge and skills relevant to home mechanical ventilation within the hospital setting before transition was perceived as having an immediate and enduring positive impact on transition. However, family-clinician conflict, information gaps, and persistent lack of trained personal support workers to provide care in the home contributed to maladjustment relating to transition. Participants strongly recommended improved transitional care in the form of respiratory health professional telephone support, home outreach, and training of personal support workers.Conclusions: Transition to home mechanical ventilation is a complex and demanding process. Extended home mechanical ventilation training and support may be helpful in mediating adjustment challenges, thus reducing stress and caregiver burden, and improving health-related quality of life for ventilator-assisted individuals and family caregivers.