Enhancing the Communication of Suddenly Speechless Critical Care Patients

Abstract

Background Sudden speechlessness is common in critically ill patients who are intubated or have had surgery for head and neck cancer. Sudden inability to speak poses challenges for hospitalized patients because strategies to facilitate communication are often limited and unreliable. Objective To determine the impact of a technology-based communication intervention on patients’ perception of communication difficulty, satisfaction with communication methods, and frustration with communication. Methods A quasi-experimental, 4-cohort (control and intervention) repeated-measures design was used. Data were collected daily for up to 10 days. Patients in adult critical care units were followed up as they were transferred to other units within the institutions selected for the study. The impact of a technology-based communication system (intervention) was compared with usual care (control). Patients’ communication outcomes pertinent to communication with nursing staff that were evaluated included perception of communication ease, satisfaction with methods used for communication, and frustration with communication. Results Compared with participants in the control group, participants in the intervention group reported lower mean frustration levels (−2.68; SE, 0.17; 95% CI, −3.02 to −2.34; P < .001) and higher mean satisfaction levels (0.59; SE, 0.16; 95% CI, 0.27 to 0.91; P < .001) with use of the communication intervention. Participants in the intervention group reported a consistent increase in perception of communication ease during the hospital stay. Conclusions The results facilitated evaluation of a bedside technology-based communication intervention tailored to the needs of suddenly speechless critically ill patients.