Accepted for/Published in: JMIR Research Protocols
Date Submitted: Sep 1, 2025
Date Accepted: Jan 9, 2026
Developing a program theory on ventilator weaning in adult intensive care: study protocol for a multi-step study
ABSTRACT
Background:
Worldwide, the rate of weaning failure is still high, although this field has been widely researched. There is a fundamental theoretical deficit in this process; interventions, outcomes and their context have not been sufficiently linked.
Objective:
To gain an in-depth theoretical understanding of ventilator weaning in adult intensive care patients.
Methods:
Along the recommendations of Funnell and Rogers (2011), a program theory for ventilator weaning is developed in two steps. First, three literature reviews on interventions and outcomes, predictors of weaning failure and patients’ experience were triangulated with stakeholder conversations. Using abduction, an initial program theory was then developed. Second, this theory will be revised in an iterative process with stakeholders in group discussions and workshops until congruence of theory and data is achieved.
Results:
The initial program theory addresses ventilator dependency as the central phenomenon. It distinguishes between preconditions, immediate, intermediate and ultimate outcomes as well as postconditions after the program. These are affected by primary interventions with a direct influence on the outcomes, secondary interventions with an indirect influence and non-program external factors.
Conclusions:
This study closes an important gap in research on mechanical ventilation. It will lead to a differentiated understanding of ventilator weaning and enable more sustainable and comprehensive research. The program theory emphasizes the interdisciplinary nature of ventilator weaning and supports professionals in combining interventions appropriately and evaluating relevant outcomes. Clinical Trial: Open Science Framework (https://doi.org/10.17605/OSF.IO/YGJ3T), registered on May 14th, 2025
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.