Communication in Patients with Ventilation Support: An Integrative Review

Abstract

Communication is a basic human need. Patients with ventilation support using an endotracheal tube
cannot communicate orally. Such condition may lead to negative impacts related to ineffective communication.
The purpose of this article was to review the literature concerning in patient situations with communication
difficulties due to airway and ventilation problems. Integrative review was conducted on published literature
in the years 2002 to 2016. Electronic databases included ProQuest Nursing & Allied Health Source, Elsevier/
Science Direct, CINAHL, and PubMed were used. The search strategies were based on PICO questions
using keyword such as communication ability, ineffective communication, ventilation support, and mechanical
ventilation. Relevant literatures were appraised following the recommendation of The Joanna Briggs Institute
for Evidence-Based Nursing. One hundred and sixty-one articles were retrieved and there were 21 articles
met the inclusion criteria. Impact of ineffective communication in patients with ventilation support included
depression and anxiety; fear and anger; frustration; and loss of control. Factors related to ineffective
communication were inability to lip-read; motor weakness; fear and avoidance of talking, and inability to
write. Augmentative and alternative communication (AAC) strategy was mostly used to enhance effective
communication. The results of this integrative review revealed gaps of knowledge about communication
methods and strategies to enhance effective communication in patients with ventilation difficulties. Support
focusing on the factors associated with ineffective communication, especially concerning emotional factors of
fear and avoidance of conversation was identified. Implications for practice were identified and discussed.