Transitions to Home Mechanical Ventilation. The Experiences of Canadian Ventilator-assisted Adults and Their Family Caregivers
Bibliographic record
Abstract
Abstract Rationale Several studies have explored the experiences of ventilator-assisted individuals living at home with family caregivers. However, few explore the experiences of these individuals as they transition from a hospital setting to living at home with a view to identifying modifiable processes that could optimize transition. Objectives This descriptive, qualitative study sought to elucidate barriers to, and facilitators of, transition to home mechanical ventilation from the perspective of Canadian ventilator-assisted individuals and their family caregivers. Methods Participant recruitment occurred through hospital and community respiratory clinicians based in the four Canadian provinces of Alberta, British Columbia, Ontario, and Saskatchewan. Semistructured telephone or face-to-face interviews at home were undertaken with 33 individuals, including 19 ventilator-assisted individuals and 14 family caregivers, after 3 to 24 months of transitioning to home mechanical ventilation. Interview data were analyzed by content analysis. Results Formal teaching of knowledge and skills relevant to home mechanical ventilation within the hospital setting before transition was perceived as having an immediate and enduring positive impact on transition. However, family–clinician conflict, information gaps, and persistent lack of trained personal support workers to provide care in the home contributed to maladjustment relating to transition. Participants strongly recommended improved transitional care in the form of respiratory health professional telephone support, home outreach, and training of personal support workers. Conclusions Transition to home mechanical ventilation is a complex and demanding process. Extended home mechanical ventilation training and support may be helpful in mediating adjustment challenges, thus reducing stress and caregiver burden, and improving health-related quality of life for ventilator-assisted individuals and family caregivers.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.016 | 0.004 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".