Augmentative and Alternative Communication in Ventilated Patients: A Scoping Review

Pina, Sara; Canellas, Madalena; Prazeres, Rita; Lopes, José Alberto Azeredo; Marcelino, Tânia; Reis, Duarte; Ferrito, Cândida

doi:10.1590/0034-7167-2019-0562

Cited by 5 publications

(13 citation statements)

References 9 publications

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“…Also, partial or complete tube cuff deflation with digital occlusion, plugging or capping of the tube, a one-way speaking valve and tracheostomy button were used. In addition, other measures were found in other studies (Flinterud & Andershed, 2015;Morris et al, 2015;Pina et al, 2020;Shiber et al, 2016;Ull et al, 2020). The use of such devices, however, is predicated on the ability of the patient to be able to use them.…”

Section: Discussionmentioning

confidence: 87%

Patterns of communicating care and caring in the intensive care unit

Al-Shamaly¹

2021

Nursing Open

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Aim: To explore the perceptions and experiences of nurses in communicating the care and caring in the intensive care unit (ICU). Design: A focused ethnography.Methods: This study was conducted in an Australian metropolitan hospital, in which data were gathered from multiple sources: participant observations, document reviews, interviews, and participant's additional written information -oversix months (April-September, 2014). The data were analysed thematically. Findings: This study addressed inclusively communicating care and caring to patients, families, nurses and other health professionals in ICU. The findings identified main themes concerning the changing patterns of communicating the care and caring in ICU, various patterns of communication used, enablers and barriers of communicating care and caring, and significant issues in communicating care and caring in ICU. Documentation of patients' psychological and emotional needs, and nurses' caring behaviours are crucial. These findings need further consideration from all stakeholders.

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Section: Discussionmentioning

confidence: 87%

Patterns of communicating care and caring in the intensive care unit

Al-Shamaly¹

2021

Nursing Open

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“…Bedside use of ET (mounted on a holder) may be challenging due to small ICU rooms with respirators, CVVHF‐ and ECMO‐devices, unfavorable positioning of the ICU patients, and nasogastric tubes for parenteral nutrition. These factors may be a limitation for using ET devices compared to other AACs 9–15 . Overall, it may not be valuable to match our experience with ET devices to hand‐controlled AAC methods, as they are characterized by a completely different range of applications.…”

Section: Discussionmentioning

confidence: 99%

“…These factors may be a limitation for using ET devices compared to other AACs. [9][10][11][12][13][14][15] Overall, it may not be valuable to match our experience with ET devices to hand-controlled AAC methods, as they are characterized by a completely different range of applications. Voiceless ICU patients who are able to use their hands do not need support through ET while voiceless ICU patients who are unable to use their hands do not profit from any non-tech or low-tech AAC.…”

Section: Discussionmentioning

confidence: 99%

“…1,36,37 A variety of AAC methods are available and may be of prime importance to enable communication in ICU patients. [9][10][11][12][13][14][15] There is growing evidence that communication interventions with intubated and invasively ventilated ICU patients are feasible, have utility, and are safe, but there is no agreement on the most effective AAC tool. 10,11,14 The development of eye-tracking (ET) technology offers a relatively new option to overcome communication barriers for patient-medical team interaction in the ICU.…”

Section: Discussionmentioning

confidence: 99%

“…7,8 Communication with nonverbal ICU patients may be enhanced by augmentative and alternative communication (AAC). [9][10][11][12][13][14][15] AAC refers to all forms of communication other than verbal language and has been grouped into the categories non-tech AAC (eg, emotions, gestures, blink, lip reading), low-tech AAC (eg, pen and paper, alphabetboard, picture, writing boards), and high-tech AAC (eg, software, tablets, apps, eye-tracking). AAC allows voiceless ICU patients to use various types of communication tools or devices to ease communication difficulties between patients and healthcare providers in the ICU setting, though it may not be suitable for each voiceless patient because of cognitive changes, critical illness, sensory alternation, and functional limitations, especially of arms and hands.…”

Section: Introductionmentioning

confidence: 99%

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Approach to the basic needs in patients on invasive ventilation using eye‐tracking devices for non‐verbal communication

et al. 2021

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Purpose To analyze the feasibility of eye‐tracking (ET) devices as a communicative approach to the basic needs (BN) of intensive care unit (ICU) and invasively ventilated nonverbal patients. Methods Prospective, monocentric, and observational study including all patients without delirium, with an endotracheal tube or tracheostomy tube, with a history of invasive ventilation for more than 48 h, and inadequate nonverbal communication skills. The investigation was performed with commercially available ET devices (Tobii Dynavox I‐15+) to express BN of ICU patients following a standardized 30‐item yes‐or‐no questionnaire. Results A total of 64 patients with a mean age of 58.6 years were included. The main diagnoses for ICU admission were major trauma (43.6%), sepsis (21.8%), and acute abdomen (15.6%). Pain during repositioning (69%), thirst (69%), sleep disorders (66%), fatigue (64%), and anxiety regarding the lifelong need for assistance (64%) were the main problems reported by the patients. However, most of the patients described expectations of health improvement (78%), good family support (66%), and an improvement in quality of life due to the use of ET devices (67%). Conclusion The use of ET in selected ICU patients with impaired communication is feasible, allowing them to express their BN. Apart from knowing the patients' individual BN, the results of our BN questionnaire may provide guidance for improvement measures in the care of patients in the ICU who are unable to speak. We believe that ET is useful for inquiring about and expressing BN and, therefore, may be capable of improving patient‐medical team interactions and patient satisfaction.

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Communication with mechanically ventilated patients in intensive care units: A concept analysis

Karlsen

Holm

Kvande

et al. 2022

Journal of Advanced Nursing

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Aims The aim of this study was to perform a concept analysis of communication with mechanically ventilated patients in intensive care units and present a preliminary model for communication practice with these patients. Design The Im & Meleis approach for concept analysis guided the study. Search Methods A literature search was performed in January 2022 in MEDLINE, Embase, CINAHL, psycINFO and Scopus, limited to 1998–2022. The main medical subject headings search terms used were artificial respiration, communication and critical care. The search resulted in 10,698 unique references. Review Methods After a blinded review by two authors, 108 references were included. Core concepts and terminology related to communication with mechanically ventilated patients were defined by content analytic methods. The concepts were then grouped into main categories after proposing relationships between them. As a final step, a preliminary model for communication with mechanically ventilated patients was developed. Results We identified 39 different phrases to describe the mechanically ventilated patient. A total of 60 relevant concepts describing the communication with mechanically ventilated patients in intensive care were identified. The concepts were categorized into five main categories in a conceptual map. The preliminary model encompasses the unique communication practice when interacting with mechanically ventilated patients in intensive care units. Conclusion Highlighting different perspectives of the communication between mechanically ventilated patients and providers through concept analysis has contributed to a deeper understanding of the phenomena and the complexity of communication when the patients have limited possibilities to express themselves. Impact A clear definition of concepts is needed in the further development of guidelines and recommendations for patient care in intensive care, as well as in future research. The preliminary model will be tested further. Patient or Public Contribution No patient or public contribution, as this is a concept analysis of previous research.

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Augmentative and Alternative Communication in Ventilated Patients: A Scoping Review

Cited by 5 publications

References 9 publications

Patterns of communicating care and caring in the intensive care unit

Patterns of communicating care and caring in the intensive care unit

Approach to the basic needs in patients on invasive ventilation using eye‐tracking devices for non‐verbal communication

Communication with mechanically ventilated patients in intensive care units: A concept analysis

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