Komunikacija z zavestnim intubiranim pacientom v enoti intenzivnega zdravljenja : diplomsko delo

Hvala, Ula (author), Djekić, Bernarda (mentor), Thaler, Darja (comentor)

Uvod: Intubacija spremeni kakovost življenja pacienta. Otežena je komunikacija, težje je sporazumevanje. Zavestni intubirani kritično bolni pacienti so zato lahko v hudi stiski. Zdravstveno osebje mora večjo pozornost posvetiti opazovanju pacienta, predvsem pa ga poskušati čim bolje razumeti skozi različne tehnike nebesedne komunikacije, če so le-te mogoče. Namen: Namen diplomskega dela je predstaviti komunikacijo zdravstvenih delavcev z zavestnim intubiranim pacientom v enoti intenzivnega zdravljenja. Želeli smo raziskati v literaturi predstavljene izkušnje pacientov z oteženo komunikacijo in ugotoviti, katere tehnike nebesedne komunikacije so pacientom najbolj v pomoč. Metode dela: V diplomskem delu je uporabljena deskriptivna metoda s pregledom literature. Uporabljeni so prosto dostopni članki, ki so bili iskani prek DIKul-a v podatkovnih bazah Medline, ScienceDirect, CINAHL in ProQuest ter s pomočjo COBIB.SI. Iskanje literature je potekalo s ključnimi besedami: mehanska ventilacija, intubacija, komunikacija, kritično bolan, otežena komunikacija, nebesedne oblike komunikacije, izkušnje pacientov. Obdobje nastanka vključenih objav je bilo od leta 2004 do 2018. Rezultati: Rezultati pregledanih raziskav so potrdili, da je nezmožnost besedne komunikacije pri intubiranih pacientih vzrok za stres, občutek nemoči, strahu in frustracij, zato je izbira ustrezne tehnike nebesedne komunikacije izjemno pomembna. Raziskovalci predlagajo uporabo različnih strategij komunikacije: pisanje s svinčnikom na papir, abecedna tabla, slikovna tabla, postavitev kratkih vprašanj, sporazumevanje s kretnjami, branje z ustnic in opazovanje mimike obraza. Nekaj avtorjev poudarja tudi pomen dotika pri komunikaciji. Na podlagi pregledanih raziskav ni mogoče sklepati, kateri način nebesedne komunikacije je najbolj ustrezen. Razprava in zaključek: Komunikacija z zavestnim intubiranim pacientom ima pozitiven vpliv, pomirja, pacienti so tako manj v stiski in strahu. Zdravstveno osebje, svojci in pacient lahko na različne načine poskušajo komunicirati, določena komunikacijska sredstva so se izkazala za zelo dobra. Medicinska sestra mora dobro poznati zdravstveno stanje pacienta in tako predvidevati, kaj bi v določenem trenutku najbolj potreboval. Za boljšo komunikacijo so potrebna dodatna strokovna izpopolnjevanja in usposabljanja zdravstvenih delavcev. Prav tako bi morali v procesu izobraževanja dati večji poudarek na učenje komunikacije in individualno obravnavo vsakega kritično bolnega pacienta.

• Language: Slovenian
• Keywords: mehanska ventilacija, kritično bolan, otežena komunikacija, nadomestne oblike komunikacije, izkušnje pacientov
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2019
• PID: 20.500.12556/RUL-106418
• COBISS.SI-ID: 5586283
• Publication date in RUL: 22.02.2019

Secondary language

• Language: English
• Title: Communication with a conscious intubated patient in a intensive care unit : diploma work

Abstract

Introduction: Intubation changes the life of a patient; communicating gets difficult. Conscious intubated critically ill patients can therefore be in a great distress. Healthcare personnel have to observe the patient closely and try to use various nonverbal communication techniques if possible. Purpose: The purpose of this diploma work is to present the communication between healthcare professionals and conscious intubated patient in the intensive care unit. We wanted to determine the most useful communication techniques based on the experience of the patients gathered in selected literature. Work methods: In this diploma work, the descriptive method through a systematic review of literature was used. The search for freely accessible articles was through DIKul in a data bases Medline, ScienceDirect, CINAHL and ProQuest and on COBIB.SI. The following key words were the entries for the search: mechanical ventilation, intubation, communication, critically ill, difficult communication, nonverbal communication, patient experience. The included articles were published between 2004 and 2018. Results: The results of the research confirmed the cause of incapable verbal communication of intubated patients: stress, sense of weakness, fear and frustrations. The choice of the appropriate nonverbal communication is therefore highly important. Researchers suggest various communication strategies: writing on paper, alphabet board, picture board, short questions, using gestures, reading lips and observing facial expressions. Some also highlight the role of touch during communication. Based solely on these researches it is impossible to find the most appropriate nonverbal communication. Discussion and conclusion: Communication with a conscious intubated patient positively impacts them; it soothes and releases distress and fear. Healthcare personnel, relatives and a patient can try to communicate in different ways; certain communication tools have proved to be very good. Medical condition of a patient has to be well known to a nurse to be able to predict the patient’s momentary needs. Communication is improved through additional professional education and training. Learning such skills as well as individual treatment of each critically ill patient should be considered highly important.

• Keywords: mechanical ventilation, critically ill, communication problems, alternnative communication, patient experience