Opportunities for Interactive Communication in Mechanically Ventilated Critically Ill Patients: A Video-Based Observational Study.

IF 2.3 Q1 NURSING
Nursing Research and Practice Pub Date : 2022-07-14 eCollection Date: 2022-01-01 DOI:10.1155/2022/1885938
Akiko Yamaguchi, Atsue Ishii, Haruna Fukushige, Yoshiaki Inoue, Izumi Akada, Rie Mitani, Akiko Ito, Mio Hosona, Sayaka Suga, Akiko Yamada, Yoko Arima
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引用次数: 1

Abstract

Background: Mechanically ventilated critically ill patients need the opportunity to communicate their physical and psychosocial concerns to nurses. However, these patients face the unique problem of lacking even the opportunity to communicate.

Aims: The study aimed to describe the characteristics of communication opportunities for critically ill mechanically ventilated patients.

Methods: The study was designed as a video-based descriptive observational study. Participants included seven mechanically ventilated critically ill patients at the intensive care unit, coronary care unit, or high care unit who were conscious and seven registered nurses (seven pairs). Videos were recorded continuously from 8 am to 4 pm, and the footage was then descriptively analyzed. Data collection took place between July 2019 and June 2020.

Results: The total recording time was 668.0 minutes. Of these 668.0 minutes, nurses stayed in the Conversation Area of the Patient for 279.6 minutes, and of these 279.6 minutes, two-way face-to-face communication between nurse and patient occurred for 78.0 minutes. Of these 78.0 minutes, communications were started by nurses for 47.2 minutes (174 scenes) and by patients for 24.2 minutes (36 scenes). The patient-started two-way communication scenes included 37 instances of Patient-Intentional-Action that triggered the start of communication. Actions using the upper limbs were observed in 20 instances and represented the most frequently used body part. The head/face, lower limbs, or trunk were also used in some of the actions. Gestures were the most commonly used action type (14 instances). Other types included lip movement, grimace, leg flex/extension, and cough.

Conclusions: We found that nurses tended to start communication more frequently than patients did and that patients demonstrated Patient-Intentional-Action with a variety of actions using various body parts. Communication opportunities for patients were created when nurses took the initiative to start communication or when they noticed and responded to the Patient-Intentional-Action. Our findings demonstrate that nurses need to recognize and always respond to Patient-Intentional-Action and to take the initiative in communicating rather than waiting for the patient to do so.

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机械通气危重患者互动交流的机会:基于视频的观察性研究。
背景:机械通气危重患者需要有机会与护士沟通他们的身体和心理问题。然而,这些病人面临着一个独特的问题,那就是连交流的机会都没有。目的:本研究旨在描述危重机械通气患者沟通机会的特点。方法:本研究设计为基于视频的描述性观察研究。参与者包括7名在重症监护室、冠状动脉监护室或高监护病房进行机械通气的危重病人和7名注册护士(7对)。从早上8点到下午4点连续录制视频,然后对视频进行描述性分析。数据收集于2019年7月至2020年6月期间进行。结果:总记录时间为668.0 min。在这668.0分钟中,护士在患者对话区停留的时间为279.6分钟,在这279.6分钟中,护士与患者进行双向面对面交流的时间为78.0分钟。在这78.0分钟中,由护士开始沟通的时间为47.2分钟(174场),由患者开始沟通的时间为24.2分钟(36场)。患者启动的双向交流场景包括37个触发交流开始的患者-故意-行动实例。在20例中观察到上肢的动作,上肢是最常用的身体部位。头/脸、下肢或躯干也被用于一些动作。手势是最常用的动作类型(14个实例)。其他类型包括嘴唇运动、鬼脸、腿弯曲/伸展和咳嗽。结论:我们发现护士比患者更倾向于开始沟通,患者表现出使用不同身体部位的各种动作的“患者-故意-行动”。当护士主动开始沟通时,或者当护士注意到并回应“患者-故意-行动”时,就为患者创造了沟通机会。我们的研究结果表明,护士需要认识到并始终对“患者故意行为”做出反应,并主动沟通,而不是等待患者这样做。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.90
自引率
0.00%
发文量
21
审稿时长
19 weeks
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