Respiratory care
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Twenty-five to 40% of patients pass a spontaneous breathing trial (SBT) but fail to wean from mechanical ventilation. There is no single appropriate and convenient predictor or method that can help clinicians to accurately predict weaning outcomes. This study designed an artificial neural network (ANN) model for predicting successful extubation in mechanically ventilated patients. ⋯ The ANN model improved the accuracy of predicting successful extubation. By applying it clinically, clinicians can select the earliest appropriate weaning time.
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Exercise training within the pulmonary rehabilitation (PR) context is considered the most effective strategy to reduce COPD symptoms. However, participation in PR and continued exercise training following program completion are low. Previous research examined factors related to attendance and adherence, but the knowledge base to date has been limited to quantitative findings that focus solely on participants diagnosed with COPD. In addition to quantitative research, exploring multiple perspectives (eg, PR participants, significant others, staff, and stakeholders) using qualitative research methods opens a window of additional understanding. The goal of this study was to obtain multiple perspectives on PR to gain insight into factors that affect exercise participation among individuals diagnosed with COPD. ⋯ In addition to enhancing task self-efficacy, findings suggest that exercise participation and adherence within the PR environment may be improved by adopting a gender-tailored approach.
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Demand for respiratory care services and staffing levels of respiratory therapists (RTs) is expected to increase over the next several years. Hence, RT job satisfaction will be a critical factor in determining recruitment and retention of RTs. Determinants of RT job satisfaction measures have received little attention in the literature. This study examines the use of respiratory care protocols and associated levels of RT job satisfaction, turnover intentions, and job stress. ⋯ The study extends prior research by examining how the use of respiratory care protocols favorably affects RTs' perceptions of job satisfaction, turnover intention, and job stress. In a time of increasing demand for respiratory care services, protocols may enhance retention of RTs.
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Bronchiectasis may change cognitive function. The mechanism responsible for cognitive dysfunction in COPD may be neuronal damage caused by hypoxia. Cognitive function in patients with bronchiectasis is also likely to be affected by similar mechanisms. The goal of this study was to determine the frequency and determinants of low cognitive ability in subjects with stable bronchiectasis. ⋯ Low cognitive ability in subjects with bronchiectasis may be associated with reduced lung function, more serious hypoxemia, and higher depressive symptoms. Subjects with bronchiectasis and low cognitive ability feel more intense dyspnea than do those with high cognitive ability.
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Editorial Comment
Noninvasive Ventilatory Support: The Detail Lies in the Interface.