Which alternative communication methods are effective for voiceless patients in Intensive Care Units? A systematic review

Abstract

There is preliminary, but inconsistent evidence that AAC strategies are effective in improving patient satisfaction with communication and reducing difficulties in communication. A lack of comparable studies precluded the identification of the most effective AAC strategy.

The work undertaken by mechanically ventilated patients in Intensive Care: A qualitative meta-ethnography of survivors’ experiences

“…Re-orientating patients to time and space and encouraging patient autonomy no matter how small could help to reduce feelings of alienation. Using familiar objects to make the environment less hostile, promoting a normal circadian rhythm through reduced lighting and the minimisation of disruptions during night hours (Kamdar et al, 2013), and using technology to augment communication (Carruthers et al, 2017) are strategies that could facilitate patient work during 'alienation'. This reorientation could allow patients to undertake more accurate 'biographical work' that have been previously distorted.…”

“…Patients cared for in Intensive Care Units do not usually have the opportunity to provide direct feedback on their experiences of care processes. More often than not they are unable to communicate as they are sedated and ventilated rendering them unable to verbally communicate their care needs and preferences (Carruthers et al, 2017). Therefore, we have rather limited information about the patient experience of Intensive Care Unit care processes which represents an obstacle to both person-centred care and quality improvement initiatives.…”

Communication with patients in intensive care units: a scoping review

“…Carruthers et al . () also highlighted such comparisons as a possible avenue for further research. Both Carruthers et al .…”

“…Both Carruthers et al . ( ) and Ten Hoorn et al . () stated that, although a reasonable amount of studies has been performed, there is still a need for further evidence in the field.…”

“…Several other reviews have examined the effectiveness of communication aids (Ten Hoorn et al, ; Carruthers et al, ) or have described patients' individual experiences of being ICU patients (Carroll, ; Cutler et al, ; Baumgarten and Poulsen, ; Egerod et al, ). To the best of our knowledge, no scoping reviews to date have described the interaction between ICU patients and health care personnel.…”