Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa.
Department of Nursing Science, University of Pretoria, Pretoria, South Africa.
Nurs Crit Care. 2022 Jan;27(1):120-129. doi: 10.1111/nicc.12612. Epub 2021 Feb 24.
Critically ill patients have the right to communicate and participate in their treatment to avoid adverse medical outcomes due to the severity of their illness, their responsiveness, and level of consciousness. This human right has often been neglected by health care professionals, as a result of limited alternative communication support provided to patients who are unable to speak due to, for example, endotracheal intubation. Despite the successful use of alternative communication strategies in critical care units (CCUs) in other countries, limited implementation in South African hospitals has been reported.
This study aimed to determine the perspectives of South African nurses working in CCUs on the frequency of use of alternative communication strategies to support patient-centred communication with critically ill adult patients.
The study followed a quantitative non-experimental survey research design.
A total of 210 nurses working in both private and public hospitals completed a survey on their perspectives on the use of alternative communication strategies in CCUs.
Nurse participants reported experience working with critically ill and communication-vulnerable patients. Nurse-patient communication mainly involved the use of pen and paper, facial expressions and gestures to obtain information relating to patients' needs and their health history. Limited use of speech-generating communication devices was reported.
Nurse training on the use and implementation of alternative communication strategies, such as communication boards or electronic speech-generating devices, should be investigated to improve nurses' communication with communication-vulnerable patients in South Africa.
The results are applicable in clinical practice due to patients' need for alternative communication. The nurses mainly used low-tech solutions, which are cheap and easy to access. However, there exists an opportunity to increase the use of available digital solutions.
由于病情严重、反应能力和意识水平等原因，重症患者有权进行沟通并参与治疗，以避免因医疗不当而产生不良后果。然而，医护人员往往忽视了这一人权，因为他们只为因气管插管等原因而无法说话的患者提供有限的替代沟通支持。尽管在其他国家的重症监护病房（CCU）中成功使用了替代沟通策略，但据报道，南非医院的实施情况有限。
本研究旨在确定在 CCU 工作的南非护士对使用替代沟通策略支持与重症成年患者进行以患者为中心的沟通的频率的看法。
该研究采用了定量非实验性调查研究设计。
共有 210 名在公立医院和私立医院工作的护士完成了一份关于他们对 CCU 中替代沟通策略使用的看法的调查。
护士参与者报告了在 CCU 中与重症和沟通障碍患者合作的经验。护士与患者的沟通主要涉及使用笔和纸、面部表情和手势来获取与患者需求和健康史相关的信息。报告的语音生成沟通设备的使用有限。
应调查对替代沟通策略（如沟通板或电子语音生成设备）的使用和实施进行护士培训，以改善南非沟通障碍患者的护士沟通。
由于患者需要替代沟通，因此研究结果适用于临床实践。护士主要使用低成本、易于获取的低技术解决方案。然而，有机会增加可用数字解决方案的使用。
