{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T10:49:00Z","timestamp":1777891740279,"version":"3.51.4"},"reference-count":33,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2014,9,2]],"date-time":"2014-09-02T00:00:00Z","timestamp":1409616000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>The aim of this study was to analyze the effects of a multidisciplinary program carried out in a chronic ventilator facility on disability, autonomy, and nursing needs of patients after a prolonged ICU stay. Secondary outcome measures were survival, weaning rate, chronic ventilator facility stay, and discharge destination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Multidisciplinary assessment, clinical stabilization, weaning attempts, and a new Disabled Patients Autonomy Planning tool to assess daily care needs were investigated in 240 subjects in a chronic ventilator facility (52 subjects after cardiovascular surgery, 60 subjects with acute respiratory failure, 71 subjects with COPD, and 57 subjects with neurological disease).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      At admission, nursing needs, disability, and autonomy differed according to diagnosis (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001); weaned subjects had greater nursing needs (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) and disability (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .0014) than unweaned subjects. During the stay, 13.8% of the subjects died irrespective of diagnosis (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .12); 47% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) were weaned with significant differences (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;.007) by diagnosis. In the 207 surviving subjects, nursing needs increased as disability increased (r = 0.59,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) and autonomy decreased (r = \u22120.66,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001); disability and autonomy were inter-related (r = 0.61,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). Oxygen saturation, hypercapnia, dyspnea, disability, autonomy, and nursing needs significantly improved (all,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). Fifty-nine percent of the subjects were discharged home. Subjects discharged to nursing homes presented mainly neurological diseases, being more disabled and less autonomous, with higher nursing needs (all,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .04). Mechanical ventilation use and tracheostomy increased the probability of being discharged to a nursing home (odds ratio [OR] of 1.84,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .04; OR 2.47,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .003, respectively). Mortality was higher in subjects who were ventilated (OR 8.44,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), male (OR 2.64,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .01), elderly (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), or malnourished (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .01) and in subjects with low autonomy (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), greater nursing needs (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .002), and more severe disabilities (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .04).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>A specialized tailored multidisciplinary program in subjects after an ICU stay contributed to recovery from disability, autonomy, and fewer nursing needs irrespective of diagnosis. Subjects discharged to a nursing home were the most severely disabled.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.03030","type":"journal-article","created":{"date-parts":[[2014,9,3]],"date-time":"2014-09-03T09:53:47Z","timestamp":1409738027000},"page":"1863-1871","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":15,"title":["Effects of a Multidisciplinary Care Program on Disability, Autonomy, and Nursing Needs in Subjects Recovering From Acute Respiratory Failure in a Chronic Ventilator Facility"],"prefix":"10.1177","volume":"59","author":[{"given":"Michele","family":"Vitacca","sequence":"first","affiliation":[{"name":"Divisione di Pneumologia Riabilitativa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mara","family":"Paneroni","sequence":"additional","affiliation":[{"name":"Divisione di Pneumologia Riabilitativa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberta","family":"Peroni","sequence":"additional","affiliation":[{"name":"Divisione di Cardiologia Riabilitativa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Barbano","sequence":"additional","affiliation":[{"name":"Divisione di Pneumologia Riabilitativa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valmira","family":"Dodaj","sequence":"additional","affiliation":[{"name":"Divisione di Pneumologia Riabilitativa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giancarlo","family":"Piaggi","sequence":"additional","affiliation":[{"name":"Divisione di Pneumologia Riabilitativa, Fondazione Salvatore Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico, Pavia, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Vanoglio","sequence":"additional","affiliation":[{"name":"Divisione di Neurologia Riabilitativa, Fondazione Salvatore Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico, Lumezzane (Brescia), Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Luisa","sequence":"additional","affiliation":[{"name":"Divisione di Neurologia Riabilitativa, Fondazione Salvatore Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico, Lumezzane (Brescia), Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amerigo","family":"Giordano","sequence":"additional","affiliation":[{"name":"Divisione di Cardiologia Riabilitativa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piero","family":"Ceriana","sequence":"additional","affiliation":[{"name":"Divisione di Pneumologia Riabilitativa, Fondazione Salvatore Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico, Pavia, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2014,9,2]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.02262"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00044067-200205000-00011"},{"key":"e_1_3_3_4_2","first-page":"691","volume-title":"Principles and practice of mechanical ventilation","author":"Nava S","year":"2006","unstructured":"Nava S, , Vitacca M. 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