Meditation Care Program for Anxiety and Breathing Control in Persons with Weaning Difficulties: A Randomized Control Trial

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Benjamard Thinhuatoey Praneed Songwathana Wongchan Petpichetchian

Abstract

                 Suffering from weaning failure leads to mind-body disharmony; however, reducing anxiety and self-reliance on breathing control may inspire patients’ capability to wean from mechanical ventilation. This randomized controlled trial examined the effects of the Integrated Concentration Meditation Care Program on anxiety level and breathing control among 54 participants suffering with difficult weaning from mechanical ventilator. Participants were randomly assigned to either the experimental (n=23) or the control group (n= 31). The experimental group received nine steps of a nurse-initiated strategy called “GREATWEAN” (Goal setting, Reducing fear and anxiety, Engaging the family to be present with the patient, Active involvement of the patient, Technology safely and appropriately used, Working together, Empowerment, Assessing, and Nurturing) in addition to usual care, while the control group received only usual care.  Data collection instruments were: a) Demographic Data Record Form, b) Visual Analogue Scale for Anxiety, and c) Breathing Control measured by respiration rate, minute ventilation and oxygen saturation in an Observation Record Form.
            The findings showed a statistical significance in anxiety reduction in the experimental group as compared to the control group at day 3 and 7 of the program implementation, whereas self-breathing control was not significant difference between the two groups. The meditation care program can be applied to reduce anxiety level in persons with difficult weaning.

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How to Cite
1.
Thinhuatoey B, Songwathana P, Petpichetchian W. Meditation Care Program for Anxiety and Breathing Control in Persons with Weaning Difficulties: A Randomized Control Trial. Pacific Rim International Journal of Nursing Research [Internet]. 28Feb.2017 [cited 15Dec.2018];21(1):18-1. Available from: https://www.tci-thaijo.org/index.php/PRIJNR/article/view/53367
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References

1. Rose L, Blackwood B, Burns SM, Frazier SK, Egerod, I. International perspectives on the influence of structure and process of weaning from mechanical ventilation. Am J Crit Care. 2011; 20: e10-e18.

2. Geiseler J, Kelbel C.Weaning from mechanical ventilation: Weaning categories and weaning concepts [abstract]. Med Klin Intensivmed Notfmed. 2016; 111(3):208-14.

3. Boles JM, Bion J, Connors A, Herridge M, Marsh B, Melot C, Pearl R, Silverman H, Stanchina M, Vieillard-Baron A, Welte T. Weaning from mechanical ventilation. Eur Respir J.2007; 29:1033-056.

4. Rose L, Dainty KN, Jordan J, Blackwood B. Weaning from mechanical ventilation; A scoping review of qualitative studies. Am J Crit Care. 2014; 23: e54-e71.

5. Khalil Y, Ibrahim E, Shabaan A, Imam M, Behairy AEL. Assessment of risk factors responsible for difficult weaning from mechanical ventilation in adults. Egyptian J Chest Dis Tuberculosis. 2012; 61: 159-66.

6. Chen Y, Jacobs WJ, Quan SF, Figueredo, AJ, Davis AHT. Psychophysiological determinants of repeated ventilator weaning failure: An explanatory model. Am J Crit Care. 2011; 20(4): 229-302.

7. Darayon R. Experiences of patients encountering difficulty weaning from mechanical ventilation.[Master thesis]. Prince of Songkla University; 2007; 115 p.

8. Campbel LM. Dyspnea. AACN Adv Crit Care. 2011; 22(3): 257-64.

9. Bone RC, Hayden WR, Levine RL, McCartney JR, Barkin RL, Clark S, Cowen J, Fontaniae D., Fromm RE, Guerrero M Jr., et al. Recognition, assessment, and treatment of anxiety, in the critical care patient. Dis Mon. 1995; 41(5): 293-395.

10. Tate JA, Dabbs AD, Hoffman L, Milbrandt E, Happ MB. Anxiety and agitation in mechanically ventilated patients. Qual Health Res. 2012; 22(2): 157-73.

11. Park E, Oh H, Kim T. The effects of relaxation breathing on procedural pain and anxiety during burn care. Burns. 2013;39: 1101-106.

12. Gutiérrez EOF, Camarena VAT. Music therapy in generalized anxiety disorder. Art Psychother.2015; 44:19-24.

13. Abbott RA, Whear R, Rodgers LR, Bethel A, Coon JT, Kuyken W, Stein K, Dickens C. Effectiveness of mindfulnessbased stress reduction and mindfulness based cognitive therapy in vascular disease: a systematic review and metaanalysis of randomised controlled trials. J Psychosom Res. 2014; 76: 341–51.

