The breath of life. Patients' experiences of breathing during and after mechanical ventilation.
BACKGROUND
Breathlessness is a prevalent and distressing symptom in intensive care, underestimated by nurses and physicians. Therefore, to develop a more comprehensive understanding of this problem, the study had two aims: to compare patients' self-reported scores of breathlessness obtained during mechanical ventilation (MV) with experiences of breathlessness later recalled by patients and: to explore the lived experience of breathing during and after MV.


METHODS
A qualitatively driven sequential mixed method design combining prospective observational breathlessness data at the end of a spontaneous breathing trial (SBT) and follow up data from 11 post-discharge interviews.


RESULTS
Four out of six patients who reported breathlessness at the end of an SBT did not remember being breathless in retrospect. Experiences of breathing intertwined with the whole illness experience and were described in four themes: existential threat; the tough time; an amorphous and boundless body and getting through.


CONCLUSIONS
Breathing was not always a clearly separate experience, but intertwined with the whole illness experience. This may explain the poor correspondence between patients' and clinicians assessments of breathlessness. The results suggest patients' own reports of breathing should form part of nursing interventions and follow-up to support patients' quest for meaning.
UiT The Arctic University of Norway, Tromsø, Norway; Nord University, Levanger, Norway; Nord-Trøndelag Hospital Trust, Levanger, Norway. Electronic address: hege.haugdahl@hnt.no.
Hege S
HS
Haugdahl
University of Gothenburg, Gothenburg, Sweden.
Helena
H
Dahlberg
St. Olav University Hospital, Trondheim, Norway; Norwegian University of Science and Technology, Trondheim, Norway.
Pål
P
Klepstad
UiT The Arctic University of Norway, Tromsø, Norway.
Sissel L
SL
Storli
D000368:Aged; D004417:Dyspnea / Q000523:psychology*; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009726:Nurses / Q000592:standards; D017060:Patient Satisfaction; D010820:Physicians / Q000592:standards; D011446:Prospective Studies; D036301:Qualitative Research; D012121:Respiration, Artificial / Q000523:psychology / Q000592:standards*; D015300:Ventilator Weaning / Q000451:nursing / Q000523:psychology
Artificial; Critical care; Critical care nursing; Hermeneutics; Intensive care; Mechanical ventilation; Mixed methods; Nursing; Phenomenology; Respiration; Spontaneous breathing trial