Australian Critical Care最新文献

{"title":"Sensory processing sensitivity and compassion fatigue in intensive care unit nurses: A chain mediation model","authors":"Jiaqi Shi MM ,&nbsp;Xinmei Cao BS ,&nbsp;Zhi Chen MM ,&nbsp;Xinyue Pang BS ,&nbsp;Danwen Zhuang RN ,&nbsp;Guohua Zhang PhD ,&nbsp;Lijie Mao MM","doi":"10.1016/j.aucc.2024.06.010","DOIUrl":"10.1016/j.aucc.2024.06.010","url":null,"abstract":"<div><h3>Background</h3><div>Compassion among intensive care unit (ICU) nurses is an essential component of humanistic care in the ICU However, the enormous pressures of the job and the lack of social support have led to persistently severe compassion fatigue. Sensory processing sensitivity, as a personality trait for individuals to perceive external factors, has underlying significance for compassion fatigue.</div></div><div><h3>Aims</h3><div>This study aims to investigate the internal and external environmental factors and the underlying mechanisms that influence the impact of sensory processing sensitivity among ICU nurses on the development of compassion fatigue.</div></div><div><h3>Study design</h3><div>A cross-sectional descriptive study was conducted with 290 nurses from various hospitals in five cities in China.</div></div><div><h3>Method</h3><div>A self-designed demographic questionnaire, the Chinese version of the Professional Quality of Life Scale, the Chinese version of the Highly Sensitive Person Scale, the Chinese version of the Perceived Social Support Scale, and the Chinese version of the Perceived Stress Scale were used to survey 290 ICU nurses. The mediating roles of perceived social support and perceived stress between sensory processing sensitivity and compassion fatigue were tested.</div></div><div><h3>Results</h3><div>The research results indicate that the total effect of sensory processing sensitivity on compassion fatigue is significant (0.245 [0.093, 1.160]), whereas the direct effect of sensory processing sensitivity on compassion fatigue is not significant (−0.43 [-0.402, 0.247]). Perceived social support and perceived stress exhibit serial mediating effects between sensory processing sensitivity and compassion fatigue (−0.065 [-0.142, -0.013]).</div></div><div><h3>Conclusion</h3><div>Our results revealed, for the first time, the underlying mechanism between sensory processing sensitivity and compassion fatigue among ICU nurses. Providing necessary stress-relief condition and abundant social support are important measures for nursing managers to reduce compassion fatigue and improve the quality of critical care humanistic nursing services.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 1","pages":"Article 101089"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of Concern: Comparison of different eye care methods to prevent dry eye and corneal ulcer in older critically ill patients: A randomised controlled trial","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 1","pages":"Article 101140"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143162548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review on the effect of telehealth communication with intensive care unit families on patient and family outcomes","authors":"Claire Crossfield MNP, RN ,&nbsp;Guncag Ozavci PhD, MBA, MSc, BPharm ,&nbsp;Robin Digby PhD, RN ,&nbsp;Tracey Bucknall PhD, RN, FAAN","doi":"10.1016/j.aucc.2024.06.013","DOIUrl":"10.1016/j.aucc.2024.06.013","url":null,"abstract":"<div><h3>Background</h3><div>During the Covid-19 pandemic, family visitation to intensive care was severely restricted. In response, family communication moved to remote-only options. The effect on patients and families of this communication change is poorly understood.</div></div><div><h3>Objective</h3><div>The aim of this review was to synthesise the available research on remote-only communication interventions and their effect on patient and family outcomes within the intensive care environment.</div></div><div><h3>Review method used</h3><div>A systematic review of relevant studies was undertaken.</div></div><div><h3>Data sources</h3><div>Databases included CINAHL, APA PsychINFO, MEDLINE, and Ovid Embase.</div></div><div><h3>Review methods</h3><div>Databases were searched with a date restriction of June 1st, 2011, to June 1st, 2023. Two independent reviewers assessed each study using the Mixed Methods Appraisal Tool, version 2 of the Cochrane risk-of-bias tool for randomised controlled trials, and the Risk Of Bias In Nonrandomised Studies of Interventions tool for methodological quality and risk of bias. Of the 2292 articles screened, 10 studies met the inclusion criteria.