The quality of life is constantly used when the patients, healthcare professional are attempting to comprehend the effects of a severe illness. Quality of life is a multidimensional concept and comprises social, physical, spiritual and psychological determinants. It can only be determined by the patient. although he members of the family physicians and other health experts can make important observations, studies often shows significant disparities between how patients and people surrounding them interpret the question of quality of life. the quality of life in ventilated patients is often faced with numerous challenges that causes death and development of new severe illnesses that the patient’s did not have during hospital admission. Quality of life is significant to the healthcare fraternity as the lives of the patients are critical. HRQL is a crucial measure of measuring the quality of life in patients in the healthcare Health-related quality of life (HRQL) is a model that comprises domains associated with physical, social, mental and social functioning.
Definition of concept
Quality of life is described as the ability of the patients to enjoy the typical life activities. Quality of life is a significant consideration is healthcare. Some medical treatments such as ventilated patients can impair the quality of life without provision of appreciable benefit s while others may greatly promote quality of life. Quality of life is used a measure of the disparities between the expectation ad hopes of a person and the person’s present experience. The concept of HRQL is paramount for the analysis and assessment of health-related results. HRQL is majorly concerned with the factors that fall within the circles of influence of the health care system and health care providers. HRQL measures are important tools as they determine the range of challenges affecting the patients. Being aware of the patients' perception of health’s, his wishes and the motivating elements when making decisions linked to his/her health as well as the application of procedures for assessing healthcare providers is critical while defining the HRQL.
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Defining Attributes
Diagnosis and treatment of illnesses utterly at the biological, medical level and the technological advances procedures signify a qualitative improvement in the survival of the patients’ in the recent decades. However, they have reduced a holistic approach to care in health fraternity because the only fight diseases without enhancing the ventilated patient welfare. Based on the holistic perspective and to quantify input of nursing in health associated results the word “Nursing Sensitive Outcome” (NSO) was established (Su et.al, 2016). Based on the National Quality Forum, the indicators which are essential to particular nursing intercessions are the measurements of the procedures structure (the procedure itself and its results) and they are affected by the nurses’ interventions’ even though the accountability is shared distributed other professionals.
The forum settled on various NSO stands like infection control, nursing expertise team, pressure ulcer care, patients’ satisfactions, prevention of falls and HRQL. Outcome assessment and knowledge of HRQL in patients’ under ventilate patients’ is crucial to comprehend hot these therapeutic models affects patients’ and hence modeling care strategies for acute and later stages of treatment. The main aim is to reduce unwanted effects and enhance cost-effectiveness and constantly considering the perspectives of the patients during the decision-making procedures (Nava et.al, 2013).
Model Case
Ventilated patients undergoing surgery or in the intensive care unit (ICU) have a high possibility of dying not because of the crucial illnesses but due to secondary processes like nosocomial infections. 86% of nosocomial infections are connected with mechanical ventilations and they are referred as ventilator associate pneumonia (VAP). The quality of life in ventilated patients is often impaired because of various risks involved such as the development of ventilator-associated pneumonia. Ventilated patients have a high risk of developing ventilated associated pneumonia (VAP). VAP is described as pneumonia which occurs 48 hours later, after the patients have received mechanical ventilation. VAP affects the quality of life in ventilated patients because they have a risk of dying and more so they develop a disease that they initially did not have during hospitalization.
Removing an ongoing ventilator support is a necessary technique especially when these devices become hindrances to ending the lives of the ventilated patients rather than maintaining a manageable life quality of the patients. The two commonly used techniques for removing mechanical ventilation in ventilated patients are known as terminal weaning and terminal extubation. Terminal weaning happens during the removal of the endotracheal tube, and the ventilator support is eliminated simultaneously (Nava et.al, 2013). Terminal weaning is considered the most suitable method in most situations unless the brain of the patients is dead.
Another source of distress for the nurses, respiratory therapists and clinicians is the family conflicts and their decisions whether to continue supporting the ventilated patients who are in severe condition or not. Unfortunately, the nurses and the respiratory therapists are often viewed as death merchants by the family members. The conflict about ending the life of the ventilated patients is common in the healthcare fraternity (Nava et.al, 2013). Due to close attachment of the family members with their patients, it becomes difficult for the nurses to accomplish their missions, especially when faced with patients’ who have severe complications.
