Why don't they accept Non-Invasive Ventilation? : Insight into the interpersonal perspectives of patients with MND.

Ando, Hikari and Williams, Carl and Robert M., Angus and Thornton, Everard W. and Chakrabarti, Biswajit and Cousins, Rosanna and Piggin, Lucy H. and Young, Carolyn A. (2014) Why don't they accept Non-Invasive Ventilation? : Insight into the interpersonal perspectives of patients with MND. British Journal of Health Psychology, 20. pp. 341-359.

Ando, Williams, Angus, Thornton, Chakrabarti, Cousins, Piggin & Young 2014.pdf

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"Objectives. Although non-invasive ventilation (NIV) can benefit survival and quality of life, it is rejected by a substantial proportion of people with motor neurone disease (MND). The aim of this study was to understand why some MND patients decline or withdraw from NIV.
Method. Nine patients withMND(male = 7, mean age = 67 years) participated in this study. These patients, from a cohort of 35 patients who were offered NIV treatment to support respiratory muscle weakness, did not participate in NIV treatment when it was clinically appropriate. Semi-structured interviews and interpretative phenomenological analysis (IPA) were employed to explore these patient’s experience of MND and their thoughts and understanding of NIV treatment.
Results. Using IPA, four themes were identified: preservation of the self, negative perceptions of NIV, negative experience with health care services, and not needing NIV. Further analysis identified the fundamental issue to be the maintenance of perceived self, which was interpreted to consist of the sense of autonomy, dignity, and quality of life.
Conclusions. The findings indicate psychological reasons for disengagement with NIV. The threat to the self, the sense of loss of control, and negative views of NIV resulting from anxiety were more important to these patients than prolonging life in its current form.
These findings suggest the importance of understanding the psychological dimension involved in decision-making regarding uptake of NIV and a need for sensitive holistic evaluation if NIV is declined."

Item Type: Article
Additional Information and Comments: This is the peer reviewed version of the following article: Ando, H., Williams, C., Angus, R.M., Thornton, E.W., Chakrabarti, B., Cousins, R., Piggin, R.H., and Young, C.A. (2014) Why don’t they accept Non-Invasive Ventilation?: Insight into the interpersonal perspectives of patients with MND, British Journal of Health Psychology, 20(2), pp.341-359, which has been published in final form at http://onlinelibrary.wiley.com/doi/10.1111/bjhp.12104/abstract. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving."
Keywords: motor neurone disease/amyotrophic lateral sclerosis; non-invasive ventilation; treatment decision; quality of life; qualitative research
Faculty / Department: Faculty of Science > Psychology
Depositing User: Philippe Chassy
Date Deposited: 17 Sep 2015 13:25
Last Modified: 29 Sep 2016 13:52
URI: https://hira.hope.ac.uk/id/eprint/487

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