Facilitating Communication for Suddenly Speechless Patients in the Critical Care Setting

Purpose:

To report on the impact of  a technology-based communication intervention on  perception of communication (ease), satisfaction with communication method, and frustration levels experienced by hospitalized patients experiencing sudden inability to verbalize needs (sudden speechlessness).

Methods:

Quasi -experimental study; usual care and intervention groups at two tertiary care institutions.  The technology based intervention incorporated a speech-generating device with three key functions to communicate: direct selection of pre-stored messages with graphic/pictorial representation, handwriting and typing screens. Data were collected daily for a maximum of 10 days including: assessment of confusion, agitation and sedation status, perception of communication difficulty, frustration level, and satisfaction with communication methods.  

Results:

Lower frustration levels {-0.2.68, SE=0.17; 95% CI -3.02 to -2.34, p=<0.001) and a higher satisfaction level with communication methods (0.59, SE=0.16; 95% CI 0.27 to 0.91; p<0.0001) were reported by patients in the intervention group. The estimated difference between the intervention and the comparison group was not statistically significant (-0.058, SE=0.039; 95% CI -0.136 to 0.020; p=0.14).  However, point estimates associated with each of the communication components evaluated were significant, supporting improved ease of communication values for participants in the intervention group in comparison with the usual care group. 

Conclusion:

Technology based communication interventions tailored to the needs of hospitalized patients have the potential to enhance the communication process during sudden speechlessness events.  Future research should focus on evaluating if technology based communication interventions enhance the  communication and management of symptoms.