A Communicative Intervention to Improve the Psychoemotional State of Critical Care Patients Transported by Ambulance

Abstract

Background Communication is key to understanding the emotional state of critical care patients. Objective To analyze the effectiveness of the communicative intervention known as CONECTEM, which incorporates basic communication skills and augmentative alternative communication, in improving pain, anxiety, and posttraumatic stress disorder symptoms in critical care patients transported by ambulance. Methods This study had a quasi-experimental design with intervention and control groups. It was carried out at 4 emergency medical centers in northern Spain. One of the centers served as the intervention unit, with the other 3 serving as control units. The nurses at the intervention center underwent training in CONECTEM. Pretest and posttest measurements were obtained using a visual analog scale to measure pain, the short-version State-Trait Anxiety Inventory to measure anxiety, and the Impact of Event Scale to measure posttraumatic stress disorder symptoms. Results In the comparative pretest-posttest analysis of the groups, significant differences were found in favor of the intervention group (Pillai multivariate, F2,110 = 57.973, P < .001). The intervention was associated with improvements in pain (mean visual analog scale score, 3.3 pretest vs 1.1 posttest; P < .001) and posttraumatic stress disorder symptoms (mean Impact of Event Scale score, 17.8 pretest vs 11.2 posttest; P < .001). Moreover, the percentage of patients whose anxiety improved was higher in the intervention group than in the control group (62% vs 4%, P < .001). Conclusion The communicative intervention CONECTEM was effective in improving psychoemotional state among critical care patients during medical transport.

Development and Validation of the Therapeutic Communication Scale in Nursing Students

“…However, since CFA (confirmatory factor analysis) builds a model based on theory to confirm factor structure, items with factor loadings below 0.50 are still considered important for theoretical validation and acceptable if the factor loading is above 0.30 [46]. Previous studies [13,23,29,30,35] also support this concept as being important in therapeutic communication. To date, therapeutic communication in nursing students has emphasized empathetic listening and support, suggesting that future therapeutic communication by nursing students should be supplemented with aspects of giving patients time and being more accepting or setting limits.…”

“…The attributes of interactive factors include empathy, environmental control, and boundary setting [23,[29][30][31], while adaptive factors include awareness, sensitivity, and self-reflection [23,[32][33][34]. Problem-solving factors encompass active listening, silence, honesty, and clarity [2,9,20], and patient-centered factors include providing sufficient time and consideration [19,29,[35][36][37]. The field study was conducted by 13 nursing professors with more than seven years of clinical and educational experience and three incumbent nurses with more than ten years of clinical experience and a master's degree in nursing (Appendix B).…”

“…Through this, the situational dimensions (patientcentered, interactive, and adaptive factors) and technical dimensions (problem-solving factors) were identified, and three attributes of relationship formation, information exchange, and mutual respect were confirmed. The attributes of interactive factors include empathy, environmental control, and boundary setting [23,[29][30][31], while adaptive factors include awareness, sensitivity, and self-reflection [23,[32][33][34]. Problem-solving factors encompass active listening, silence, honesty, and clarity [2,9,20], and patient-centered factors include providing sufficient time and consideration [19,29,[35][36][37].…”