The effect of the Patient Health Engagement model-based care strategy on improving patient-ventilator synchrony in patients with respiratory failure: a quasi-experimental study.

Background: Non-invasive positive pressure ventilation (NPPV) is a crucial method for treating acute and chronic respiratory failure. The effectiveness of NPPV treatment heavily depends on the active participation of patients. However, research on strategies to enhance patient engagement during NPPV therapy is still lacking.

Aim: To evaluate the effect of nursing interventions based on the Patient Health Engagement (PHE) model in enhancing patient-ventilator synchrony and improving outcomes of NPPV in patients with respiratory failure.

Study Design: This quasi-experimental study employed a pre-post design with non-equivalent control group. Convenience sampling was used to select patients with respiratory failure receiving NPPV at Zhongshan Hospital, Fudan University. A total of 104 participants entered the data analysis phase. The control group (n = 52) received routine NPPV care, while the intervention group (n = 52) received care based on the PHE model.

Results: The intervention group showed decreased patient-ventilator asynchrony index {Δ [95% confidence interval (95% CI)] = -2.82 (-4.02, -1.62), p < 0.001} and NPPV non-adherence score [Δ (95% CI) = -1.08 (-1.42, -0.74), p < 0.001] within 48 h compared to the control group. The dyspnoea score in the intervention group decreased more rapidly after NPPV and was lower than that in the control group at 4 h [Δ (95% CI) = -1.27 (-2.03, -0.51), p = 0.001]. Additionally, the intervention group had higher comfort scores [Δ (95% CI) = 2.26 (1.56, 2.96), p < 0.001] and shorter ICU stays [Δ (95% CI) = -0.95 (-1.89, -0.01), p = 0.049].

Conclusion: Interventions based on the PHE model enhance comfort, synchrony, and adherence during NPPV in patients with respiratory failure, leading to improved respiratory and oxygenation outcomes, and reduced ICU stays.

Relevance To Clinical Practice: Patient engagement is essential for optimizing NPPV outcomes in critical care. This study provides recommendations on cognitive, behavioural, and emotional aspects of NPPV care, offering a reference for intensive care managers to enhance nursing processes, standards, and the integration of humanistic care in the critical care setting.