</div></div><div><h3>Results</h3><div>Ten studies were included (n = 3861). Methodological quality was mostly poor, with one study evaluated as high on Mixed Methods Appraisal Tool quality criteria. Two themes were derived from the literature: (i) patient and family satisfaction; and (ii) patient and family psychological distress symptoms. Five studies reported patient and family satisfaction, with four studies finding statistically significant improvement following the communication intervention. However, only one of the five studies specifically evaluated the satisfaction with the communication intervention. Nine studies reported patient and family psychological distress symptoms, using 12 measurement tools. A variable effect of interventions was found within this theme.</div></div><div><h3>Conclusions</h3><div>This review identified important gaps in the research examining remote-only family communication interventions in intensive care. Inconsistent delivery of remote-only communication interventions, biased research methods, and variable outcome measurement tools impacted the reliability and validity of current evidence. Further research on remote-only communication interventions and the effect on families is recommended.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 1","pages":"Article 101094"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Live music in the intensive care unit—A mixed-methods pilot study exploring the experience and impact of live music played for the adult intensive care patient","authors":"Linette Thorn RN, CCRN, MScN ,&nbsp;Margrethe Langer Bro PhD ,&nbsp;Trine Højfeldt Lund RN, CCRN ,&nbsp;Pia Dreyer RN, PhD","doi":"10.1016/j.aucc.2024.07.077","DOIUrl":"10.1016/j.aucc.2024.07.077","url":null,"abstract":"<div><h3>Background</h3><div>Evidence for music's beneficial effect on physical and mental disorders is mounting. Intensive care unit (ICU) patients experience multiple uncomfortable symptoms, which may be alleviated using a music-based intervention. Few studies have examined the experience and the physical impact of patient-tailored live music offered by trained health musicians in an adult ICU.</div></div><div><h3>Aims</h3><div>This study aimed to explore the experience of live music in adult patients admitted to an ICU, focusing on its effects on relaxation, stress, and pain.</div></div><div><h3>Study design</h3><div>A pilot study with a convergent mixed-methods design. A total of 27 intensive care patients at a Danish University Hospital were offered patient-tailored live music by trained musicians in a single-session design. We performed participant observation and conducted patient interviews using an observational and semistructured interview guide. These data were supported by quantitative pre-post measurements of heart rate, respiration rate, mean arterial blood pressure, subjective pain experience, and heart-rate variability. The study was conducted from February 2020 to December 2021.</div></div><div><h3>Findings</h3><div>Using a Ricoeur-inspired analysis of observations and interviews, we elicited four themes: <em>‘A break where you can swim away and relax’, ‘The living presence makes the play unique’, ‘Happy memories of the past and longing for home’</em>, and <em>‘An intense and meaningful experience’</em>. The quantitative analysis showed a significant decrease in heart rate (4.33 bpm, p &lt; 0.02), respiration rate (2.93, p &lt; 0.001), and blood pressure (3.30, p &lt; 0.05) and a significant increase in heart-rate variation (−0.22, p &lt; 0.01). Seven patients reported pain reduction after the music intervention, corresponding to a 24% reduction.</div></div><div><h3>Conclusion</h3><div>Live music contributes to meaningful moments by bringing elements of everyday life into the ICU and may promote relaxation and reduce stress and pain.</div></div><div><h3>Relevance to clinical practice</h3><div>Our findings indicate that live music is a nonpharmacological experience that creates meaningful moments for critically ill patients.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 1","pages":"Article 101092"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients' and relatives' experiences of cognitive impairment following an intensive care unit admission. A qualitative study","authors":"Anette Bjerregaard Alrø RN, MScN ,&nbsp;Helle Svenningsen CCN, MCN, PhD ,&nbsp;Helene Korvenius Nedergaard MD, PhD ,&nbsp;Hanne Irene Jensen CCN, MScN, PhD ,&nbsp;Pia Dreyer RN, MScN, PhD","doi":"10.1016/j.aucc.2024.05.004","DOIUrl":"10.1016/j.aucc.2024.05.004","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive impairment poses a significant challenge following critical illness in the intensive care unit. A knowledge gap exists concerning how patients experience cognitive impairments.</div></div><div><h3>Objectives</h3><div>The aim was to explore patients' and relatives' experiences of patients' cognitive impairment due to critical illness following an intensive care unit admission.</div></div><div><h3>Methods</h3><div>A qualitative multicentre study was conducted in Denmark with 3- and 6-month follow-ups using single and dyadic interviews. A phenomenological hermeneutic approach was adopted using a Ricoeur-inspired textual in-depth analysis method. The Consolidated Criteria for Reporting Qualitative Research checklist was used.