| Learning Objective #1: Discuss perceptions of symptoms of mechanically ventilated patients with large abdomens | |||
| Learning Objective #2: Evaluate findings regarding symptom perception in various positions |
The theoretical framework for the study was Neuman's System Model (1995) which guides research with clients who are experiencing complex stressors. In addition, the UCSF Symptom Management Model (2001) was used to aid in interpreting symptom perceptions. Three data collection forms were used: Confusion Assessment Method (CAM-ICU) (Ely et al, 2001), Physiological Assessment of Intubated Patients (PAIP) (Twibell, Siela, Baccora & Anderson, 2002) and four visually analogue scales (VAS) to measure dyspnea, fatigue, anxiety, and comfort. Data from the PAIP included age, multiple hemodynamic and respiratory parameters, length of time on ventilation, and medical diagnoses.
Participants were placed in four different positions in the bed which included the standard head of bed at 30 degrees, 45 degrees, 45 degrees in reverse trendelenberg, and 90 degrees. After ten minutes in each position, measures were taken and recorded on the PAIP. Patients were asked in each position to rate their level of anxiety, dyspnea, fatigue, and comfort on the VAS.
Initial data analysis suggests that most patients perceive high levels of discomfort in any of the four positions. Participants perceive moderate fatigue more so at 90 degrees. Dyspnea and anxiety are perceived at lower levels of intensity than discomfort or fatigue. The identification of the correlates of these four perceptions in mechanically ventilated patients with large abdomens can enable the nurse to plan interventions to assist with their management.