Patient Compliance to Non-Invasive Ventilation in Sub-IntensiveCare Unit: An Observational Study

Background:Thesuccessof noninvasiveventilationdependsonmanyfactorsandeffectivedeliveryrequiresteamwork.Informationonthetherapeuticprogrammustbesustainedbyhealthcarestaffandfamily. Objectives: Investigatetheclinicalandcarefactorsthataffectthelevelof patientcompliancetononinvasiveventilation. Methods: A prospective, observational and multicentre study was conducted between November ۱, ۲۰۱۵ and February ۱۵, ۲۰۱۶ in three sub-intensive wards. A data collection tool was created with the working definition of “Patient intolerant to non invasive ventilation” and a structured interview was conducted to investigate patient experience of NIV. Statistical analysis was conducted withtheSTATAMP۱۳software. Results: Coordination of patient-ventilator interaction prevents intolerance (OR = ۰.۶۸, ۹۵% IC ۰.۴۶ - ۰.۹۸; P = ۰.۰۴). Overweight andobesepatientsshowedahigherprobabilityof intolerancetononinvasiveventilationwithrespecttounderweightandnormal weight patients (OR = ۰.۵۳, ۹۵% IC ۰.۳۴ - ۰.۸۲; P = ۰.۰۰۵). Patients with a higher probability of intolerance experienced a NRS level of ۴/۵(OR=۱.۷۶, ۹۵% IC۱.۳۰-۲.۴۱; P≤۰.۰۰۱)whilereceivingcontinuoustreatment(OR=۱.۲۶, ۹۵% IC۱.۰۴-۱.۵۳; P=۰.۰۱۹). Patients in open-space settings experienced less intolerance (۴.۷ SD±۱.۲) with respect to patients in single rooms (۲.۵ SD±۰.۹). Anxious patientsdevelopedmoreintolerancethancalmandinformedpatients(OR=۷.۳۹,۹۵% IC۳.۱۹-۱۷.۱۳;P≤۰.۰۰۱) Conclusions: Compliance to non invasive ventilation depends on multiple factors, including relational aspects that affect treatment success. Attention to patient comfort, pain control, and collaboration with the caregiver appear to have the most influence onpatientcompliance. Keywords: Nurses,Patients,NoninvasiveVentilation,IntensiveCareUnits,Compliance,Masks