Communication difficulties in mechanically ventilated voiceless patients in intensive care units: A qualitative study.

IF 3 3区 医学 Q1 NURSING
Sara Brambilla, Davide Ausili, Giulia Locatelli, Stefania Di Mauro, Giacomo Bellani, Michela Luciani
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Abstract

Background: Mechanically ventilated patients are unable to verbally communicate due to the endotracheal tube or tracheostomy, rendering them temporarily 'voiceless'. More and more patients are conscious during mechanical ventilation because of a new paradigm based on mild/no sedation. Communicating with conscious voiceless patients can be complex and frustrating, leading to negative outcomes and experiences for patients, family members and health care professionals.

Aim: To explore the negative effects of the inability to communicate verbally among voiceless patients in intensive care units (ICUs), considering the perspectives of voiceless patients, health care professionals and family members.

Study design: This qualitative study uses Interpretive Description methodology. Semi-structured interviews were conducted with patients, family members and health care professionals. Data were collected at three ICUs in Italy over 3 months. Data were analysed using the Rapid and Rigorous qualitative data analysis.

Results: Forty-three people were interviewed (10 patients, 13 caregivers, 13 nurses and 7 physicians). Three major themes were identified: perception of communication difficulties, negative impacts on relationships and emotions, and negative effects on care. These findings indicate that communication difficulties in ICU have negative emotional and psychological consequences for all participants and the health care provided.

Conclusions: Effective communication with voiceless patients is essential for their well-being and quality of care. Future research should focus on identifying and evaluating tailored communication methods for voiceless patients.

Relevance to clinical practice: This study emphasizes the importance of interventions improving voiceless communication, including training health care professionals and critical care nurses in alternative communication strategies, providing psychological support to voiceless patients, and encouraging extended family presence.

重症监护病房机械通气失声患者的沟通困难:一项定性研究。
背景:机械通气患者由于气管内插管或气管造口术而无法言语交流,使他们暂时“无声”。越来越多的患者在机械通气期间意识清醒,因为一种基于轻度/无镇静的新模式。与有意识的无法发声的患者沟通可能是复杂和令人沮丧的,这会给患者、家庭成员和医疗保健专业人员带来负面的结果和经历。目的:从失声患者、医护人员和家属的角度,探讨失声患者在重症监护病房(icu)无法进行语言交流的负面影响。研究设计:本定性研究采用解释性描述方法。对患者、家属和保健专业人员进行了半结构化访谈。数据收集于意大利3个icu,时间超过3个月。数据分析采用快速和严格的定性数据分析。结果:共访谈43人(患者10人,护理人员13人,护士13人,医生7人)。确定了三个主要主题:沟通困难的感知,对关系和情绪的负面影响,以及对护理的负面影响。这些研究结果表明,ICU中的沟通困难对所有参与者和所提供的医疗保健都有负面的情绪和心理影响。结论:与失声患者的有效沟通对他们的健康和护理质量至关重要。未来的研究应侧重于识别和评估为失声患者量身定制的沟通方法。与临床实践的相关性:本研究强调了改善无声沟通的干预措施的重要性,包括培训卫生保健专业人员和重症监护护士采用替代的沟通策略,为无声患者提供心理支持,并鼓励家人在场。
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来源期刊
CiteScore
6.00
自引率
13.30%
发文量
109
审稿时长
>12 weeks
期刊介绍: Nursing in Critical Care is an international peer-reviewed journal covering any aspect of critical care nursing practice, research, education or management. Critical care nursing is defined as the whole spectrum of skills, knowledge and attitudes utilised by practitioners in any setting where adults or children, and their families, are experiencing acute and critical illness. Such settings encompass general and specialist hospitals, and the community. Nursing in Critical Care covers the diverse specialities of critical care nursing including surgery, medicine, cardiac, renal, neurosciences, haematology, obstetrics, accident and emergency, neonatal nursing and paediatrics. Papers published in the journal normally fall into one of the following categories: -research reports -literature reviews -developments in practice, education or management -reflections on practice
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