Rojo-Rojo Andrés, Martínez-Abril José Eugenio, Muñoz-Rubio Gloria María, Iniesta-Cortés Paloma, Cánovas-Pallarés Juan Manuel
Intensive Care Unit, Virgen de la Arrixaca Universitary Hospital, Public Murcian Health Service, 30120 Murcia, Spain.
Faculty of Nursing, Catholic University of Murcia (UCAM), 30107 Murcia, Spain.
Healthcare (Basel). 2025 Feb 12;13(4):398. doi: 10.3390/healthcare13040398.
Effective communication in critical care is crucial, particularly with the constraints of Personal Protective Equipment (PPE). This study aimed to evaluate speech intelligibility under varying conditions of distance, ambient noise, and PPE types in a simulated ICU. A quasi-experimental design was used with 23 participants in 24 scenarios, combining three distances (1, 2, and 5 m), two noise levels (quiet and ICU-like), and four PPE types (no mask, surgical mask, N95, and PAPR). Speech intelligibility was assessed by positioning the subjects at varying distances while playing phonetically balanced words through a playback device equipped with the different PPE being tested. The evaluation was conducted under two sound conditions (25 dB(A) and 45 dB(A)). The percentage of correct responses by the subjects to the perceived sounds was determined as a measure of intelligibility. The relation between variables was analyzed using the Wilcoxon Test and the Friedman Test. Significant differences in word recognition were observed across conditions. Ambient noise reduced intelligibility, with recognition percentages significantly lowering in noisy environments. PPE type also influenced comprehension, with PAPR posing the greatest challenge. Friedman's test showed that increasing distance significantly decreased recognition accuracy. Distances beyond two meters negatively impacted intelligibility across all devices tested. In noisy conditions (>45 dB(A)), a combination of distances greater than two meters and PPE use reduced intelligibility by over 40%, potentially compromising patient safety. The use of communication aids, such as visual cues or alternative speech devices, is recommended, particularly with PAPRs, to enhance comprehension and ensure effective communication between healthcare providers and patients.
重症监护中的有效沟通至关重要，尤其是在个人防护装备（PPE）的限制下。本研究旨在评估模拟重症监护病房中不同距离、环境噪声和PPE类型条件下的语音清晰度。采用准实验设计，23名参与者参与24种场景，结合三种距离（1米、2米和5米）、两种噪声水平（安静和类似重症监护病房的噪声）以及四种PPE类型（不戴口罩、外科口罩、N95口罩和动力空气净化呼吸器）。通过将受试者置于不同距离，同时通过配备正在测试的不同PPE的回放设备播放语音平衡的单词来评估语音清晰度。评估在两种声音条件（25 dB(A)和45 dB(A)）下进行。确定受试者对感知声音的正确反应百分比作为清晰度的衡量标准。使用Wilcoxon检验和Friedman检验分析变量之间的关系。在不同条件下观察到单词识别存在显著差异。环境噪声会降低清晰度，在嘈杂环境中识别百分比显著降低。PPE类型也会影响理解，动力空气净化呼吸器带来的挑战最大。Friedman检验表明，距离增加会显著降低识别准确率。超过两米的距离对所有测试设备的清晰度都有负面影响。在嘈杂条件（>45 dB(A)）下，大于两米的距离和使用PPE的组合会使清晰度降低超过40%，这可能会危及患者安全。建议使用沟通辅助工具，如视觉提示或替代语音设备，尤其是在使用动力空气净化呼吸器时，以提高理解并确保医护人员与患者之间的有效沟通。
