Communication difficulties in mechanically ventilated voiceless patients in intensive care units: A qualitative study.
Sara Brambilla, Davide Ausili, Giulia Locatelli and 3 others
PMID 40181753WHAT IT FOUND
In intensive care, conscious patients who cannot speak because of tubes often could not be understood.
Participants linked this to distress, isolation, care that missed needs, and medications or restraints for agitation.
Key findings
01All groups reported negative emotions when they could not communicate or understand each other.
02After repeated unsuccessful communication attempts, participants reported fatigue and anger and stopped trying, and patients described isolating themselves.
03Health care professionals said not understanding voiceless patients increased the likelihood of inadequate care and could lead to medications or restraints for agitated patients.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample came from one Italian hospital, so experiences may not match other ICUs. The interviews happened during the COVID-19 pandemic, when family visits were partly restricted, which may have shaped family involvement and communication. Patients were excluded if they had psychiatric conditions or did not remember their ICU stay, so the findings do not cover those patients. The study reported experiences and themes, not tested outcomes, so it cannot show that any communication strategy improves care.
Declared interests
One author, Prof. Giacomo Bellani, declared equities in DICO Technologies SRL. The other authors declared no conflict of interest.
The easy way to misread this
Do not treat this as proof that communication training or aids reduce missed care or overtreatment. The study described experiences and did not test any intervention.