"I had the feeling that I was trapped": a bedside qualitative study of cognitive and affective attitudes towards noninvasive ventilation in patients with acute respiratory failure

Marina Iosifian; Matthieu  Schmidt; Amélie  Hurbault; Julien Mayaux; Christian  Delafosse; Marina  Mishenko; Nathalie  Nion; Alexandre Demoule; Thomas Similowski

doi:10.1186/s13613-019-0608-6

"I had the feeling that I was trapped": a bedside qualitative study of cognitive and affective attitudes towards noninvasive ventilation in patients with acute respiratory failure

Marina Iosifian, Matthieu Schmidt, Amélie Hurbault, Julien Mayaux, Christian Delafosse, Marina Mishenko, Nathalie Nion, Alexandre Demoule, Thomas Similowski

School of Divinity

Research output: Contribution to journal › Article › peer-review

Abstract

Background

Noninvasive ventilation (NIV) is the application of mechanical ventilation through a mask. It is used to treat certain forms of acute respiratory failure in intensive care units (ICU). NIV has clinical benefits but can be anxiogenic for the patients. This study aimed at describing cognitive and affective attitudes toward NIV among patients experiencing NIV for the first time in the context of an ICU stay.

Methods

Semi-structured interviews were conducted in 10 patients during their ICU stay and soon after their first NIV experience. None of the patients had ever received NIV previously. Evaluative assertion analysis and thematic analysis were used to investigate cognitive and affective attitudes toward NIV before, during, and after the first NIV experience, as well as patient attitudes toward caregivers and relatives.

Results

Before their first NIV session, the cognitive attitudes of the patients were generally positive. They became less so and more ambiguous during and after NIV, as the patients discovered the actual barriers associated with NIV. Affective attitudes during NIV were more negative than affective attitudes before and after NIV, with reports of dyspnea, anxiety, fear, claustrophobic feelings, and reactivation of past traumatic experiences. The patients had more positive attitudes toward the presence of a caregiver during NIV, compared to the presence of a family member.

Conclusion

This study corroborates the possibly negative—or even traumatic—nature of the NIV experience, with emphasis on the role of affective attitudes. This is a rationale for evaluating the impact of NIV-targeted psychological interventions in ICU patients with acute respiratory failure.

Original language	English
Article number	134
Number of pages	10
Journal	Annals of Intensive Care
Volume	9
DOIs	https://doi.org/10.1186/s13613-019-0608-6
Publication status	Published - 2 Dec 2019

Keywords

Noninvasive ventilation (NIV)
Qualitative research
Cognitive attitudes
Affective attitudes
Dyspnea

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1186/s13613-019-0608-6Licence: CC BY

Iosifyan_2019_AIC_Trapped_CC
Copyright © The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons .org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Final published version, 0.98 MBLicence: CC BY

Cite this

Iosifian, M., Schmidt, M., Hurbault, A., Mayaux, J., Delafosse, C., Mishenko, M., Nion, N., Demoule, A., & Similowski, T. (2019). "I had the feeling that I was trapped": a bedside qualitative study of cognitive and affective attitudes towards noninvasive ventilation in patients with acute respiratory failure. Annals of Intensive Care, 9, Article 134. https://doi.org/10.1186/s13613-019-0608-6

@article{c67a63d0a18c435f9590582b481ec6ca,

title = "{"}I had the feeling that I was trapped{"}: a bedside qualitative study of cognitive and affective attitudes towards noninvasive ventilation in patients with acute respiratory failure",

abstract = "BackgroundNoninvasive ventilation (NIV) is the application of mechanical ventilation through a mask. It is used to treat certain forms of acute respiratory failure in intensive care units (ICU). NIV has clinical benefits but can be anxiogenic for the patients. This study aimed at describing cognitive and affective attitudes toward NIV among patients experiencing NIV for the first time in the context of an ICU stay.MethodsSemi-structured interviews were conducted in 10 patients during their ICU stay and soon after their first NIV experience. None of the patients had ever received NIV previously. Evaluative assertion analysis and thematic analysis were used to investigate cognitive and affective attitudes toward NIV before, during, and after the first NIV experience, as well as patient attitudes toward caregivers and relatives.ResultsBefore their first NIV session, the cognitive attitudes of the patients were generally positive. They became less so and more ambiguous during and after NIV, as the patients discovered the actual barriers associated with NIV. Affective attitudes during NIV were more negative than affective attitudes before and after NIV, with reports of dyspnea, anxiety, fear, claustrophobic feelings, and reactivation of past traumatic experiences. The patients had more positive attitudes toward the presence of a caregiver during NIV, compared to the presence of a family member.ConclusionThis study corroborates the possibly negative—or even traumatic—nature of the NIV experience, with emphasis on the role of affective attitudes. This is a rationale for evaluating the impact of NIV-targeted psychological interventions in ICU patients with acute respiratory failure.",

keywords = "Noninvasive ventilation (NIV), Qualitative research, Cognitive attitudes, Affective attitudes, Dyspnea",

author = "Marina Iosifian and Matthieu Schmidt and Am{\'e}lie Hurbault and Julien Mayaux and Christian Delafosse and Marina Mishenko and Nathalie Nion and Alexandre Demoule and Thomas Similowski",

