The intervention will consist of a structured two-session synchrony-optimized NIV education program designed to improve patient-ventilator interaction and reduce NIV-related complications. In the first 20-40-minute session, patients will be taught the ventilator's inspiratory and expiratory cycles and will practice synchronizing their breathing with the device through guided diaphragmatic exercises and real-time feedback until they demonstrate stable synchrony. The second 45-60-minute session, delivered 18-24 hours later, will provide supplementary training on proper mask selection and fixation, prevention of common NIV complications, leak reduction techniques, equipment maintenance, advanced breathing exercises, and basic ventilator monitoring and alarm management. An educational booklet summarizing all essential topics will be provided to support ongoing adherence and self-management.

Standard care will include regular education on the ICU environment, basic intensive care processes, the use of monitoring devices, ICU rules, effective communication with critically ill patients, and basic principles of patient care.

The intervention will include two educational sessions to improve patient-ventilator synchrony and NIV management. The first session will teach patients about the ventilator's breathing cycles and train them to coordinate their breathing using visual aids and hands-on practice with real-time feedback. Competency will be assessed by their ability to maintain synchrony with minimal mask leak. The second session, held 18-24 hours later, will cover mask fitting, prevention of common complications, leak reduction, equipment care, advanced breathing exercises, and basic ventilator alarm management. Communication and relaxation techniques will also be taught, and patients will receive a booklet summarizing the key information.

Adherence data, including daily NIV usage, will be retrieved from the NIV machine. Adherence will be defined as more than 4 hours of nighttime use for more than 70% of days until study completion or a mean daily use of more than 5 hours.

Levels of anxiety and depression will be assessed using the Hospital Anxiety and Depression Scale (HADS), a 14-item self-report instrument divided into two subscales: anxiety (HADS-A) and depression (HADS-D), each comprising seven items. Participants will rate each item on a 4-point scale (0-3), yielding subscale scores ranging from 0 to 21. Scores for both subscales will be interpreted as follows: 0-7 indicating no symptoms, 8-10 mild, 11-14 moderate, and 15-21 severe. The internal consistency of the anxiety subscale (HADS-A) and depression subscale (HADS-D) will have been demonstrated with Cronbach's alpha coefficients of 0.820 and 0.807, respectively. The Persian version of the HADS will have shown good reliability and validity in clinical populations. Montazeri et al. (2003) will have found it acceptable by 99% of patients, with Cronbach's alpha of 0.78 for anxiety and 0.86 for depression subscales.