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Research Article: Qualitative study of COVID-19 patient experiences with non-invasive ventilation and pronation: strategies to enhance treatment adherence

Date Published: 2023-12-09

Abstract:
Introduction Non-invasive ventilation (NIV) treatment combined with pronation in patients with COVID-19 respiratory failure has been shown to be effective in improving respiratory function and better patient outcomes. These patients may experience discomfort or anxiety that may reduce adherence to treatment. Objective The aim of this study was to explore and describe the subjective experiences of patients undergoing helmet NIV and pronation during hospitalisation for COVID-19 respiratory failure, with a focus on the elements of care and strategies adopted by patients that enabled good adaptation to treatments. Method A qualitative descriptive study, using face-to-face interviews, was carried out with a purposeful sample of 20 participants discharged from a pulmonary intensive care unit who underwent helmet continuous positive airway pressure and pronation during hospitalisation for COVID-19. Results Content analysis of the transcripts revealed feelings and experiences related to illness and treatments, strategies for managing one’s own negative thoughts, and practical strategies of one’s own and healthcare workers to facilitate adaptation to pronation and helmet. Experience was reflected in five major topics related to specific time points and settings: feelings and experiences, helmet and pronation: heavy but beneficial, positive thinking strategies, patients’ practical strategies, support of healthcare professionals (HCPs). Conclusions This study may be useful to HCPs to improve the quality and appropriateness of care they provide.

Introduction:
In recent years, non-invasive ventilation (NIV), including non-invasive variable positive airway pressure ventilation and continuous positive airway pressure (CPAP), has progressively gained a key role in the therapy of both hypoxaemic and hypercapnic acute respiratory failure. 1 2 About 15% of patients with severe acute hypoxaemic respiratory failure (AHRF) have been treated with NIV in recent years, with an important increase during the COVID-19 pandemic. 3 4 Helmet CPAP (HCPAP), significantly reduces intubation…

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