The Study Of Demands Investigation And Comfort Care For Conscious Patients Of Via Oral Cavity Endotracheal Intubation Mechanical Ventilation

Mechanical ventilation is the process that the mechanical devicesare applied to substitute or assist breathing machines to work whenrespiration failure due to various kinds of reasons. The rapid andeffective establishment of artificial airway is the key step for keepingrespiratory tract unobstructed and initiating mechanical ventilation.Endotracheal intubation via oral cavity is the most commonly usedapproach to keep the respiratory tract unobstructed when first aid andin the intensive care units, and endotracheal intubating in time andpromptly is thought to be one of the most important factors in manysucceeding clinical cardio-pulmonary resuscitation cases. Due to vocalcommunication disorder, the patients with endotracheal intubatingexpress their demands only via their facial performances, gestureseven restlessness or extracting the tube. The existing sensorydiscomforts in physiological, psychological, communicating,information acquiring and environmental facets may present somenegative emotional responses such as anxiety, depression, restlessnessand apprehensiveness and so on, which may cause the patients unableto cooperate with the treatment and nursing care well.Investigations have showed that communication disorder owingto unable to speak was the most distressful thing for the patients whowere ventilated mechanically via endotracheal intubating. Accordingto many researches, patients who were unable to speak andcommunicate successfully experienced more negative emotionalresponses such as tension, anxiety, apprehensiveness, restlessness,depression, loneliness, feeling of deficiency of information, objectionagainst breathing machine and dyssomnia, ect., among whichcommunication disorder, discomfort due to endotracheal intubatingand sucking sputum, thirsty and so on were the most commoncomfortable requirements for them. Comfortable nursing care for thepatients who were ventilated mechanically has been focused on sincerecent years. Control researches on psychological obstacles andrelated factors as well comfortable nursing care for the patients whowere ventilated mechanically via endotracheal intubating have notbeen reported in China till now. Purpose of the present research is tocompare the psychological obstacles of the patients on breathingmachines between two groups and try to find out the related factors.Subsequently, comfortable nursing care measures are expected to bedetermined in order to relieve discomfort of the patients. Playing a keyrole in communicating between doctors and patients, nurses canprovide the firsthand data for clinical physicians, improve the patients'quality of life and accelerate their recovery. In present study, 70 sanepatients who were hospitalized in intensive care unit of the secondhospital of JiLin University and ventilated mechanically viaendotracheal intubating to connect with breathing machines sinceFebruary 2004 to February 2006 randomly were randomized into twogroups (34 in treatment group vs. 36 in control group). Surveys wereaccomplished and recorded in Hamilton anxiety scale (HAMA),Hamilton depression rating scale for depression (HRSD) and otherauto-designed investigation forms of related factors 24 hours beforeand after mechanical ventilation with breathing machines as well 24hours after off-breathing machines, respectively. Heart rates (HR) ofthe patients were recorded simultaneously. All data were input intodatabase Foxpro11.0 and statistically analyzed with SPSS13.0software. Chi-squared test was done in enumeration data and t test inmeasurement data. The results showed that: 1. Heart rates (HR) andlevels of anxiety and depression of the patients 24 hours aftermechanical ventilation with breathing machines were significantlyhigher than 24 hours before mechanical ventilation with breathingmachines and 24 hours after off-breathing machines in control group(P<0.05);2. Heart rates (HR) and levels of anxiety and depression ofthe patients in treatment group either 24 hours after mechanicalventilation with breathing machines or 24 hours off-breathing machinewere significantly lower than control group (P<0.05);3. the sequenceof fundamental requirements of the patients were: (1)worry to die afteroff-breathing machine (83.3%);(2) feel unbearable and want toextract the tube (80.6%);(3) worry about the medical cost (72.2%);(4)feel thirsty and want to drink (69.4%);(5) fear their contracted disease(61.1%);(6) feel discomfortable when sucking sputum (58.3%);(7)want to know the condition of breathing machine (52.8%);(8) want tospeak (50.0%);(9) feel discomfortable for their posture and want tomobilize their bodies (44.4%);(10) dyssomnia (41.7%). Conclusions :It may decrease the heart rates and relieve the emotional responsessuch as anxiety and depression of the patients who were ventilatedmechanically through detecting their various requirements in time andpracticing comfortable nursing care in psychological, physiological,communicating, and environmental facets.