Patients who are receiving the end of life care necessitate assistive treatment that comes as a form of mechanical ventilation. The ventilators are utilized in short term applications like surgery, acute illness, and drug overdose. The utilization of the ventilator offers a crucial assistance to the ventilated patients until they can maintain their ventilation. However, numerous ventilated patients require mechanical ventilation so as to survive for a long time (Zaidi, 2014). These patients experience terminal challenges on their road to recovery, and hence they have to depend on the mechanical ventilations for their survival, or else they die. The nurses and respiratory therapists have knowledge and skills in all the facets of healthcare.
Empirical Relevance
The Need Theory
Virginia Henderson defined nursing as her “concept” and stressed the significance of increasing the independence of the patient so that the hospitalization progress would not be delayed. Henderson classified nursing activities into 14 components grounded in in human needs. She defined the roles of the nurses as substitutive (doing for the individual), complementary (working for an individual), supplementary (helping and individual) with the aim of assisting the individuals to become independent as possible (Ahtisham & Jacoline, 2015). Henderson posits that nursing is a distinct function of the nurses to help an individual to be well to become better in performing activities that will contribute to health recovery or a peaceful death.
She focused on individual care whereby she emphasized the importance of helping people to recover or to attain a peaceful death. The nurses provide care for patients and individuals with the consideration of the psychological, biological and spiritual needs ((Henderson, 2006). Therefore patients seeking mechanical ventilation should be helped by the nurses to achieve a state of health and comfort or attain a peaceful death. The environment comprises of the external hospital conditions and the relationship between the patients with their families. The nurses should promote an environment that is conducive so that the patients can be able to heal.
The nurses’ taking care of ventilated patients should ensure that the have provided a favorable environment for the healing process of the patients. A state of health is often a challenge to the nurses, and they have to assist the patients to achieve the utmost comfort in health. Overall taking care of ventilated patients is a challenge and hence the nurses should be prepared to promote good health to the patients. If the patient situation is severe and is seems that they do not have any hope of recovering, the nurses should also assist the patients to achieve a peaceful death (Henderson, 2006). Every patient is unique and hence the nurses should individualize their health care so that they can attain a state of general health. The need theory comprises of 14 components namely;
breath normally
drink and eat adequately
eliminate the body wastes
move and maintain appropriate postures
sleep and rest
select appropriate dressing
maintain body temperature by modifying the environment and adjusting clothing
keep the body well groomed and clean and also protect the environment
avoid injuring other as well as avoiding the dangers of the environment
communicate with others through expressing of needs, fears, emotions or opinions
worship in agreement with an individual’s faith
work in a way that sense of accomplishment is achieved
participate or play in different forms of recreation
Learn, discover or fulfill the curiosity that results in the normal development of health and utilizes the available facilities of health.
Henderson theory uses concepts important in human need, culture, bio-physiology, and interaction communication which make the theory dynamic and covers the needs of the patients. Additionally, it is more concise compared to other models because it effectively addresses the needs of the patients and elaborates the role of the nurses. Henderson theory is similar to the Maslow hierarchy of human needs, and it is important when addressing ventilated patients. The quality of life in ventilated patients remains a huge challenge facing the nurses and other clinicians.
References
Ahtisham, Y., & Jacoline, S. (2015). Integrating Nursing Theory and Process into Practice; Virginia's Henderson Need Theory. International Journal of Caring Sciences , 8 (2).
Henderson, V. (2006). The concept of nursing. Journal of Advanced Nursing , 53 (1), 21-31.
Nava, S., Ferrer, M., Esquinas, A., Scala, R., Groff, P., Cosentini, R., & Grassi, M. (2013). Palliative use of non-invasive ventilation in end-of-life patients with solid tumours: a randomized feasibility trial. The lancet oncology , 14 (3), 219-227.
Su, W. H., Huang, M. Y., & Lai, E. Y. (2016). Outcomes of Palliative Care Team Consultation for Ventilator Withdrawal from Terminally Ill Patients in the Intensive Care Unit. International Journal of Gerontology , 10 (3), 156-158.
Zaidi, S. H. (2014). Quality of Life, Assisted Prolongation of Life, and End of Life Issues. In Ethics in Medicine (pp. 223-240). Springer International Publishing.