</div></div><div><h3>Results</h3><div>Three themes emerged from interviews with 18 patients and 14 relatives: 'It feels like living in a parallel world', 'Getting back to a normal everyday life with a vulnerable self', and 'Managing everyday life using self-invented strategies'. Patients used self-invented strategies to manage their vulnerability and newly acquired cognitive impairments when no help or support was provided specifically targeting their cognitive impairments. Not being as cognitively capable as they previously had been turned their lives upside down. Losing control and not being themselves made them vulnerable. Patients did not want to burden others. However, support from relatives was invaluable in their recovery and rehabilitation.</div></div><div><h3>Conclusions</h3><div>Patients experienced multiple cognitive impairments affecting their adaption to everyday life. They strove to overcome their vulnerability using a variety of self-invented strategies and activities.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 1","pages":"Article 101067"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The development of a family-led novel intervention for delirium prevention and management in the adult intensive care unit: A co-design qualitative study","authors":"Gideon U. Johnson RN, MSN ,&nbsp;Amanda Towell-Barnard RN, PhD ,&nbsp;Christopher McLean RN, PhD ,&nbsp;Beverley Ewens RN, PhD","doi":"10.1016/j.aucc.2024.07.076","DOIUrl":"10.1016/j.aucc.2024.07.076","url":null,"abstract":"<div><h3>Aim</h3><div>The aim of this study was to codesign a Family Members’ Voice Reorientation Intervention (FAMVR) for delirium prevention and management in critically ill adult patients through collaborative process with previous patients, families, and clinical staff.</div></div><div><h3>Background</h3><div>Delirium is a common consequence of intensive care admission, and there is limited evidence to support family-led interventions to prevent or minimise delirium in intensive care. People with lived experience of intensive care are seldom involved in codesigning delirium prevention and management interventions despite the identified benefits of their involvement in delirium care.</div></div><div><h3>Design</h3><div>Codesign qualitative study.</div></div><div><h3>Methods</h3><div>The process of co-designing was undertaken using the four stages of the Double Diamond model. Participants included people with lived experience of the intensive care unit, family members, and intensive care clinicians. The codesign approach was utilised, and data were gathered from a series of focus groups and individual interviews. Data were digitally recorded, transcribed verbatim, and analysed using thematic analysis.</div></div><div><h3>Findings</h3><div>Of the 26 people who indicated their interest in participating, 12 (46%) completed the first and second stages, and nine (35%) completed the third and fourth stages of the Family Members’ Voice Reorientation Intervention development. All participant groups were represented in the fourth stage: patients (n = 4), family members (n = 1), nurses (n = 2), and medical staff (n = 2). Four themes were identified: message content, wording, reactions, and tone, all of which informed the prototype of the intervention and its associated domains.</div></div><div><h3>Conclusion</h3><div>A codesign approach was important for developing a delirium management intervention. This process enabled participants to provide their feedback in the context of their unique experiences, which in turn enhanced the authenticity and appropriateness of this unique intervention.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 1","pages":"Article 101088"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurses’ perceptions of patient pain, delirium, and sedation assessments in the intensive care unit: A qualitative study","authors":"Anu Correya RN, MScNurs ,&nbsp;Helen Rawson RN, PhD ,&nbsp;Cherene Ockerby BA (Hons) ,&nbsp;Alison M. Hutchinson RN, PhD","doi":"10.1016/j.aucc.2024.05.013","DOIUrl":"10.1016/j.aucc.2024.05.013","url":null,"abstract":"<div><h3>Background</h3><div>Pain, delirium, and sedation should be assessed routinely using validated assessment scales. Inappropriately managed pain, delirium, and sedation in critically ill patients can have serious consequences regarding mortality, morbidity, and increased healthcare costs. Despite the benefits of a bundled approach to pain, delirium, and sedation assessments, few studies have explored nurses' perceptions of using validated scales for such assessments. Furthermore, no studies have examined nurses’ perceptions of undertaking these assessments as a bundled approach.