A Qualitative Study on the Factors Affecting Comfort During Awake Prone Positioning in ARDS Patients

BACKGROUND: Awake prone positioning (APP) is a promising strategy for enhancing ventilation and oxygenation in patients with acute respiratory distress syndrome (ARDS). However, its implementation is often hindered by issues related to patient comfort, which is crucial for its effectiveness. AIM: This study aims to explore the factors influencing comfort during awake prone positioning in ARDS patients. STUDY DESIGN: A purposive sampling method was employed to select ARDS patients for this qualitative study. An interview outline was developed based on a literature review, and semi-structured interviews were conducted to gain a comprehensive understanding of patients' comfort experiences during awake prone positioning. Qualitative content analysis (QCA) was utilised to organise and analyse the transcribed data. FINDINGS: The analysis of data from 18 patients revealed five themes and 14 subthemes. The themes include physiological experience, psychological and emotional experience, family and social relationships, communication and support from the medical team and environmental perception. The subthemes covered a wide range of factors influencing comfort across these domains. CONCLUSION: This study highlights the diversity and complexity of factors influencing the comfort of ARDS patients during awake prone positioning, emphasising the need for tailored interventions to enhance patient experiences and improve outcomes. RELEVANCE TO CLINICAL PRACTICE: Understanding the multifaceted factors that influence comfort during awake prone positioning in ARDS patients is essential for improving adherence and clinical outcomes. This study provides valuable insights for critical care nurses to develop individualised care strategies that address both physical and psychosocial needs. Enhancing patient comfort through targeted communication, environmental adjustments and emotional support may facilitate longer and more effective prone sessions, ultimately contributing to better respiratory outcomes and patient satisfaction.