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探讨重症监护病房的沟通需求和挑战:来自提供者和患者视角的调查研究。

Exploring Communication Needs and Challenges in the Intensive Care Unit: A Survey Study From Providers' and Patients' Perspectives.

机构信息

Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin.

Department of Obstetrics and Gynecology, John Peter Smith Hospital, Fort Worth, TX.

出版信息

Am J Speech Lang Pathol. 2024 Sep 18;33(5):2311-2326. doi: 10.1044/2024_AJSLP-23-00385. Epub 2024 Jul 25.

Abstract

PURPOSE

Effective communication between nonspeaking patients and providers is critical for the quality of care in intensive care units (ICUs). This study aims to evaluate perspectives of health care providers and nonspeaking patients on effective communication and communication barriers in the ICU.

METHOD

Qualitative and quantitative survey methodologies were employed to evaluate providers' and patients' perspectives on effective communication. Rating scales were utilized to measure patients' frustration levels and communication effectiveness. Open-ended questions were employed to reflect on barriers to communication in the ICU, instances of ineffective communication, and recommendations for enhancing effective communication.

RESULTS

The results of the study suggest that nonspeaking patients experienced high levels of frustration due to ineffective communication. However, the data reveal that access to appropriate augmentative and alternative communication (AAC) strategies and materials could help mitigate patients' frustration. Providers mainly communicated via asking yes/no questions, which largely limited the information patients conveyed, leading to frequent communication breakdowns. Providers expressed a desire to participate in training programs to utilize appropriate AAC strategies and promote effective communication.

CONCLUSIONS

This study provides preliminary survey results on perspectives of patients and providers on effective communication in the ICU. Both providers and patients reported experiencing challenges and frustration during their communication, due to barriers such as providers' insufficient training experience and lack of access to AAC materials. Skill training is warranted to promote effective patient-provider communication in intensive care settings.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.26339623.

摘要

目的

在重症监护病房(ICU)中,非言语患者与医护人员之间的有效沟通对于护理质量至关重要。本研究旨在评估医护人员和非言语患者对 ICU 中有效沟通和沟通障碍的看法。

方法

采用定性和定量调查方法评估医护人员和患者对有效沟通的看法。使用评分量表来衡量患者的挫败感水平和沟通效果。采用开放式问题来反映 ICU 中的沟通障碍、无效沟通的实例以及增强有效沟通的建议。

结果

研究结果表明,非言语患者由于沟通不畅而感到高度挫败。然而,数据显示,获得适当的辅助和替代性沟通(AAC)策略和材料可以帮助减轻患者的挫败感。医护人员主要通过问是/否问题进行沟通,这极大地限制了患者传达的信息,导致频繁出现沟通中断。医护人员表示希望参加培训计划,以使用适当的 AAC 策略并促进有效沟通。

结论

本研究提供了关于 ICU 中患者和医护人员对有效沟通看法的初步调查结果。医护人员和患者都报告在沟通中遇到了挑战和挫折,这是由于提供者的培训经验不足和缺乏 AAC 材料等障碍造成的。需要进行技能培训,以促进重症监护环境中的医患有效沟通。

补充材料

https://doi.org/10.23641/asha.26339623.

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