Complex need of care in patients with chronic respiratory failure starting home mechanical ventilation

Autor: Roy T.M. Sprooten, N.A.M. Cobben, Sander C.M. Steyns, Marijke Rutten, Geertjan Wesseling, Bettine A. H. Vosse
Rok vydání: 2020
Předmět:
Zdroj: Rehabilitation and chronic care.
DOI: 10.1183/13993003.congress-2020.1831
Popis: Background: Initiating home mechanical ventilation (HMV) in patients suffering from chronic respiratory failure is one of the most advanced and complicated types of medical treatment taking place outside a hospital setting. This study was aimed to assess complexity with regard to quality of life, mental health and the need for care of patients starting on HMV. Methods: Patients who started HMV between July, 2014 and January, 2016 were included. Demographic data, diagnosis, severity of respiratory failure, severe respiratory insufficiency questionnaire (SRI), hospital anxiety and depression scale (HADS), care dependency scale (CDS) and care giver strain index (CSI) were assessed. Results: 142 Patients (44% males, age: 60.9±13.4years) were included and classified by disease category: 27%(n:38) End-stage Lung Diseases/Chronic Obstructive Pulmonary Disease (ELD/COPD), 20%(n:28) rapidly progressive neuromuscular disease (rpNMD), 21%(n:30) slowly progressive NMD and thoracic deformities, 15%(n:22) myotonic dystrophy type 1 and 17%(n:24) hypercapnic sleep disorders. Overall, the SRI summary scale (range 0-100) was 48.0±13.4. Respectively 27% and 23% had HADS depression and HADS anxiety scores >11 points. 30% of subjects scored a CDS as fully independent and 49% patients scored the CSI as being overloaded. Patients with ELD/COPD had the worst results followed by rpNMD. Myotonic Dystrophy type 1 and slowly progressive NMD and thoracic deformities scored best. Conclusions: In patients starting with HMV the need of care is advanced and complex, especially in ELD/COPD and in rpNMD group. Integrated assessment before initiating HMV can be helpful in to provide the best care for these patients.
Databáze: OpenAIRE