Communication ; Patient-centered care ; Critical illness ; Artificial airway ; Review
Abstract
The aim of this integrative review was to describe communication experiences and needs among the
critically ill with an artificial airway and evaluate relevant intervention studies. Methods : Using the method
employed by Whittemore and Knafl (2005), we searched for papers on PubMed, CINAHL, and Web of Science
published from January 1, 2015 to September 25, 2020. A total of 26 papers (11 descriptive studies, 15 experimental
ones) were identified and evaluated. Results : Communication experiences while having an artificial airway, identified
either by patients’ recall or direct observation, were predominantly negative. However, positive experiences were
reported in patients with improvements in physical conditions and functions. Patients’ communication needs
were diverse, encompassing physical, psycho-emotional, social, spiritual, and medical issues. Interventions tested
included alternative and augmentative communication strategies, communication intervention packages, and voice
restorative devices. Physical, psychosocial, and communication-related patient outcomes were evaluated using
various methods including self-report surveys, interviews, and observations. Conclusions : The findings from
this review represent the state of science regarding communication of the critically ill whose vocal abilities are
inhibited by the presence of an artificial airway. Future studies with rigorous experimental designs and measures
are warranted to better understand and support the complex needs of this highly vulnerable patient population