护士与重症监护室机械通气患者的沟通:伞式回顾

Aim To conduct a review summarizing evidence concerning communication with mechanically ventilated patients in the intensive care unit (ICU). Background ICU patients undergoing mechanical ventilation are unable to communicate verbally, causing many negative emotions. Due to changes in sedation practice, a growing number of patients are conscious and experience communication difficulties. Design The umbrella review method guided by the Joanna Briggs Institute was applied. Data Sources A systematic search was done in the Cochrane Library, the Joanna Briggs Institute database, Cinahl, Pubmed, PsycINFO and Scopus between January ‐April 2019. Search terms were ‘nurse‐patient communication’, ‘mechanical ventilation’, ‘intensive care’, and ‘reviews as publication type’. Literature from 2009–2019 was included. Review Methods Following recommendations by the Joanna Briggs Institute, a quality appraisal, data extraction, and synthesis were done. Results Seven research syntheses were included. There were two main themes and six subthemes: (1) Characterization of the nurse–patient communication: (a) Patients' communication; (b) Nurses' communication; (2) Nursing interventions that facilitate communication: (a) Communication assessment and documentation; (b) Communication methods and approaches; (c) Education and training of nurses; and (d) Augmentative and alternative communication. Conclusion Nurse–patient communication was characterized by an unequal power relationship with a common experience – frustration. Four key interventions were identified and an integration of these may be key to designing and implementing future ICU communication packages. Impact Nurse–patient communication is characterized by an unequal power relationship with one joint experience – frustration. Four key interventions should be integrated when designing and implementing communication packages in the ICU. Findings are transferable to ICU practices where patients are conscious and experience communication difficulties.