Barriers to and facilitators for the use of augmentative and alternative communication and voice restorative strategies for adults with an advanced airway in the intensive care unit: A scoping review

Istanboulian, Laura; Rose, Louise; Gorospe, Franklin; Yunusova, Yana; Dale, Craig

doi:10.1016/j.jcrc.2020.02.015

Cited by 35 publications

(30 citation statements)

References 77 publications

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“…Barriers and enablers reported by patients and HCPs were extracted separately. Different extraction methods were used for qualitative and quantitative studies [ 34 ]. From qualitative studies, all barriers and enablers reported by patients or HCPs were extracted.…”

Section: Methodsmentioning

confidence: 99%

Barriers and enablers to physical activity in patients during hospital stay: a scoping review

et al. 2021

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Background Low levels of physical activity are common during the hospital stay and have been associated with negative health outcomes. Understanding barriers and enablers to physical activity during a hospital stay can improve the development and implementation of tailored interventions aimed at improving physical activity. Previous studies have identified many barriers and enablers, but a comprehensive overview is lacking. This study aimed to identify and categorize all published patient- and healthcare professional-reported barriers and enablers to physical activity during a hospital stay for acute care, using the Theoretical Domains Framework (TDF). Methods We conducted a scoping review of Dutch and English articles using MEDLINE, CINAHL Plus, EMBASE, PsycINFO, and Cochrane Library (inception to September 2020), which included quantitative, qualitative, and mixed-methods studies reporting barriers and enablers to physical activity during a hospital stay for acute care, as perceived by patients or healthcare professionals. Two reviewers systematically extracted, coded, and categorized all barriers and enablers into TDF domains. Results Fifty-six articles were included in this review (32 qualitative, 7 quantitative, and 17 mixed-methods). In total, 264 barriers and 228 enablers were reported by patients, and 415 barriers and 409 enablers by healthcare professionals. Patient-reported barriers were most frequently assigned to the TDF domains Environmental Context & Resources (ECR, n = 148), Social Influences (n = 32), and Beliefs about Consequences (n = 25), while most enablers were assigned to ECR (n = 67), Social Influences (n = 54), and Goals (n = 32). Barriers reported by healthcare professionals were most frequently assigned to ECR (n = 210), Memory, Attention and Decision Process (n = 45), and Social/Professional Role & Identity (n = 31), while most healthcare professional-reported enablers were assigned to the TDF domains ECR (n = 143), Social Influences (n = 76), and Behavioural Regulation (n = 54). Conclusions Our scoping review presents a comprehensive overview of all barriers and enablers to physical activity during a hospital stay and highlights the prominent role of the TDF domains ECR and Social Influences in hospitalized patients’ physical activity behavior. This TDF-based overview provides a theoretical foundation to guide clinicians and researchers in future intervention development and implementation. Scoping review registration No protocol was registered for this review.

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Section: Methodsmentioning

confidence: 99%

Barriers and enablers to physical activity in patients during hospital stay: a scoping review

et al. 2021

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“… 8 Successful implementation of systems requires access to a variety of equipment to meet communication need diversity, dedicated staff training, and—ideally—family presence and sufficient staffing. 9 The increased need and use of systems and strategies is parallel with the global need and use of additional staff resources and ICU beds during this pandemic, potentially resulting in reduced patient support during its implementation. Caution must be exercised, however.…”

Section: Augmentative and Alternative Communication Systems And Stratmentioning

confidence: 99%

Coronavirus disease 2019 (COVID-19) cuts ties with patients' outside world

Freeman‐Sanderson

Rose

Brodsky

2020

Australian Critical Care

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Coronavirus disease 2019 (COVID-19) cuts ties with patients' outside world * 1. Mechanisms and manifestations of altered communication function in the intensive care unit during COVID-19 Communication relies on more than words. Facial expressions, gestures, and voice qualities convey essential meaning and context to conversations. The importance of clear and effective communication is an essential aspect of care within the intensive care unit (ICU), impacting safety, delivery of care, and patient experience. The COVID-19 pandemic has altered the manner and mode of communication in the ICU for both patients and healthcare professionals. The transmission risk of the highly infectious SARS-CoV-2 has necessitated the use of personal protective equipment including masks and face shields, radically impeding oral communication and the human interactions that support it. 1 Before COVID-19, face-to-face conversations were only affected by masks in isolation rooms and surgical suites. In the context of COVID-19, healthcare professionals in the ICU are sporting different attire. Use of personal protective equipment is ubiquitous, including face masks, face shields, goggles, and gowns, each obscuring important facets of communication among healthcare providers (HCPs) and between HCPs and patients. All promote safety, while impeding communication in some form. Perhaps the most obvious barrier to communication is the unassuming face mask, impeding facial expressions, preventing lip reading, reducing voice volume, distorting speech, and muffling voice intonations. Not to be outdone, face shields and goggles bring with them glare and difficulty seeing the speaker's eyes. Gowns simply cover HCPs' IDs, removing the last verifiable method for identifying the person with whom you are speaking. The ICU environment itself, with constant noise and alarms, provides limited context to aid conversations. Ease of "normal" speech intelligibility is reduced by 13e17% while using N95 masks, with HCPs confirming communication difficulty with patients during their clinical use. 2,3 Loss of speech intelligibility negatively impacts the strength of the outgoing message and understanding key messages. Altered communication may leave patients vulnerable for compromised medical care. 4,5

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“…According to different needs, AAC uses high-tech, low-tech, and non-tech assistance. The emotions of stakeholders should be taken into account, which will affect their willingness to communicate [27] and the use of AAC for emotional communication between patients and caregivers can improve the patients' quality of life [28].…”

Section: Aac Is Applied To Doctor-patient Communicationmentioning

confidence: 99%

Exploring Pictorial Health Education Tools for Long-Term Home Care: A Qualitative Perspective

2020

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Regarding long-term home care needs, nurses need to communicate effectively and reasonably when teaching home caregivers. Designers can assist medical staff and develop pictorial tools to enhance communication. The purpose of this study is to explore a theoretical basis from the perspective of designers, patients’ home caregivers, and medical staff to construct a theoretical framework that can jointly develop pictorial health education tools and healthcare system. The qualitative methods, including in-depth interview and observation, are applied to this study; ground theory sets out to construct a framework from the verbatim transcript of the interviews. Based on interview results, six axial codes were extracted: (1) the method of interdisciplinary cooperation; (2) medical research ethics; (3) communication methods; (4) forms of health education tools; (5) development of health education tools; (6) home care intubation procedure. Eight groups of home caregivers offered suggestions from their experiences. The designers need to assist medical staff to solve real problems, pay attention to professional norms, and forms of cooperation. Health education tools need to meet the needs of medical staff and home caregivers and designers should pay attention to the processes of communication. This study can also assist in interdisciplinary cooperation to explore the theoretical basis of pictorial health education tools for nurses in the context of long-term care at home.

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Barriers to and facilitators for the use of augmentative and alternative communication and voice restorative strategies for adults with an advanced airway in the intensive care unit: A scoping review

Cited by 35 publications

References 77 publications

Barriers and enablers to physical activity in patients during hospital stay: a scoping review

Barriers and enablers to physical activity in patients during hospital stay: a scoping review

Coronavirus disease 2019 (COVID-19) cuts ties with patients' outside world

Exploring Pictorial Health Education Tools for Long-Term Home Care: A Qualitative Perspective

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