title: What can we learn from patients to improve their non-invasive ventilation experience? 'It was unpleasant; if I was offered it again, I would do what I was told'.
abstract: OBJECTIVE
  Non-invasive ventilation (NIV) is widely used as a lifesaving treatment in acute exacerbations of chronic obstructive pulmonary disease; however, little is known about the patients' experience of this treatment. This study was designed to investigate the experiences and perceptions of participants using NIV. The study interprets the participants' views and explores implications for clinical practice.
  
  
  METHODS
  Participants with respiratory failure requiring NIV were interviewed 2 weeks after discharge. A grounded theory methodology was used to order and sort the data. Theoretical sufficiency was achieved after 15 participants.
  
  
  RESULTS
  Four themes emerged from the data: levels of discomfort with NIV, cognitive experiences with NIV, NIV as a life saver and concern for others. NIV was uncomfortable for participants and affected their cognition; they still reported considering NIV as a viable option for future treatment. Participants described a high level of trust in healthcare professionals and delegated decision-making to them regarding ongoing care.
  
  
  CONCLUSIONS
  This study provides insights into ways clinicians could improve the physical experience for patients with NIV. It also identifies a lack of recall and delegation of decision-making, highlighting the need for clinical leadership to advocate for patients.
authors: Department of Medicine, University of Otago, Christchurch, New Zealand.|Canterbury Respiratory Services, Canterbury District Health Board, Christchurch, New Zealand.
authors: Lutz
authors: http://orcid.org/0000-0002-2688-9325
authors: L
authors: Beckert
authors: Canterbury Respiratory Services, Canterbury District Health Board, Christchurch, New Zealand.
authors: Rachel
authors: R
authors: Wiseman
authors: Maori/Indigenous Health Institute, University of Otago, Christchurch, New Zealand.
authors: Suzanne
authors: S
authors: Pitama
authors: Department of Medicine, University of Otago, Christchurch, New Zealand.|Nurse Maude Hospice Palliative Care Service, Christchurch New Zealand.
authors: Amanda
authors: A
authors: Landers
mesh_terms: D000368:Aged; D003657:Decision Making; D005260:Female; D066296:Grounded Theory; D006801:Humans; D008297:Male; D008875:Middle Aged; D063087:Noninvasive Ventilation / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000523:psychology* / Q000628:therapy; D036301:Qualitative Research; D012131:Respiratory Insufficiency / Q000523:psychology* / Q000628:therapy
keywords: BiPAP; COPD; NIV; Patient's Perspective; Qualitative Research