Unidentified communication challenges in the intensive care unit: A qualitative study using multiple triangulations.

Area of Science:

• Critical Care Medicine
• Healthcare Communication
• Patient Experience

Background:

• Intensive care unit (ICU) communication is complex due to patient intubation and illness.
• Existing research often focuses on tools, techniques, or individual perspectives.
• Few studies integrate patient, family, and clinician viewpoints on ICU communication.

Purpose of the Study:

• To explore communication dynamics between ICU patients, family members, and nurses.
• To identify previously unrecognized communication challenges in the ICU setting.

Main Methods:

• A case-oriented design with multiple triangulations was employed.
• Participant observations and individual interviews were conducted in two Norwegian ICUs.
• Data were gathered from 9 mechanically ventilated patients, 6 family members, and 9 healthcare personnel.

Main Results:

• Communication appeared smooth during observations but interviews revealed discrepancies in perceived importance.
• Family members were crucial in interpreting patient signs, uncovering challenges unknown to nurses.
• A gap existed between the perceived simplicity of communication and the underlying complexities.

Conclusions:

• ICU communication challenges may be subtle and not immediately apparent to all involved.
• Nurses must recognize these hidden challenges, requiring extensive patient and family involvement.
• Addressing these communication issues may extend beyond the immediate care period.