note = "At the time of the study, Dr. Schmidt was supported by grants from the “Soci{\'e}t{\'e} de R{\'e}animation de Langue Fran{\c c}aise”, “Fonds de Recherche en Sant{\'e} Respiratoire”, “Coll{\`e}ge des Enseignants de R{\'e}animation M{\'e}dicale”, and “Fonds d{\textquoteright}Etudes et de Recherche du Corps M{\'e}dical des H{\^o}pitaux de Paris”. ",

year = "2019",

month = dec,

day = "2",

doi = "10.1186/s13613-019-0608-6",

language = "English",

volume = "9",

journal = "Annals of Intensive Care",

issn = "2110-5820",

publisher = "Springer-Verlag",

}

Iosifian, M, Schmidt, M, Hurbault, A, Mayaux, J, Delafosse, C, Mishenko, M, Nion, N, Demoule, A & Similowski, T 2019, '"I had the feeling that I was trapped": a bedside qualitative study of cognitive and affective attitudes towards noninvasive ventilation in patients with acute respiratory failure', Annals of Intensive Care, vol. 9, 134. https://doi.org/10.1186/s13613-019-0608-6

TY - JOUR

T1 - "I had the feeling that I was trapped"

T2 - a bedside qualitative study of cognitive and affective attitudes towards noninvasive ventilation in patients with acute respiratory failure

AU - Iosifian, Marina

AU - Schmidt, Matthieu

AU - Hurbault, Amélie

AU - Mayaux, Julien

AU - Delafosse, Christian

AU - Mishenko, Marina

AU - Nion, Nathalie

AU - Demoule, Alexandre

AU - Similowski, Thomas

N1 - At the time of the study, Dr. Schmidt was supported by grants from the “Société de Réanimation de Langue Française”, “Fonds de Recherche en Santé Respiratoire”, “Collège des Enseignants de Réanimation Médicale”, and “Fonds d’Etudes et de Recherche du Corps Médical des Hôpitaux de Paris”.

PY - 2019/12/2

Y1 - 2019/12/2

N2 - BackgroundNoninvasive ventilation (NIV) is the application of mechanical ventilation through a mask. It is used to treat certain forms of acute respiratory failure in intensive care units (ICU). NIV has clinical benefits but can be anxiogenic for the patients. This study aimed at describing cognitive and affective attitudes toward NIV among patients experiencing NIV for the first time in the context of an ICU stay.MethodsSemi-structured interviews were conducted in 10 patients during their ICU stay and soon after their first NIV experience. None of the patients had ever received NIV previously. Evaluative assertion analysis and thematic analysis were used to investigate cognitive and affective attitudes toward NIV before, during, and after the first NIV experience, as well as patient attitudes toward caregivers and relatives.ResultsBefore their first NIV session, the cognitive attitudes of the patients were generally positive. They became less so and more ambiguous during and after NIV, as the patients discovered the actual barriers associated with NIV. Affective attitudes during NIV were more negative than affective attitudes before and after NIV, with reports of dyspnea, anxiety, fear, claustrophobic feelings, and reactivation of past traumatic experiences. The patients had more positive attitudes toward the presence of a caregiver during NIV, compared to the presence of a family member.ConclusionThis study corroborates the possibly negative—or even traumatic—nature of the NIV experience, with emphasis on the role of affective attitudes. This is a rationale for evaluating the impact of NIV-targeted psychological interventions in ICU patients with acute respiratory failure.

AB - BackgroundNoninvasive ventilation (NIV) is the application of mechanical ventilation through a mask. It is used to treat certain forms of acute respiratory failure in intensive care units (ICU). NIV has clinical benefits but can be anxiogenic for the patients. This study aimed at describing cognitive and affective attitudes toward NIV among patients experiencing NIV for the first time in the context of an ICU stay.MethodsSemi-structured interviews were conducted in 10 patients during their ICU stay and soon after their first NIV experience. None of the patients had ever received NIV previously. Evaluative assertion analysis and thematic analysis were used to investigate cognitive and affective attitudes toward NIV before, during, and after the first NIV experience, as well as patient attitudes toward caregivers and relatives.ResultsBefore their first NIV session, the cognitive attitudes of the patients were generally positive. They became less so and more ambiguous during and after NIV, as the patients discovered the actual barriers associated with NIV. Affective attitudes during NIV were more negative than affective attitudes before and after NIV, with reports of dyspnea, anxiety, fear, claustrophobic feelings, and reactivation of past traumatic experiences. The patients had more positive attitudes toward the presence of a caregiver during NIV, compared to the presence of a family member.ConclusionThis study corroborates the possibly negative—or even traumatic—nature of the NIV experience, with emphasis on the role of affective attitudes. This is a rationale for evaluating the impact of NIV-targeted psychological interventions in ICU patients with acute respiratory failure.

KW - Noninvasive ventilation (NIV)

KW - Qualitative research

KW - Cognitive attitudes

KW - Affective attitudes

KW - Dyspnea

U2 - 10.1186/s13613-019-0608-6

DO - 10.1186/s13613-019-0608-6

M3 - Article

SN - 2110-5820

VL - 9

JO - Annals of Intensive Care

JF - Annals of Intensive Care

M1 - 134

ER -

"I had the feeling that I was trapped": a bedside qualitative study of cognitive and affective attitudes towards noninvasive ventilation in patients with acute respiratory failure

Abstract

Keywords

UN SDGs

Access to Document

Fingerprint

Cite this