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Nurses' Perspectives on a Communication Model Between Providers and Mechanically Ventilated Patients in the Intensive
Marte-Marie Wallander Karlsen1, Lena Günterberg Heyn2, Monica Evelyn Kvande1
1Lovisenberg Diaconal University College, Oslo, Norway.
Background:
Communication with mechanically ventilated patients in intensive care is complex. Decades of research demonstrate that communication barriers are commonly experienced and one of the most challenging experiences during an intensive care stay. Support for the health care providers in these situations could be a model for communication, guiding the interaction.
Aim:
The aim of this study was to examine critical care nurses' (CCNs') perspectives of the clinical relevance and applicability of a communication model for mechanically ventilated patients.
Study Design:
Qualitative, explorative design in accordance with Im & Meleis' phases of development of situation-specific theories. We conducted six focus group interviews with CCNs from Denmark, Norway and the United States, two in each country, lasting between 58 and 90 min. The interviews were analysed by a content analytic approach with both inductive and deductive phases.
Findings:
Twenty-nine CCNs participated in the focus group interviews. The main category was identified during the analysis, which was: 'Relationship-building as a starting point for meaningful communication'. The main category was further described by three subcategories: (1) Patients' abilities and challenges in communication while being mechanically ventilated. (2) Nurses' competencies and strategies for effective communication with mechanically ventilated patients and (3) Tools and resources in practice.
Conclusions:
The nurses' perspectives yielded a deeper understanding of how clinical practice both corresponds to and departs from a theoretical lens. Given that the interviews with nurses revealed the relational component as a critical starting point of communication, the model should highlight this specific element more explicitly. To understand the complexity occurring in the daily practice of an ICU, a situation-specific theory will be useful for providing examples of good practice.
Relevance To Clinical Practice:
Communication in an ICU setting requires the establishment of a relationship to find effective ways to communicate. Integrating clinical perspectives can refine and adapt the preliminary model to the real communication encounters and improve care.
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