14. Tipsut S. The effect of here and now technique on anxiety reduction in adult patients with ventilator via endotracheal tube. [Master thesis]. Khon Kaen University, 1998; 88 p.

15. Chanchamnong S. The Buddha’s core teaching. Bangkok (Thailand): Tatata; 2003. Chapter I, Religion in Perspective; p. 28-34.

16. Payutto PP. Buddhadhamma: natural laws and values for life. Olson GA, translator. Albany (NY): State University of New York Press; c1995, 302 p.

17. Eckerblad J, Eriksson H, Karner A, Edell-Gustafsson U. Nurses’ conceptions of facilitative strategies of weaning patients from mechanical ventilation- a phenomenographic study. Intensive Crit Care Nurs.2009; 25: 225-32.

18. Sullivan TJ. Collaboration: a health care imperative. New York: McGraw-Hill; c1998. Chapter 1, Concept analysis of collaboration: part I; p. 3-40.

19. Dossy BM, Keegan L. Holistic nursing: a handbook for practice. 5th ed. Boston: Jones & Bartlett; c2009. Chapter 1; Integral and holistic nursing: local to global; p. 1-46.

20. Holiday JE, Hyers TM. The reduction of weaning time from mechanical ventilation using tidal volume and relaxation biofeedback. Am Rev Respir Dis. 1990; 141(5): 1214-20.

21. Cohen J. Statistical power analysis for behavioural sciences.2nd ed. New York: Lawrence- Erlbaum; c1988. Chapter 2, The t test for means; p. 19-74.

22. Suresh KP. An overview of randomization techniques: an unbiased assessment of outcome in clinical research. J Hum Reprod Sci. 2011; 4(1): 8–11.

23. Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med. 1985; 13(10):818-29.

24. Chlan LL. Relationship between two anxiety instruments in patients receiving mechanical ventilator support. JAN. 2004; 48(5): 493-99.

25. Chlan L, Savik K. Patterns of anxiety in critical ill patients receiving mechanical ventilator support. Nurs Res. 2011; 60(3s), s50-s7.

26. Burns N, Grove SK. The practice of nursing research: appraisal, synthesis, and generation of evidence. 6th ed. St. Louis (MO): Saunders; c2009. Chapter 15, Measurement concepts ; p. 371-94.

27. Bumroongkit C, Liwsrisakun C, Deesomchok A, Theerakkittkul T, Pothirat C. Efficacy of weaning protocol in medical intensive care unit of tertiary care center. J Med Assoc Thai. 2005; 88(1): 52-6.

28. Lorentz MM. Stress and psychoneuroimmunology revisited: using mind-body interventions to reduce stress. Altern J Nur.2006; 11:1-11.

29. Creswell JD, Pacilio LE, Lindsay EK, Brown KW. Brief mindfulness meditation training alters psychological and neuroendocrine responses to social evaluative stress. Psychoneuroendocrinology.2014;44: 1-12.

30. Delmore BA. Levine’s framework in long-term ventilated patients during the weaning course. NursSci Quart.2006; 19: 247-58.

31. Ray K, Bodenham A, Paramasivam E. Pulmonary atelectasis in an aesthesia and critical care. CEACCP. 2013;14(5): 236-45.

32. Zimmer MB, Nantwi K, GoshgarianHG. Effect of spinal cord injury on the respiratory system: basic research and current clinical treatment options. J Spinal Cord Med. 2007;30: 319-30.

33. Figueroa MS, Peters JI. Congestive heart failure: diagnosis, pathophysiology, therapy, and implications for respiratory care. Respir Care. 2006;51(4): 403-12.

34. Routsi C, Stanopoulos I, Zakynthinos E, Politis P. Papas V, Zervakis D, Zakynthinos S. Nitroglycerine can facilitate weaning of difficult-to-wean chronic obstructive pulmonary disease patients: a prospective interventional non-randomized study. Crit Care.2010:14: R204.

35. Arslanian-Engoren C, Scott LD. The lived experience of survivors of prolonged mechanical ventilation: a phenomenological study. Heart Lung. 2003; 32:328-34.

36. Lumma A-L, Kok BE, & Singer T. Is meditation always relaxing? Investigating heart rate, heart rate variability, experienced effort and likeability during raining of three types of meditation. Int J Psychophysiol. 2015; 97:38-45.

37. Carpene` N, Vagheggini G, Panait E, Gabbrielli L, Ambrosino N. A proposal of a new model for long-term weaning: respiratory intensive care unit and weaning center. Respir Med. 2010; 104:1505-11.

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