الفهرس 
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Abstract
Mechanical ventilation is the main supportive therapy for patients with life threatening illness. MV can be both physiologically and psychologically stressful. Most patients report that being a ventilated is a miserable experience, it is a highly stressful event; it may evoke fear, anxiety, and emotional responses for patients and their families.
Mechanical ventilated patients experience considerable fear and anxiety, this fear and anxiety is related to being ill, the threat posed by mechanical ventilator, sensation of breathlessness, frequent suctioning, inability to talk, uncertainty regarding surroundings, discomfort, isolation from others, pain at rest due to the disease process, also a procedural pain as a result of exposure to multiple invasive procedures, ICU environment, the potential negative effects during weaning process, and fear of death.
Current guidelines recommend that most MVPs admitted to the ICU be maintained in anxiety and fear free to prevent delirium and further weaning failure. Critical care nurses have a responsibility in mitigating MVPs’ suffering. So, identifying stressors facing MVPs, particularly those associated with anxiety and fear are essential for nurses since it helps them prioritize and develop appropriate and effective intervention to control anxiety and fear high levels.
Aim of the study
A descriptive research design was used in this study to determine the effect of anxiety and fear level on the weaning success or failure among mechanically ventilated patients.
This study was carried out at the General intensive care units of Damanhur Medical Institute: General intensive care unit, cardiopulmonary intensive care; and General intensive care unit of Hosh Eisa General Hospital.
A convenience sampling of 60 adult mechanically ventilated patients were included in the study. Patients who have altered level of consciousness, and or on anxiolytics will be excluded from the study. The period of data collection from July 2017 to April 2018.
Materials and method
To accomplish the aim of the current study; three tools were used for data collection. Beck Anxiety Inventory (BAI) was adopted from Beck (1988) (139,140), Numerical Rating Scale Fear Assessment was adopted from Chen (2006)
The study was accomplished as follow:
An official approval to conduct this study was obtained after providing explanation of the aim of the study. Tools of the study were adopted the Arabic version of the two tools; Beak anxiety inventory (139,140)and Numerical Rating Scale Fear Assessment(21)were used and tool three was adopted from Ahmed (141) and were assessed for clarity and content validity. An Oral informed /written consent was obtained from patients or patients’ legal guardians. It includes the aim of the study, potential benefits, risks and discomforts associated with participation. Patients’ anonymity, confidentiality, and privacy were maintained during implementation of the study.
A pilot study was carried out to assess the clarity and applicability of the tools, and all necessary modifications were done. Reliability of the tools was measured using Cronbach Alpha reliability, the reliability coefficients was (r=0.921) which is good. Newly admitted adult MVPs were enrolled in the study except patients with the exclusion criteria. The demographic and clinical data of the studied MVPs were obtained and recorded immediately after the initiation of mechanical ventilation. Anxiety and fear level was assessed three times; immediately after the initiation of mechanical ventilation, immediately before the weaning trial and the third time immediately after completion the weaning trial using tool I and II. Before the weaning trial MVPs were monitored by the researcher for weaning trial readiness using part I of tool III. After conducting weaning trial, MVPs were monitored by the researcher for weaning trial tolerance using part II of tool III for the consecutive 30-120 minutes of SBT and immediately after 1 minute of conducting SBT .
Results of the study
Most of the studied MVPs in this study were females (55%); aged more than fifty years old. The most common diagnosis was related to respiratory disorders followed by cancer diseases. Most of the studied MVPs in this study were attached with ETT (83.3%), while (16.7%) attached with tracheostomy tube. The mean length of stay was11 ± 8.7. As regard (21), and Weaning Trial Readiness and Tolerance Screen was adopted from Ahmed (2016) (141). In addition to patient’s sociodemographic data and clinical data.