Anna-Liisa Sutt is a speech pathologist, Critical Care Research Group, Adult Intensive Care Services, The Prince Charles Hospital, Brisbane, Queensland, Australia and an industry fellow, Faculty of Medicine, University of Queensland, Brisbane, Australia.
Petrea L. Cornwell is an associate professor, School of Applied Psychology, Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia.
Am J Crit Care. 2022 Sep 1;31(5):411-415. doi: 10.4037/ajcc2022516.
Communication with patients receiving mechanical ventilation in an intensive care unit can be challenging. Once a patient is tracheostomized, a speaking valve may enable restoration of verbal communication. To date, no data are available on the effect of speaking valves on communication success in intensive care units.
The aim of this prospective cohort study was to measure communication success before and during speaking valve use for intensive care patients being weaned from mechanical ventilation, from both the nurses' and the patients' perspectives.
In a prospective cohort study, consecutive eligible patients and their nurses were asked to complete newly developed questionnaires on communication success before and while patients used a speaking valve (6 questions for patients, 5 questions for nurses, answers on a 10-point scale with 10 the best score). The Wilcoxon signed rank test was used to analyze score differences.
For all questionnaire items, both patients (n = 25) and nursing staff (n = 52) reported significantly higher communication success during speaking valve use. Nurses understood moderately well that their patients were in pain (median [IQR], 5.8 [4.7-7.4]) even before speaking valve use. Most patients found it challenging to say something quickly even while using a speaking valve (6.9 [5.7-10.0]). Overall, speaking valve use markedly increased communication success.
A speaking valve should be considered for patients with a tracheostomy as soon as possible to improve their communication success.
与重症监护病房接受机械通气的患者进行沟通可能具有挑战性。一旦患者行气管切开术，使用说话阀可能会恢复言语交流。迄今为止，尚无关于说话阀对重症监护病房患者通气撤离期间沟通成功率影响的数据。
本前瞻性队列研究旨在从护士和患者的角度测量接受机械通气撤机的重症监护患者使用说话阀前后的沟通成功率。
在一项前瞻性队列研究中，连续纳入符合条件的患者及其护士，要求他们在患者使用说话阀之前和使用期间填写新开发的沟通成功率问卷（患者 6 个问题，护士 5 个问题，答案为 10 分制，10 分为最佳评分）。采用 Wilcoxon 符号秩检验分析评分差异。
对于所有问卷项目，患者（n=25）和护理人员（n=52）均报告在使用说话阀期间沟通成功率显著提高。即使在使用说话阀之前，护士也能较好地理解患者的疼痛程度（中位数[四分位距]，5.8[4.7-7.4]）。大多数患者发现即使使用说话阀也很难快速说话（6.9[5.7-10.0]）。总的来说，使用说话阀显著提高了沟通成功率。
一旦患者行气管切开术，应尽快考虑使用说话阀，以提高其沟通成功率。
