Perelló-Campaner Catalina, González-Trujillo Antonio, Alorda-Terrassa Carme, González-Gascúe Maite, Pérez-Castelló Josep Antoni, Morales-Asencio José Miguel, Molina-Mula Jesús
Emergency Care Service 061, 07011 Palma, Spain.
SATSE CIDEFIB, c/Antoni Marques, 4. Bjs izqda, 07003 Palma, Spain.
Healthcare (Basel). 2023 Sep 28;11(19):2645. doi: 10.3390/healthcare11192645.
To explore what factors determine communication with awake intubated critically ill patients from the point of view of critical care nursing professionals.
Impaired communication frequently affects mechanically ventilated patients with artificial airways in the intensive care unit. Consequences of communication breaches comprise emotional and ethical aspects as well as clinical safety, affecting both patients and their conversation partners. Identification of determining factors in communication with awake intubated patients is needed to design effective action strategies.
A qualitative phenomenological approach was used.
Semi-structured interviews were used as the data collection method. A total of 11 participants from three intensive care units of three Majorcan public hospitals, selected by purposive sampling, were interviewed.
Three major themes regarding the communication determinants of the awake intubated critically ill patients were identified from the interviewees' statements: factors related to the patient (physical and cognitive functionality to communicate, their relational and communicative style and their personal circumstances), to the context (family presence, ICU characteristics, workload, availability/adequacy of communication aids, features of the messages and communication situations) and, finally, those related to the professionals themselves (professional experience and person-centredness).
The present study reveals determinants that influence communication with the awake intubated patient, as there are attitudes and professional beliefs.
The discovery of relations between different kinds of determinants (of patient, context or professionals) provides a multi-factor perspective on the communicative problem which should be considered in the design of new approaches to improve communicative effectiveness. This study is reported according to the COREQ checklist.
从重症护理专业人员的角度探讨哪些因素决定了与清醒状态下接受气管插管的重症患者的沟通。
沟通障碍经常影响重症监护病房中使用人工气道进行机械通气的患者。沟通中断的后果包括情感和伦理方面以及临床安全性，对患者及其对话伙伴都会产生影响。需要确定与清醒状态下接受气管插管患者沟通的决定因素，以设计有效的行动策略。
采用定性现象学方法。
使用半结构化访谈作为数据收集方法。通过目的抽样从马略卡岛三家公立医院的三个重症监护病房中选取了11名参与者进行访谈。
从受访者的陈述中确定了关于清醒状态下接受气管插管的重症患者沟通决定因素的三个主要主题：与患者相关的因素（沟通的身体和认知功能、他们的关系和沟通风格以及个人情况）、与环境相关的因素（家属在场情况、重症监护病房特点、工作量、沟通辅助工具的可用性/充分性、信息和沟通情境的特征），以及最后与专业人员自身相关的因素（专业经验和以患者为中心）。
本研究揭示了影响与清醒状态下接受气管插管患者沟通的决定因素，以及态度和专业信念。
发现不同类型的决定因素（患者、环境或专业人员的）之间的关系，为沟通问题提供了一个多因素视角，在设计提高沟通效果的新方法时应予以考虑。本研究按照COREQ清单报告。
