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Physicians' decision making when weaning patients from mechanical ventilation: A qualitative content analysis
Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Department of Anaesthesia and Intensive Care Medicine, Ryhov County Hospital, Jönköping SE-55185, Sweden.ORCID iD: 0000-0003-2260-3219
Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.
Department of Anaesthesia and Intensive Care Medicine, Ryhov County Hospital, Jönköping, Sweden; Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Jönköping University, School of Health and Welfare, HHJ, Department of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. Studies on Integrated Health and Welfare (SIHW).ORCID iD: 0000-0002-7406-8732
2025 (English)In: Australian Critical Care, ISSN 1036-7314, E-ISSN 1878-1721, Vol. 38, no 1, article id 101096Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Weaning from mechanical ventilation is a complex and central intensive care process. This complexity indicates that the challenges of weaning must be explored from different perspectives. Furthermore, physicians' experiences and the factors influencing their decision-making regarding weaning are unclear.

OBJECTIVES: This study aimed to explore and describe the factors influencing physicians' decision-making when weaning patients from invasive mechanical ventilation in Swedish intensive care units (ICUs).

METHODS: This qualitative study used an exploratory and descriptive design with qualitative content analysis. Sixteen physicians from five ICUs across Sweden were purposively included and interviewed regarding their weaning experiences.

FINDINGS: The physicians expressed that prioritising the patient's well-being was evident, and there was agreement that both the physical and mental condition of the patient had a substantial impact on decision-making. Furthermore, there was a lack of agreement on whether patients should be involved in the weaning process and how their resources, needs, and wishes should be included in decision-making. In addition, there were factors not directly linked to the patient but which still influenced decision-making, such as the available resources and teamwork. Sometimes, it was difficult to point out the basis for decisions; in that decisions were made by gut feeling, intuition, or clinical experience.

CONCLUSION: Physicians' decision-making regarding weaning was a dynamic process influenced by several factors. These factors were related to the patient's condition and the structure for weaning. Increased understanding of weaning from the physicians' and ICU teams' perspectives may improve the weaning process by broadening the knowledge about the aspects influencing the decision-making.

Place, publisher, year, edition, pages
Elsevier, 2025. Vol. 38, no 1, article id 101096
Keywords [en]
Decision making, Intensive care, Mechanical ventilation, Qualitative research, Ventilator weaning
National Category
Nursing
Identifiers
URN: urn:nbn:se:hj:diva-65961DOI: 10.1016/j.aucc.2024.06.015ISI: 001398851100001PubMedID: 39122604Scopus ID: 2-s2.0-85200852673Local ID: HOA;;966095OAI: oai:DiVA.org:hj-65961DiVA, id: diva2:1889644
Funder
Medical Research Council of Southeast Sweden (FORSS)Cancerforskningsfonden i NorrlandFuturum - Academy for Health and Care, Jönköping County Council, SwedenRegion Jönköping CountyAvailable from: 2024-08-16 Created: 2024-08-16 Last updated: 2025-02-03Bibliographically approved

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Tingsvik, CatarinaHenricson, MariaMårtensson, Jan

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