Quality of nurses’ communication with mechanically ventilated patients in a cardiac surgery intensive care unit
Objective. To describe the quality of the relationship between nurses and patients under mechanical ventilation.
Methods. This observational study, performed in a cardiac surgery intensive care unit in Iran, selected 10 nurses and 35 patients through simple random and convenience sampling, respectively. One of the researchers observed 175 communications between nurses and patients in different work shifts and recorded the results according to a checklist. Nurse and patient satisfaction with the communication was assessed by using a six-item Likert scale, 8 to 12 h after extubation.
Results. Most of the patients were male (77.1%), while most of the nurses were female (60%). Patients started over 75% of the communications observed. The content of the communication was related mostly to physical needs and pain. Besides, the majority of patients used purposeful stares and hand gestures, and head nod for communication. Most of the communications between patients and nurses were satisfied ‘very low’ (45.7% in nurses, versus 54.3% in patients). However, ‘complete satisfaction’ was lower in nurses (0%), compared with patients (5.7%). No statistically significant correlation was found between patients’ and nurses’ satisfaction and demographic variables.
Conclusion. The results showed that communication between nurses and mechanically ventilated patients was built through traditional methods and was based on the patients’ requests. This issue might be the cause of an undesirable level of their satisfaction with the communication, given that effective communication can lead to understanding and meeting the needs of the patients.
How to cite this article: Momennasab M, Ardakani MS, Rad FD, Dokoohaki R, Dakhesh R, Jaberi A. Quality of Nurses’ Communication with Mechanically Ventilated Patients in a Cardiac Surgery Intensive Care Unit. Invest. Educ. Enferm. 2019; 37(2):e02.
(1) Felce D, Perry J. Quality of Life: Its Definition and Measurement. Res. Dev. Disabil. 1995; 16(1):51-74.
(2) Khalaila R, Zbidat W, Anwar K, Bayya A, Linton DM, Sviri S. Communication difficulties and psychoemotional distress in patients receiving mechanical ventilation. Am. J. Crit. Care. 2011; 20(6):470-9.
(3) Wang Y, Li H, Zou H, Li Y. Analysis of complaints from patients during mechanical ventilation after cardiac surgery: a retrospective study. J. Cardiothorac. Vasc. Anesth. 2015; 29(4):990-4.
(4) Myhren H, Ekeberg O, Stokland O. Satisfaction with communication in ICU patients and relatives: comparisons with medical staffs’ expectations and the relationship with psychological distress. Patient Educ. Couns. 2011; 85(2):237-44.
(5) Marasinghe M, Fonseka W, Wanishri P, Nissanka N, Silva B. An Exploration of Patients’ Experiences of Mechanical Ventilation. OUSL J. 2015; 9:83-96.
(6) Flinterud SI, Andershed B. Transitions in the communication experiences of tracheostomised patients in intensive care: a qualitative descriptive study. J. Clin. Nurs. 2015; 24(15-16):2295-304.
(7) Sutt A-L, Cornwell P, Mullany D, Kinneally T, Fraser JF. The use of tracheostomy speaking valves in mechanically ventilated patients results in improved communication and does not prolong ventilation time in cardiothoracic intensive care unit patients. J. Crit. Care. 2015; 30(3):491-4.
(8) Happ MB, Seaman JB, Nilsen ML, Sciulli A, Tate JA, Saul M, et al. The number of mechanically ventilated ICU patients meeting communication criteria. Heart Lung. 2015; 44(1):45-9.
(8) Happ MB, Sereika SM, Houze MP, Seaman JB, Tate JA, Nilsen ML, et al. Quality of care and resource use among mechanically ventilated patients before and after an intervention to assist nurse-nonvocal patient communication. Heart Lung.2015; 44(5):408-15.
(10) Alasad J, Ahmad M. Communication with critically ill patients. Journal of advanced nursing. 2005; 50(4):356-62.
(11) Sabet Sarvestani R, Moattari M, Nasrabadi AN, Momennasab M, Yektatalab S. Challenges of nursing handover: A qualitative study. Clin. Nurs. Res. 2015; 24(3):234-52.
(12) Anderson WG, Puntillo K, Boyle D, Barbour S, Turner K, Cimino J, et al. ICU Bedside Nurses' Involvement in Palliative Care Communication: A Multicenter Survey. J. Pain Symptom Manage. 2016; 51(3):589-96.
