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Thursday, 17 May 2018

The communication experience of tracheostomy patients with nurses in the intensive care unit: A phenomenological study



by Angela Tolotti, Annamaria Bagnasco, Gianluca Catania, Giuseppe Aleo, Nicola Pagnucci, Lucia Cadorin, Milko Zanini, Gennaro Rocco, Alessandro Stievano, Franco A. Carnevale, Loredana Sasso  

Intensive Critical Care Nursing – In press

Abstract

Objectives

To describe the experience and sources of comfort and discomfort in tracheostomy patients, when they communicate with nurses in the Intensive Care Unit.

Research methodology/design

Benner’s interpretive phenomenology. Data were collected through: a) semi-structured interviews conducted with the patients after leaving the intensive care unit; b) participant observation; c) situated interviews with intensive care nurses.

Setting

The intensive care unit of a hospital in Northern Italy.

Findings

Eight patients and seven nurses were included in this study. Two main themes were identified 1) feeling powerless and frustrated due to the impossibility to use voice to communicate; 2) facing continual misunderstanding, resignation, and anger during moments of difficulty and/or communication misunderstandings. The main communication discomfort factors were: struggling with not knowing what was happening, feeling like others had given up on me, living in isolation and feeling invisible. The main comfort factors were: being with family members, feeling reassured by having a call bell nearby and nurses' presence.

Conclusions

This study highlights the important role of communication in tracheostomy patients in intensive care and how closely it is linked to all the aspects of a person’s life, which cannot be underestimated as just not being able to use one’s voice.

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