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

基本信息

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
项目类别：
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

项目摘要

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)，这可能会导致持续的高度焦虑并增加并发症的风险，并导致住院时间更长以及发病率和死亡率更高。一般来说，当患者从急性疾病中恢复时，他们可以“断奶”呼吸机。撤机是指逐渐减少呼吸机设置，从而摆脱机械通气支持。焦虑是 MV 期间和 MV 断奶过程中经历的主要心理问题。音乐干预是一种综合疗法，可减少 MV 期间的疼痛和焦虑。将音乐纳入机械通气患者的护理中具有很大的潜力，可以减轻症状负担和传统治疗的高成本，并提高患者满意度并促进有效脱机。很少有研究评估音乐对呼吸机脱机试验的影响。虽然之前已经在 MV 患者中研究了音乐，但关于音乐在呼吸机脱机试验期间的影响存在很大的知识差距。进一步评估期间音乐干预脱机试验对于确定这种辅助治疗是否可以减少脱机试验期间的焦虑并促进有效的呼吸机释放至关重要。在呼吸机脱机试验中加入音乐是一个创新的想法，值得更彻底的研究。拟议的研究是使用探索性生存分析、比例风险回归和线性回归对主要申办者 R01-NR009295（L.Chlan，PI）的数据进行二次分析。该项目意义重大，因为它对通气患者具有潜在的临床益处。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，深入分析焦虑对呼吸机脱机试验的影响以及机械呼吸机脱机试验期间音乐对焦虑的影响。从这项研究中获得的知识将推进目前机械通气患者脱机试验期间焦虑管理的实践。这项研究与 NINR 的 2011 年战略计划一致，即通过急性疾病期间的症状管理来提高生活质量。研究结果将提供关于 MV 断奶期间焦虑的影响以及音乐对 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为机械通气患者的医疗管理带来创新的观点和策略，并建立支持使用综合疗法作为护理患者的可行辅助手段的证据基础。据估计，每年有 500 万患者患有急性危重疾病。