[Communication with intubated patients]

For critically ill patients on assisted respiration caring behavior is particularly important. In this paper we review the literature on patient satisfaction with medical care and with their communication with the nursing staff. Communication skills of staff of intensive respiratory care units were studied by direct observation, debriefing of hospitalized patients and by interview of discharged patients. Direct observation showed that nurses spent only a small proportion of their time talking to patients. The interactions dealt with technical rather than emotional matters and consisted mostly of negative and discouraging comments rather than positive and supporting messages. Debriefing of hospitalized intubated patients revealed a high degree of overall satisfaction with care on the one hand, and complaints of communication problems, anxiety and anger on the other. Lastly, interviews with discharged patients revealed that as many as a quarter of those who could remember their hospitalization reported feelings of anxiety, anger, distrust in the staff and difficulty in communication. These findings suggest that the nursing staff needs improved communication skills. There is evidence that the judicious use of communication techniques may improve patient satisfaction, reduce anxiety and reduce duration of treatment.