A Qualitative Study on the Factors Affecting Comfort During Awake Prone Positioning in ARDS Patients

Area of Science:

• Critical care medicine
• Respiratory therapy
• Qualitative research methodology

Background:

• Awake prone positioning (APP) improves ventilation and oxygenation in acute respiratory distress syndrome (ARDS) patients.
• Patient comfort is a significant barrier to effective APP implementation.
• Understanding comfort factors is crucial for optimizing APP therapy.

Purpose of the Study:

• To explore the multifaceted factors influencing patient comfort during awake prone positioning (APP) in acute respiratory distress syndrome (ARDS).
• To identify key domains affecting patient comfort during this intervention.

Main Methods:

• Qualitative content analysis (QCA) of semi-structured interviews with 18 ARDS patients.
• Purposive sampling to select participants.
• Development of an interview guide based on a literature review.

Main Results:

• Five major themes emerged: physiological, psychological/emotional, family/social, medical team communication/support, and environmental perception.
• Fourteen subthemes detailed specific comfort-influencing factors across these domains.
• Patient comfort is influenced by a complex interplay of physical sensations, emotional state, social connections, and healthcare interactions.

Conclusions:

• Patient comfort during APP for ARDS is diverse and complex, requiring individualized interventions.
• Addressing physical, psychological, and social needs is essential for enhancing patient comfort and adherence.
• Tailored care strategies can improve APP effectiveness, patient satisfaction, and clinical outcomes.