Communication Difficulties and Psychological Stress in Patients Receiving Mechanical Ventilation

Abstract

Introduction: Communication is fundamental for an individual to verbalize their feelings. Inability of the patient receiving mechanical ventilation to communicate the needs to the health care provider often leads to psychological stress.
 Objective: The objective of the study is to assess the communication difficulties and psychological stress in patients receiving mechanical ventilation.
 Methodology: A cross-sectional research design was used for the study. A total of 48 patient extubated within the preceding 72 hours, was taken as a sample by using a convenience sampling method. Data were collected by using a interview technique in patients from January–September 2018 from a 41- bedded ICU at Nobel Medical College Teaching Hospital. Data analysis was done by descriptive and inferential statistics.
 Results: Difficulty in communication was found where majority of the respondents (82.29%) rated general communication as extremely hard. The study further revealed that 100% of the respondents used hands for pointing and gesturing followed by shaking heads (65.38%), whisper (19.23%) and writing (11.53%). Sleeping and communication difficulty was the major problem 97.91% and 96.94% respectively. Majority of respondents (66.66%) scored Intensive Care Psychological Assessment Tool more than 7. In addition, there is significant association between the sex, total length of ventilation and prior experience with ICU (p= <0.05).
 Conclusion: Patient with mechanical ventilation experience a moderate to extreme level of psychological stress because they have difficulty in communicating their needs. Alternative communication methods should be developed, and health care provider should be aware about the communication difficulties, thereby reducing the stress caused by ineffective communication.

Fluxograma e protocolo de intervenção psicológica em Unidade de Terapia Intensiva

“…No caso de pacientes impossibilitados de falar devido à presença do tubo endotraqueal, o psicólogo deve se atentar para a linguagem não verbal, desenvolvendo estratégias criativas de comunicação, como gestos, escrita ou sinais impressos que viabilizem uma via de expressão de suas necessidades e desejos, de modo a identificar focos de angústia e reduzir o sentimento de solidão. O objetivo dessa comunicação não é apenas a transmissão de informações, mas a sinalização da presença ao lado do paciente em condição de cuidado, viabilizando expressão de sentimentos e emoções (Thapa, Dahal & Singh, 2019).…”

Hearing the Silent Voices of COVID-19 Patients on Mechanical Ventilators: The Use of Augmentative and Alternative Communication (AAC) Approach

“…The need for the use of the AAC program increased after the COVID-19 where the medical staff had difficulty communicating with patients in general due to heavy PPE or due to patients being on ventilation, or due to the noise coming from the equipment. Thapa et al (2019).…”

Effectiveness of augmented alternative communication method on physiological parameters among conscious mechanical ventilation patients

“…The number of ventilator assisted individuals (VAIs) varies between 6.6 and 23 per 1,00,000 [2].Communication is essential for a person in order to verbalise their feelings. When a patient receiving MV is unable to communicate their requirements to the health care provider, it might result in psychological distress [3]. Patients who are treated with MV report a variety of psychological stress like anxiety, depression, anger, fear, panic, trouble sleeping as well as reduced self-esteem due to inability to communicate [4, 5 6, 7].…”