¿Cómo viven la ventilación no invasiva los enfermos y sus cuidadores? Revisión bibliográfica sistemática de investigaciones cualitativas / How do sick people their caregivers live non-invasive ventilation? Systematic literature review of qualitative research

Introducción. Sabemos que la ventilación no invasiva (VNI) es un soporte ventilatorio de elección, aunque a veces fracasa, por intolerancia, falta de adherencia, incumplimiento, etc. ¿Cómo podemos anticiparnos a ese fracaso? Objetivo. Explorar la evidencia cualitativa sobre las vivencias de las personas en tratamiento con VNI y sus cuidadores formales e informales. Método. Revisión bibliográfica sistemática de artículos originales indexados entre 2005 y 2015 que estudian la VNI en población adulta con metodología cualitativa, en seis bases de datos. Evaluación por pares de la calidad científica con herramienta del Programa CASPe. Metasíntesis cualitativa de los hallazgos. Resultados. 15 artículos cumplen criterios de selección, basados en la Teoría Fundamentada y en Fenomenología, que utilizan: entrevistas, observación y grupo focal, tanto a enfermos como a familias y profesionales de salud. Destaca la sensación de angustia y pérdida de control, aunque la VNI les alivia la disnea (ambivalencia). Búsqueda del bienestar cotidiano a través de rutinas y participación activa. Interacción dependencia/autonomía, sobre todo en la toma de decisiones, y se encuentran divergencias que hacen complejo el proceso de información y voluntades anticipadas. La sabiduría práctica de enfermería se describe como básica, y se manifiestan dificultades: falta de tiempo, sobrecarga de trabajo, tecnocentrismo, inexperiencia. Conclusiones. La evidencia cualitativa del tratamiento con VNI, aunque escasa, es variada, pues se exploran diferentes parcelas (situaciones agudas, crónicas, terminales), y desde diferentes puntos de vista. Integrar esos hallazgos en nuestra práctica profesional nos ayudará a aumentar la adherencia y el éxito del tratamiento, pero sobre todo a mejorar la calidad de vida de los pacientes ventilados y sus familias (AU)

Introduction. We know that non-invasive ventilation (NIV) is a basic ventilator support, but sometimes it fails, because of intolerance, lack of adherence, breach, etc. How can we anticipate that failure? We intend to explore the qualitative evidence on the experiences of people with this treatment and their formal and informal caregivers. Method. Systematic literature review of original articles indexed from 2005 to 2015, which study the NIV in adult population with qualitative methodology in six databases. Peer review of scientific quality with tool of the CASPe Program. Qualitative metasynthesis of the findings. Results. 15 articles met selection criteria, based on Grounded Theory and Phenomenology, which use interviews, observation and focus group, directed both patients, and families and health professionals. Its studies emphasize the feeling of anxiety and loss of control, although the NIV relieves them dyspnea (ambivalence). Search daily well-being through routines and active participation. Interaction dependence/autonomy, especially in decision-making, finding differences that make complex the process information and advance directives. Practical wisdom of nursing care 24 hours with patients is described basic, and difficulties being narrated: lack of time, overload of work, technocentrism, inexperience. Conclusions. The qualitative evidence of treatment with VNI is varied although scarce; different plots (acute situations, chronic, terminals) are explored, from different points of view. The integration of these findings in our practice will help us to increase adherence and become the treatment successful, but especially to improve the quality of life of ventilated patients and their families (AU)

[How do Sick People and Their Caregivers Live Non-Invasive Ventilation? Systematic Literature Review of Qualitative Research]. / ¿Cómo viven la ventilación no invasiva los enfermos y sus cuidadores?.

Introduction: W know that non-invasive ventilation (NIV) is a basic ventilator support, but sometimes it fails, because of intolerance, lack of adherence, breach, etc. How can we anticipate that failure? We intend to explore the qualitative evidence on the experiences of people with this treatment and their formal and informal caregivers. Method: Systematic literature review of original articles indexed from 2005 to 2015, which study the NIV in adult population with qualitative methodology in six databases. Peer review of scientific quality with tool of the CASPe Program. Qualitative metasynthesis of the findings. Results: 15 articles met selection criteria, based on Grounded Theory and Phenomenology, which use interviews, observation and focus group, directed both patients, and families and health professionals. Its studies emphasize the feeling of anxiety and loss of control, although the NIV relieves them dyspnea (ambivalence). Search daily well-being through routines and active participation. Interaction dependence/autonomy, especially in decision-making, finding differences that make complex the process information and advance directives. Practical wisdom of nursing care 24 hours with patients id described basic, and difficulties being narrated: lack of time, overload of work, technocentrism, inexperience. Conclulsions: The qualitative evidence of treatment with VNI is varied although scarce; different plots (acute situations, chronic, terminals) are explored, from different points of view. The integration of these findings in our practice will help us to increase adherence and become the treatment successful, but especially to improve the quality of life of ventilated patients and their families.