Stræben efter habituel velvære: Et grounded theory studie

Aims: We present a theoretical account of the pattern of behaviour in patients with acute respiratory failure due to chronic obstructive pulmonary disease while undergoing non-invasive ventilation in a hospital setting.
Background. Strong evidence supports a positive effect of non-invasive ventilation, but successful treatment remains a challenge. Little attention has been given to patients’ intolerance of non-invasive ventilation as a cause of treatment failure. A better understanding of the patients’ patterns of behaviour during non-invasive ventilation may improve treatment success.
Design. A constant comparative classic grounded theory study was performed.
Methods. Data collection consisted of participant observation during the treatment of 21 patients undergoing non-invasive ventilation, followed by interviews with 11 of the patients after treatment completion. Data were collected from December 2009 to January 2012.
Results. A substantive theory of striving for habitual well-being was developed. The theory included three phases: initiation, transition, and determination. Each phase contained a set of subcategories to indicate the dimensions of and variations in the participants’ behaviour.
Conclusions. The substantive theory revealed that the patients’ behaviour was related to their breathlessness, sensation of being restrained by the mask and head gear, and the side effects of non-invasive ventilation.
Relevance to clinical practice. This inter-relationship should be addressed in the use of non-invasive ventilation for the treatment of chronic obstructive pulmonary disease patients in order to achieve treatment success.