The Effect of Family-Centered Care on the Duration of Weaning From Mechanical Ventilation in Coronary Artery Bypass Surgery Patients: A Clinical Trial Study

Abstract

Background: The use of nonpharmacological methods has been emphasized in the recent years. These methods are used to decrease the duration of weaning from mechanical ventilation after coronary artery bypass graft (CABG) surgery. Objectives: The present study aimed at determining the effect of family-centered care on the duration of weaning from mechanical ventilation in patients undergoing CABG. Methods: This clinical trial study was conducted in Jamaran Heart Subspecialty hospital in Tehran in 2016. Initially, convenient sampling method and random allocation were used by quaternary blocks to allocate patients into 2 groups of experimental and control, with 35 participants in each group. In the intervention group, the patients' family member chosen by the patient was entered into the ward during the weaning process. Patient's entrance time to the ward to extubation time was considered as the duration of weaning from mechanical ventilation in the 2 groups. Results: Duration of weaning in the experimental group was 97 minutes less than the control group; in other words, the weaning duration of those in the control group was 1.4 times greater than those in the experimental group. This difference was statistically significant between the 2 groups (P = 0.05). Conclusions: Family-centered care reduced the duration of weaning from mechanical ventilator in patients undergoing coronary artery surgery, which can remarkably decrease complications due to ventilation with positive pressure in these patients.

Family-Centered Care: An Evolutionary Concept Analysis

“…Improving family and patient satisfaction, 22 increasing self-efficacy, improving quality of life, 23,24 improving the information flow and interactions between families and treatment professionals, 25 helping intensive care patients to be aware of the care process, giving them relaxation and a sense of security, 26 improving communication between patient and family, achieving improved treatment outcomes, [27][28][29] acquiring a sense of re-control in family management, 30 reducing nursing job burnout, 31 creating a more effective relationship, increasing holistic nursing, 18,32 and reducing depression and fatigue among caregivers, 13,33,34 are the results extracted from studies on family-centered healthcare.…”

The effect of planned presence of the family at the time of weaning on the length of weaning from mechanical ventilation in patients with brain injury admitted to intensive care units

“…Safaeepour et al [ 4 ] studied the effect of family-centered care on weaning from MV in patients undergoing coronary artery bypass surgery. They showed longer weaning in patients whose family members were present at their bedside immediately after their admission to the cardiac ICU.…”

“…Most of the mechanically ventilated patients experience a lot of anxiety and stress because they are treated aggressively, do not have many visitors, and are in a loud and strange place, which can make them reliant on MV. For those admitted to ICUs, sensory deprivation caused by the absence of family visits can lead to a greater reliance on MV [ 4 ]. Happ et al [ 5 ] conducted a qualitative study and showed that families, who were present at the patient’s bedside during the weaning process, communicated with them through physical contact, touching, kissing and even supervision.…”

“…They found that having a family was relaxing and useful during weaning from MV. Safaeepour et al [ 4 ] conducted a study and showed longer weaning in patients whose family members were present at their bedside immediately after their admission to the cardiac ICU. Also, Burns et al [ 6 ] showed that early family involvement could have many benefits for the patient’s weaning and prevent the complications of MV.…”

The impact of family care visitation programme on patients and caregivers in the intensive care unit: A mixed methods study

“…In previous studies, the most important need of the families of patients admitted to the coronary intensive care were related to assurance and information (Coelho et al, 2022). Family presence and participation were found to be helpful in reducing the patients' anxiety, improving communication (Coelho et al, 2022) and stabilising haemodynamic and respiratory indicators, such as blood pressure, pulse rate and respiratory rate (Lolaty et al, 2014); this was also found to be effective in reducing ventilator withdrawal time and complications due to positive pressure (Safaeepour et al, 2017). Haemodynamic and respiratory indicators such as blood pressure, pulse rate, respiratory rate, in the ICU are essential for preventing organ failure by ensuring stability between oxygen delivery and demand in the relevant tissues (Majumdar, 2017).…”