Developing a Program Theory on Ventilator Weaning in Adult Intensive Care: Protocol for a Multimethods Study

Area of Science:

• Critical Care Medicine
• Health Services Research
• Theoretical & Computational Chemistry

Background:

• Mechanical ventilation and ventilator weaning are extensively researched, yet weaning failure rates remain high.
• Existing guidelines lack a unified theoretical framework to organize interventions, outcomes, and contexts.
• Ventilator weaning is recognized as a complex intervention under the Medical Research Council framework.

Purpose of the Study:

• To explore the interconnectedness of interventions, outcomes, and context in adult intensive care patients undergoing ventilator weaning.
• To develop a comprehensive program theory for ventilator weaning.

Main Methods:

• A multimethod study employing the Funnell and Rogers approach to develop a program theory.
• Initial program theory development through triangulation of literature reviews and stakeholder conversations, using abduction.
• Iterative refinement of the program theory via semistructured group discussions, workshops, and deductive thematic analysis.

Main Results:

• An initial program theory has been developed based on literature reviews and stakeholder input.
• The program theory is currently undergoing iterative refinement and will be finalized in 2026.
• The study protocol is registered on the Open Science Framework (OSF YGJ3T).

Conclusions:

• The study will yield a program theory for ventilator weaning, adhering to the Medical Research Council framework.
• This program theory is expected to foster a more nuanced understanding of ventilator weaning.
• It aims to support more sustainable, comprehensive research and guide healthcare professionals in intervention selection and outcome evaluation.