(13) Otuzoğlu M, Karahan A. Determining the effectiveness of illustrated communication material for communication with intubated patients at an intensive care unit. Int. J. Nurs. Pract. 2014; 20(5):490-8.
(14) Jarvis C, Forbes H, Watt E. Jarnis's physical examination & health assessment. Sydney: Saunders Elsevier Australia; 2012.
(15) Karlsson V, Forsberg A, Bergbom I. Communication when patients are conscious during respirator treatment—A hermeneutic observation study. Intensive Crit. Care Nurs. 2012; 28(4):197-207.
(16) Shafipour V, Mohammad E, Ahmadi F. Barriers to Nurse-Patient Communication in Cardiac Surgery Wards: A Qualitative Study. Glob. J. Health Science. 2014; 6(6):234-44.
(17) Arabi A, Tavakol K. Patient's experiences of mechanical ventilation. Iran. J. Nurs. Midwifery Res. 2009; 14(2).
(18) Taylor RC, Lillis C, LeMone P. Fundamentals of Nursing: The Art and Science of Nursing Care. Philadelphia: Lippincott Williams & Wilkins; 2010.
(19) Chahraoui K, Laurent A, Bioy A, Quenot J-P. Psychological experience of patients 3 months after a stay in the intensive care unit: A descriptive and qualitative study. J. Crit. Care. 2015; 30(3):599-605.
(20) Happ MB, Garrett K, Thomas DD, et al. Nurse-patient communication interactions in the intensive care unit. American J. Crit. Care..2011; 20(2):e28-e40.
(21) Tadrisi S, Madani S, Farmand F, Ebadi A, KarimiZarchi AA, Mirhashemi S, et al. Richmond agitation–sedation scale validity and reliability in intensive care unit adult patients Persian version. J. Crit. Care. Nurs. 2009; 2(1):15-21.
(22) Teasdale G, Jennett B. Assessment of coma and impaired consciousness: a practical scale. Lancet. 1974; 304(7872):81-4.
(23) Nilsen ML, Sereika SM, Hoffman LA, Barnato A, Donovan H, Happ MB. Nurse and Patient Interaction Behaviors’ Effects on Nursing Care Quality for Mechanically Ventilated Older Adults in the ICU. Res. Gerontol. Nurs. 2014; 7(3):113-25.
(24) Gold RL. Roles in sociological field observations. Soc. Forces. 1958:217-23.
(25) Gashmard R, Bagherzadeh R, Pouladi Sh, Akaberuan S, Jahanor F. Evaluating the Factors Influencing Productivity of Medical Staff in Hospitals Affiliated Bushehr University of Medical Sciences 2012, Bushehr, Iran. World Appl. Sci. J. 2013; 28(12):2061-8.
(26) Magnus VS, Turkington L. Communication interaction in ICU—patient and staff experiences and perceptions. Intensive Crit. Care Nurs. 2006; 22(3):167-80.
(27) SabetSarvestani R, Moattari M, Nasrabadi AN, Momennasab M, Yektatalab S, Jafari A. Empowering nurses through action research for developing a new nursing handover program in a pediatric ward in Iran. Action Res. 2017; 15(2):214-35.
(28) Momennasab M, Ghahramani T, Yektatalab S, Zand F. Physical and Mental Health of Patients Immediately After Discharge From Intensive Care Unit and 24 Hours Later. Trauma Mon. 2016; 21(1):e29231.
(29) Hedayati E, Hazrati M, Momennasab M, et al. The effect of need-based spiritual/religious intervention on spiritual well-being and anxiety of elderly people. Holist. Nurs. Pract. 2015; 29(3):136-43.
(30) Balandin S, Hemsley B, Sigafoos J, Green V. Communicating with nurses: The experiences of 10 adults with cerebral palsy and complex communication needs. Appl. Nurs. Res. 2007; 20(2):56-62.
(31) Happ MB, Tuite P, Dobbin K, DiVirgilio-Thomas D, Kitutu J. Communication ability, method, and content among nonspeaking nonsurviving patients treated with mechanical ventilation in the intensive care unit. Am. J. Crit. Care. 2004; 13(3):210-8.
(32) Happ MB, Garrett KL, Tate JA, DiVirgilio D, Houze MP, Demirci JR, et al. Effect of a multi-level intervention on nurse–patient communication in the intensive care unit: results of the SPEACS trial. Heart Lung. 2014; 43(2):89-98.
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