</div></div><div><h3>Objectives</h3><div>The objective of this study was to explore nurses’ knowledge, perceptions, attitudes, and experiences regarding the use of validated pain, delirium, and sedation assessment tools as a bundled approach in the intensive care unit (ICU).</div></div><div><h3>Methods</h3><div>A qualitative exploratory descriptive design was adopted. We conducted four focus groups and 10 individual interviews with 23 nurses from a 26-bed adult ICU at an Australian metropolitan tertiary teaching hospital. Data were analysed using thematic analysis techniques.</div></div><div><h3>Findings</h3><div>Four themes were identified: (i) factors impacting nurses' ability to undertake pain, delirium, and sedation assessments in the ICU; (ii) use, misuse, and nonuse of tools and use of alternative strategies to assess pain, delirium, and sedation; (iii) implementing assessment tools; and (iv) consequences of suboptimal pain, delirium, and sedation assessments. A gap was found in nurses’ use of validated scales to assess pain, delirium, and sedation as a bundled approach, and they were not familiar with using a bundled approach to assessment.</div></div><div><h3>Conclusion</h3><div>The practice gap could be addressed using a carefully planned implementation strategy. Strategies could include a policy and protocol for assessing pain, delirium, and sedation in the ICU, engagement of change champions to facilitate uptake of the strategy, reminder and feedback systems, further in-service education, and ongoing workplace training for nurses.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 1","pages":"Article 101076"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutrition intake, muscle thickness, and recovery outcomes for critically ill patients requiring non-invasive forms of respiratory support: A prospective observational study","authors":"Elizabeth Viner Smith BND (Hons) ,&nbsp;Matthew J. Summers BSc, MDiet ,&nbsp;Imogen Asser BHlthMedSc ,&nbsp;Rhea Louis BMedSc (Hons) ,&nbsp;Kylie Lange BSc Ma&CompSci (Hons) ,&nbsp;Emma J. Ridley BNutrDiet, PhD ,&nbsp;Lee-anne S. Chapple BMedSc, MNutrDiet, PhD","doi":"10.1016/j.aucc.2024.07.078","DOIUrl":"10.1016/j.aucc.2024.07.078","url":null,"abstract":"<div><h3>Background</h3><div>Use of high-flow nasal cannula (HFNC) and non-invasive ventilation (NIV) in the intensive care unit (ICU) is increasing, yet reporting of nutrition intake, muscle thickness, or recovery outcomes in this population is limited.</div></div><div><h3>Objective</h3><div>The objective of this study was to quantify muscle thickness, nutrition intake, and functional recovery outcomes for patients receiving HFNC/NIV within the ICU.</div></div><div><h3>Methods</h3><div>A single-centre, prospective, observational study in adult ICU patients recruited within 48 hrs of commencing HFNC/NIV. Change in quadriceps muscle layer thickness using ultrasound (primary outcome) and 24 hr nutrition intake from study inclusion to day 7 (D7), functional capacity (Barthel Index), and quality of life (EuroQol five-dimension five-level utility index) at D90 were assessed. Data are <em>n</em> (%), mean ± standard deviation or median [interquartile range], are compared using paired sample t-test, and a <em>P</em> value of &lt;0.05 was considered significant.</div></div><div><h3>Results</h3><div>Primary outcome data were available for <em>n</em> = 28/42: 64 ± 13 y, 61% male, body mass index: 29.1 ± 9.0 kg/m², and Acute Physiology and Chronic Health Evaluation II score: 17 ± 5. Quadriceps muscle layer thickness reduced from 2.41 ± 0.87 to 2.12 ± 0.73 cm; mean difference: −0.29 cm (95% confidence interval: -0.44, −0.13). Nutrition intake increased from study inclusion to D7: 1735 ± 1283 to 5448 ± 2858 kJ and 17.4 ± 16.6 to 60.9 ± 36.8g protein. Barthel Index was 87 ± 20 at baseline and 91 ± 15 at D90 (out of 100). Quality of life was impaired at D90: 0.64 ± 0.23 (health = 1.0).</div></div><div><h3>Conclusion</h3><div>Critically ill patients receiving HFNC/NIV experienced muscle loss and impaired quality of life.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 1","pages":"Article 101097"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of different mouthwashes on ventilator-related outcomes and mortality in intensive care unit patients: A network meta-analysis","authors":"Qianqian He BSc(Nurs) ,&nbsp;Zengjin Peng MSc(Nurs) ,&nbsp;Caiyun He RN ,&nbsp;Chao Zhang BSc(Nurs) ,&nbsp;Rong Hu BSc(Nurs)","doi":"10.1016/j.aucc.2024.06.014","DOIUrl":"10.1016/j.aucc.2024.06.014","url":null,"abstract":"<div><h3>Background</h3><div>Ventilator-associated pneumonia is a common and life-threatening complication in intensive care unit (ICU) patients. Maintaining oral hygiene is crucial for reducing ventilator-associated pneumonia incidence. Various mouthwash solutions are used for oral care in ICU settings, but their comparative effectiveness remains unclear. This study aims to systematically evaluate and compare the efficacy and safety of commonly used mouthwashes for oral care in mechanically ventilated ICU patients.