Abstract
To determine acceptability of medical cannabis research in critically ill patients. Q-methodology survey. Convenience sample of healthcare providers and the general public were recruited at an acute care community hospital in Ontario, Canada. In the first phase, 63 respondents provided 197 unique viewpoints in response to a topic statement about medical cannabis use in critically ill patients. Twenty-five viewpoints were selected for the q-sample. In the second phase, 99 respondents ranked these viewpoints according to an a priori quasi normal distribution ranging from +4 (most agree) to -4 (least agree). Factor analysis was combined with comments provided by survey respondents to label and describe the extracted factors. The factor labels were hoping and caring (factor 1), pragmatic progress (factor 2), and cautious/conservative and protectionist (factor 3). Factor 1 describes a viewpoint of unequivocal support for medical cannabis research in this population with few caveats. Factor 2 describes a viewpoint of cautious support with a need to monitor for unintended adverse effects. Factor 3 describes a viewpoint of ensuring that current analgosedation techniques are optimized before exposing patients to another potentially harmful drug. Using a q-methodology design, we were able to sample and describe the viewpoints that exist about medical cannabis research in critically ill patients. Three factors emerged that seemed to adequately describe the relative ranking of q-statements by the majority of respondents. Combining the distinguishing statements along with respondent comments allowed us to determine that the majority support medical cannabis research in critically ill patients.
Highlights
Life-sustaining therapies, such as invasive mechanical ventilation, are commonly employed in patients admitted to an intensive care unit (ICU) with life-threatening illnesses
Using a q-methodology design, we were able to sample and describe the viewpoints that exist about medical cannabis research in critically ill patients
Combining the distinguishing statements along with respondent comments allowed us to determine that the majority support medical cannabis research in critically ill patients
Summary
Life-sustaining therapies, such as invasive mechanical ventilation, are commonly employed in patients admitted to an intensive care unit (ICU) with life-threatening illnesses The majority of these patients require pain control and sedation to facilitate their care and to alleviate suffering directly related to their illness [1]. The current strategies to manage pain in critically ill patients depend on using validated pain scoring systems and frequent clinical assessment by ICU nurses to guide the titration of opioids and other pharmacologic therapies used for analgosedation [3]. Despite these considerable efforts, many patients still receive either too little or too much opioids during their ICU admission, either of which may have many negative consequences for patients. Too much opioids exposes patients to excess days on a ventilator due to respiratory depression, altered levels of alertness and severe delirium, and the development of tolerance to opioids requiring ever-increasing amounts to manage pain that may lead to the risk of a withdrawal syndrome and chronic opioid tolerance
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