Literature Review of Nursing Support in Respiratory Decision-making for Amyotrophic Lateral Sclerosis Therapists

Abstract

The objective of this study was to examine research on patient needs and nursing support for the decision-making process of respiratory therapy in patients with amyotrophic lateral sclerosis (ALS). A literature review was conducted using keywords such as “decision-making”, “support ”, and “ALS ” or “amyotrophic lateral sclerosis” in EBSCO host and a search system called “Ichushi-Web”. Eleven studies were then analyzed. The following categories were identified regarding patients’ 10 needs for respiratory decision-making : guarantee of self-determination, discussing choices and decisions with others, information required for selection or decision, life-and-death conflict linked to respiratory therapy choices, anxiety and fear of dyspnea, desire to live, professional support, family understanding, self-determination, concerns about increased family care burden, concerns about quality of life after the introduction of mechanical ventilation, and the concrete image of life with a respiratory system. Meanwhile, nursing support can be classified into 7 categories : image of medical treatment life with auxiliary ventilation, assessment of respiratory function and general conditions, palliative care for symptoms, establishing a care system according to the progression of symptoms, building good relationships, thorough respect for the patient’s will, and attitude of waiting for manifestation of intention. It is considered that the number of documents is small, and nursing support is not sufficiently included. Thus, it is necessary to deepen the knowledge of nursing support that supports the decision-making process of respiratory therapy from both sides-patient and nurse, combine quantitative research, and integrate nursing support that assists in the decision-making process, such as the elements and structure of nursing support.