Aim: To conduct a review summarizing evidence concerning communication with mechanically ventilated patients in the intensive care unit (ICU).
Background: ICU patients undergoing mechanical ventilation are unable to communicate verbally, causing many negative emotions. Due to changes in sedation practice, a growing number of patients are conscious and experience communication difficulties.
Design: The umbrella review method guided by the Joanna Briggs Institute was applied.
Data sources: A systematic search was done in the Cochrane Library, the Joanna Briggs Institute database, Cinahl, Pubmed, PsycINFO and Scopus between January -April 2019. Search terms were 'nurse-patient communication', 'mechanical ventilation', 'intensive care', and 'reviews as publication type'. Literature from 2009-2019 was included.
Review methods: Following recommendations by the Joanna Briggs Institute, a quality appraisal, data extraction, and synthesis were done.
Results: Seven research syntheses were included. There were two main themes and six subthemes: (1) Characterization of the nurse-patient communication: (a) Patients' communication; (b) Nurses' communication; (2) Nursing interventions that facilitate communication: (a) Communication assessment and documentation; (b) Communication methods and approaches; (c) Education and training of nurses; and (d) Augmentative and alternative communication.
Conclusion: Nurse-patient communication was characterized by an unequal power relationship with a common experience - frustration. Four key interventions were identified and an integration of these may be key to designing and implementing future ICU communication packages.
Impact: Nurse-patient communication is characterized by an unequal power relationship with one joint experience - frustration. Four key interventions should be integrated when designing and implementing communication packages in the ICU. Findings are transferable to ICU practices where patients are conscious and experience communication difficulties.
目标: 有关于与重症监护室(ICU)机械通气患者的沟通进行回顾性总结取证。 背景资料: 重症监护室(ICU)内进行机械通气的患者无法进行言语交流,导致其产生诸多的负面情绪。由于镇静方法的改变,越来越多的患者意识清醒,并出现沟通困难。 设计: 采用澳大利亚JBI循证护理中心指导的伞式回顾方法。 数据来源: 对考克兰图书馆、澳大利亚JBI循证护理中心数据库、护理学数据库(CINAHL)、国际文献数据库(PubMed)、心理学文摘(PsycINFO)和Scopus电子数据库2019年1月至4月的内容进行系统性搜索。搜索词为“护患沟通”、“机械通气”、“重症监护”和“出版类回顾 ”。包括了2009年至2019年的文献。 评审方法: 根据澳大利亚JBI循证护理中心的建议,进行了质量评估、数据提取和合成。 结果: 包含了七篇研究合成。有两大主题和六个子主题:(1) 护患沟通的特点:(a) 患者的沟通;(b)护士的沟通;(2)促进沟通的护理干预措施:(a) 沟通评估和记录;(b)沟通方式和方法;(c)护士的教育和培训;以及(d)补充和替代沟通。 结论: 护患沟通的特点是不平等的权力关系和共同的挫折体验。确定了四大关键干预措施,这些措施的整合可能是设计和实施未来重症监护室沟通方案的关键。 影响: 护患沟通的特点是不平等的权力关系和共同的挫折体验。在设计和实施重症监护室的沟通方案时,应整合四大关键干预措施。研究发现可应用于重症监护室内患者意识清醒且沟通困难的实践。.
Keywords: augmentative and alternative communication; communication; critical care; intensive care unit; mechanical ventilation; nurse-patient relations; nursing; nursing interventions; umbrella review.
© 2020 John Wiley & Sons Ltd.