Influence of Auditory Stimulation on Anxiety in Weaning from Mechanical Ventilation

听觉刺激对机械通气撤机焦虑的影响

• 批准号: 8915982
• 负责人: Breanna D Hetland
• 金额: $ 0.34万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-07-01 至 2015-08-07
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8915982
• 关键词: Accounting; Acid-Base Equilibrium; Acoustic Stimulation; Acute; Address; Analgesics; Anxiety; Caring; Client satisfaction; Clinical; Complement; Conscious; Control Groups; Critical Illness; Data; Data Analyses; Delirium; Edema; Environmental air flow; Evaluation; Failure; Fatigue; Goals; Hospitals; Intensive Care Units; Intervention; Investigation; Knowledge; Lead; Length; Length of Stay; Life; Linear Regressions; Mechanical ventilation; Mechanics; Medical; Mental Depression; Modality; Morbidity - disease rate; Muscle Weakness; Music; Neurological status; Pain; Parents; Pathological anxiety; Patients; Pharmaceutical Preparations; Physiological; Post-Traumatic Stress Disorders; Process; Quality of life; Randomized Controlled Clinical Trials; Randomized Controlled Trials; Recovery; Recruitment Activity; Research; Respiratory Failure; Respiratory Muscles; Risk; Secondary to; Sedation procedure; Site; Sleep disturbances; Strategic Planning; Survival Analysis; Sympathetic Nervous System; Symptoms; Time; Training; Trauma; Ventilator; Ventilator Weaning; Weaning; Work of Breathing; anxiety management; base; clinical practice; conventional therapy; cost; deconditioning; evidence base; experience; hazard; innovation; mortality; muscle strength; nutrition; psychologic; public health relevance; respiratory; sedative; success; symptom management; ventilator-associated pneumonia

DESCRIPTION (provided by applicant): Many ICU patients require mechanical ventilation (MV) which can cause consistent high levels of anxiety and increase the risk of complications, as well as lead to longer lengths of hospital stays and higher rates of morbidity and mortality. Generally, as patients recover from acute illness, they can be "weaned" off of the ventilator. Weaning is a gradual decrease in ventilator settings that leads to liberation from mechanical ventilatory support. Anxiety is a major psychological issue experienced during MV and during the MV weaning process. Music intervention is one integrative therapy shown to decrease pain and anxiety during MV. Incorporating music into the care of the mechanically ventilated patient has strong potential to alleviate the symptom burden and the high cost of conventional treatments, as well as increase patient satisfaction and promote efficient weaning. Little research has been conducted to evaluate the impact of music on ventilator weaning trials. While music has been studied previously in MV patients, a large knowledge gap exists regarding music's influence during ventilator weaning trials. Further evaluation of music intervention during weaning trials is essential to determine if this adjunctive therapy can reduce anxiety during weaning trials and promote efficient ventilator liberation. Incorporating music during ventilator weaning trials is an innovative idea that warrants more thorough investigation. The proposed research is a secondary analysis of data from the primary sponsor's R01-NR009295 (L.Chlan, PI) using exploratory survival analysis, a proportional hazards regression, and linear regression. This project is significant because of the potential clinical benefit to ventilated patients. It wil provide an in-depth analysis of the influence of anxiety on ventilator weaning trials as well as th effect of music on anxiety during mechanical ventilator weaning trials by evaluating objective data originally obtained through a large randomized controlled clinical trial. The knowledge gained from this study will advance current practices of anxiety management during weaning trials in mechanically ventilated patients. This study is consistent with NINR's 2011 Strategic Plan to advance the quality of life through symptom management during acute illness. The findings will provide new information regarding the influence of anxiety during weaning from MV and the potential impact of music on anxiety during weaning from MV. The knowledge obtained through activities proposed in this training plan has the potential to lead to innovative perspectives and strategies for medical management of the mechanically ventilated patient, as well as build the evidence base supporting the use of integrative therapies as viable adjuncts in the care of the estimated 5 million patients who experience acute critical illness each year.

描述（由申请人提供）：许多ICU患者需要机械通气（MV），这可能会引起一致的高水平的焦虑并增加并发症的风险，并导致住院时间更长，发病率和死亡率更高。通常，随着患者从急性疾病中恢复过来，可以从呼吸机上“断奶”。断奶是通风机设置的逐渐减少，从而导致从机械通气支撑中解放。焦虑是MV和MV断奶过程中遇到的主要心理问题。音乐干预是一种综合疗法，可减轻MV期间的疼痛和焦虑。将音乐纳入机械通风患者的护理中，具有减轻症状负担和高昂的常规治疗费用，以及提高患者满意度并促进有效断奶的强大潜力。很少进行研究来评估音乐对呼吸机断奶试验的影响。虽然以前曾在MV患者中对音乐进行了研究，但在呼吸机断奶试验期间音乐的影响存在很大的知识差距。进一步评估音乐干预期间 断奶试验对于确定这种辅助疗法是否可以减轻断奶试验期间的焦虑并促进有效的呼吸机解释至关重要。在呼吸机断奶试验期间合并音乐是一个创新的想法，需要进行更彻底的调查。拟议的研究是对主要赞助商R01-NR009295（L.Chlan，pi）的数据进行二次分析，该数据使用探索性生存分析，比例危害回归和线性回归。由于对通风患者的潜在临床益处，该项目很重要。它将通过评估最初通过大型随机对照临床试验获得的客观数据，对焦虑对呼吸机断奶试验的影响以及音乐对焦虑的影响以及音乐对焦虑的影响提供深入分析。从这项研究中获得的知识将在机械通风的患者的断奶试验中推动当前对焦虑管理的实践。这项研究与Ninr 2011年的战略计划一致，该计划旨在通过急性疾病期间通过症状管理提高生活质量。这些发现将提供有关MV断奶期间焦虑影响以及音乐对MV断奶期间焦虑的潜在影响的新信息。通过本培训计划中提出的活动获得的知识有可能导致创新的观点和机械通风患者医疗管理的策略，并建立证据基础，支持将综合疗法用作可行的辅助人员，以照顾估计每年急性重症患者的估计500万患者。