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Identifier 000438872
Title Επικοινωνία στη ΜΕΘ αξιολόγηση μιας εναλλακτικής μεθόδου επικοινωνίας σε διασωληνωμένους ασθενείς
Alternative Title Communication in ICU efficacy of an alternative method to improve communication with intubated patients"
Author Μαραγκάκη, Καλλιόπη
Thesis advisor Κονδύλη, Ευμορφία
Reviewer Μπριασούλης, Γεώργιος
Ηλία, Σταυρούλα
Abstract Background Communication is the process of exchanging information between two or more members and involves the exchange of thoughts, messages, feelings through speech, image, writing and behavior and It is distinguished into verbal and non-verbal communication. Communication between patient and nursing staff is a key factor in the quality of health care provided. Patients admitted to the Intensive Care Unit (ICU) often suffer from serious diseases and are intubated in mechanical ventilation, with inability to speak and communicate. Studies have shown that patients who are unable to communicate their needs show high rates of frustration, psychological burden and post-traumatic stress. On the contrary, the degree of patient satisfaction depends to a large extent on communication. The challenge is to find and utilize in daily clinical practice the application of the appropriate communication tool for the seriously ill. Studies show that the use of an alternative means of communication, in case the patient is in mechanical support of the breath, facilitates communication and helps to reduce his levels of stress and anxiety (2), in order to achieve the best possible outcome. Objective The main objective of the study is the systematic review of available data through research that has been carried out so far and concerns the use of alternative media in intubated and / or mechanically ventilated patients, who can communicate. The possibilities, perceptions and obstacles in communication with alternative methods and modern means will be studied, in order to suggest applicable ways and tactics for more effective communication with these patients. A secondary goal is a pilot study of the number of patients in the ICU of the University Hospital of Heraklion (PAGNI) Crete to study and measure their satisfaction in communication that can provide an illustrated laminated table of needs and desires and the use of the same illustrated table. Methods This is a retrospective review of published studies, articles and systematic reviews from 2003 to date, with data searched by search engines, PubMed, GoogleScholar and Medline. The pilot study included ICU PAGNI patients intubated (July-December 2020) as long as they were able to communicate, not necessarily to speak. Demographic, clinical and laboratory data, cause of admission, severity of disease, medication, delirium (CAM-ICU) and final outcome were recorded. In the patients who were finally included, methods of oral communication (verbal) and nods were applied as well as non-verbal communication with an illustrated laminated table of needs and desires as well as with the same illustrated table in electronic form in the form of a tablet. Satisfaction was assessed directly with questions and answers on the LIKERT scale (Not at all-A little- Moderate-Very-Very Much). Results The retrospective review identified 38 articles, 7 of which met the criteria. These studies highlighted alternative modes of communication such as communication cards, standard illustrated tables, interactive devices with computers, and "Eye-tracking" technology with eye-tracking techniques. Despite the small number of patients participating in all studies, greater patient satisfaction, reduction of stress and pain, positive response from nursing staff and opportunities for training and learning systems emerged. The pilot study involved 14 ICU patients (10 men, 4 women) of whom 8 patients were diagnosed with COVID-19. 78.6% expressed the wish "I want", 50% "asked for water", 14% "wanted the pipe to come out" and 14% asked "where am I". Patients' satisfaction with the use of the tool was very good in questions / needs "I want" and moderate or a little in issues "I feel", "I speak", "I am hungry" (p = 0.011). The degree of satisfaction between Covid-19 and non-Covid-19 patients did not differ (p = 0.307) and showed high rates of high satisfaction "Very" with the use of the tool (75%) compared to the non-use of the tool (60% ). Conclusion Understanding and meeting the needs of intubated ICU patients leads to greater patient satisfaction resulting in reduced stress, better outcome and high quality health care. The ways of communication can be simple conventional and alternative with the use of technology. The individualization of the patient's needs will also determine the adapted use of the means of communication. The specialized training of the nurse that provides direct care to the patient and the patient himself contributes significantly to the full utilization of alternative media for the holistic and effective provision of high quality health care.
Language Greek
Subject Mechanical ventilation
Nurse patient relation
Μηχανικός αερισμός
Σχέσεις νοσηλευτή ασθενή
Issue date 2021-03-29
Collection   School/Department--School of Medicine--Department of Medicine--Post-graduate theses
  Type of Work--Post-graduate theses
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