</div></div><div><h3>Methods</h3><div>We searched PubMed, Web of Science, Embase, and Cochrane Library for randomised controlled trials (RCTs) comparing saline, chlorhexidine, sodium bicarbonate, oxidising agents, herbal extracts, and povidone-iodine for oral care in ventilated ICU patients. Outcomes included ventilator-associated pneumonia incidence, ICU mortality, duration of ventilation, and <em>Escherichia coli</em> fixed value. A network meta-analysis (NMA) was conducted to synthesise direct and indirect evidence. This study is registered with the International Platform of Registered Systematic Review and Meta-analysis Protocols, 2023120028.</div></div><div><h3>Results</h3><div>FourteenRCTs with 1644 participants were included. Oxidising agents showed a trend towards reducing the incidence of VAP compared to the control group (risk ratio: 0.24, 95% confidence interval: 0.05–1.10). Administration of saline was associated with a notable reduction in ICU mortality (risk ratio: 0.18, 95% confidence interval: 0.04–0.88) versus no mouthwash. No significant differences were observed in the duration of mechanical ventilation between chlorhexidine, povidone-iodine, and the control group.</div></div><div><h3>Conclusions</h3><div>Antimicrobial mouthwashes, especially chlorhexidine, pose potential risks in ICU patients; oxidising solutions demonstrate relative safety. Saline solution emerges as a promising alternative, associated with a significant reduction in mortality rates. However, the need for large, high-quality RCTs remains paramount to substantiate these findings and establish evidence-based oral-care protocols in ICU settings.</div></div><div><h3>Registration</h3><div>This study is registered with the International Platform of Registered Systematic Review and Meta-analysis Protocols, 2023120028.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 1","pages":"Article 101095"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness, experience, and usability of low-technology augmentative and alternative communication in intensive care: A mixed-methods systematic review","authors":"Hissah A. Alodan OT, MSc ,&nbsp;Anna-Liisa Sutt MSPA, CPSP, PhD ,&nbsp;Rebekah Hill RGN, MSc, MA, PhD ,&nbsp;Joud Alsadhan OT, MSc ,&nbsp;Jane L. Cross Grad Dip Phys, MSc, EdD","doi":"10.1016/j.aucc.2024.04.006","DOIUrl":"10.1016/j.aucc.2024.04.006","url":null,"abstract":"<div><h3>Background</h3><div>Patients in the intensive care unit (ICU) are commonly on mechanical ventilation, either through endotracheal intubation or tracheostomy, which usually leaves them nonverbal. Low-technology augmentative and alternative communication (AAC) strategies are simple and effective ways to enhance communication between patients and their communication partners but are underutilised.</div></div><div><h3>Aim</h3><div>The aim of this study was to systematically review current evidence regarding the effectiveness, experience of use, and usability of low-technology AAC with nonverbal patients and their communication partners in the ICU.</div></div><div><h3>Methods</h3><div>This review included quantitative, qualitative, and mixed-methods studies of adult ICU patients aged 18 or older who were nonverbal due to mechanical ventilation and their communication partners. Studies using low-technology AAC, such as communication boards and pen and paper, were included. Six databases were searched, and the review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A convergent segregated approach was used for data synthesis.</div></div><div><h3>Results</h3><div>Thirty-two studies were included. Low-technology AAC improved patient satisfaction, facilitated communication, and met patients' physical and psychological needs. Communication boards with mixed content (e.g., pictures, words, and letters) were preferred but were used less frequently than unaided strategies due to patients' medical status, tool availability, and staff attitudes. Boards should be user-friendly, tailored, include pen/paper, and introduced preoperation to increase patient's comfort when using them postoperatively.</div></div><div><h3>Conclusion</h3><div>Existing evidence support low-technology AAC's efficacy in meeting patients' needs. Better usability hinges on proper implementation and addressing challenges. Further research is crucial for refining communication-board design, ensuring both user-friendliness and sophistication to cater to ICU patients' diverse needs.</div></div><div><h3>Registration</h3><div>The review protocol was registered in the International Prospective Register of Systematic Reviews, with registration number CRD42022331566.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 1","pages":"Article 101061"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}