• Dorthe Sørensen, Kirsten Frederiksen, Thorbjoern Groefte, and Kirsten Lomborg.
• Section for Nursing Health, Aarhus University, Aarhus, Denmark.
• J Clin Nurs. 2014 Jun 1;23(11-12):1726-35.

Aims And ObjectivesTo present a theoretical account of the pattern of behaviour in patients with acute respiratory failure due to chronic obstructive pulmonary disease while undergoing noninvasive ventilation in a hospital setting.BackgroundStrong evidence supports a positive effect of noninvasive ventilation, but successful treatment remains a challenge. Little attention has been given to patient intolerance to noninvasive ventilation as a cause of treatment failure. A better understanding of the patients' patterns of behaviour during noninvasive ventilation may improve treatment success.DesignA constant comparative classic grounded theory study was performed.MethodsData collection consisted of participant observation during the treatment of 21 patients undergoing noninvasive ventilation, followed by interviews with 11 of the patients after treatment completion. Data were collected from December 2009-January 2012.ResultsA substantive theory of striving for habitual well-being was developed. The theory included three phases: initiation, transition and determination. Each phase contained a set of subcategories to indicate the dimensions of and variations in the participants' behaviour.ConclusionsThe substantive theory revealed that the patients' behaviour was related to their breathlessness, sensation of being restrained by the mask and head gear, and the side effects of noninvasive ventilation.Relevance To Clinical PracticeThis inter-relationship should be addressed in the use of noninvasive ventilation for the treatment of patients with chronic obstructive pulmonary disease to achieve treatment success.© 2013 John Wiley & Sons Ltd.

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