Yoğun Bakımda Tedavi Gören Bireyler İçin Yüksek Teknolojili Alternatif ve Destekleyici İletişim Sistemi Gereksinimlerinin Belirlenmesi ve Prototip Geliştirilmesi

Year 2023, , 58 - 84, 30.04.2023

Havva Nur Yırtık , Esma Nur Yelek , Tuğçe Karahan , İsmail Barış Bozkuş , Maviş Emel Kulak Kayıkçı

https://doi.org/10.21020/husbfd.1110709

Abstract

Amaç: Çalışmanın birinci amacı yetişkin yoğun bakım ünitelerinde tedavi alan ve tedavi aldığı süre boyunca sözel iletişim kuramayan bireylerin yoğun bakımdaki iletişim gereksinimlerini belirlemektir. Çalışmanın bir diğer amacı ise belirlenen iletişim gereksinimlerini referans alarak bireylerin gereksinimlerini karşılayabilecek yüksek teknolojili bir alternatif ve destekleyici iletişim sistemine uygun prototip geliştirmektir.
Gereç ve Yöntem: Çalışma, iki ayrı örneklem grubu ile yürütülmüştür. Bunlar yoğun bakım ünitelerinde iş deneyimi olan sağlık profesyonelleri (n = 5) ve yoğun bakımda tedavi deneyimi olan kişilerdir (n = 2). Nitel araştırma deseninin kullanıldığı bu çalışmada her iki örneklem grubu ile görüşmeler düzenlenmiştir. Verilerin yorumlayıcı fenomonolojik analiz yöntemi ile incelenmiştir.
Bulgular: Görüşmelerin analizinden elde edilen temalar; yoğun bakımda iletişim, farkındalık ve duygular-düşüncelerdir. Yoğun bakımda iletişim temasından elde edilen verilerden faydalanılarak yoğun bakımda sözel iletişim kuramayan bireylerin iletişim gereksinimleri için yüksek teknolojili bir prototip geliştirilmiştir.
Sonuç: Sonuçlar, yoğun bakım ünitesinde tedavi gören bireylerin alternatif iletişimde yüksek teknolojili bir uygulamanın kullanılmasının gerekliliğini ortaya koymaktadır. Ayrıca, bu çalışma; dil ve konuşma terapisi alanında ülkemizde yürütülen ve farklı örneklem gruplarının deneyimlerinden faydalanılarak yüksek teknolojili bir alternatif ve destekleyici iletişim sistemi uygulaması geliştirilen ilk çalışmalardan biri olması nedeniyle öncü çalışmalar arasında yer almaktadır.

Keywords

alternatif ve destekleyici iletişim sistemleri, yoğun bakım üniteleri, iletişim

Supporting Institution

TÜRKİYE BİLİMSEL VE TEKNOLOJİK ARAŞTIRMA KURUMU (TÜBİTAK)

Project Number

1919B012002311

Thanks

(Teşekkür): Çalışmamıza dahil olan katılımcılarımıza teşekkür ederiz. (Finansal Destek): Çalışma uygulama aşamasında hizmet bedeli harcamaları için TÜBİTAK 2209-A Üniversite Öğrencileri Araştırma Projeleri Destekleme Programı'ndan 1919B012002311 başvuru numarası ile destek görmüştür.

Development of a Prototype and Determination of High-Tech Augmentative and Alternative Communication System Requirements for Individuals in Intensive Care Units

Abstract

Objectives: The primary goal of the study is to identify the communication needs of people receiving treatment in intensive care units who are unable to communicate verbally. The second goal of this study is to develop a prototype for a high-tech augmentative and alternative communication system that can communication demands of individuals.
Materials and Methods: The study was conducted with two separate sample groups. These are health professionals with work experience in intensive care units (n = 5) and individuals with intensive care unit treatment experience (n = 2). Interviews were conducted with sample gropus using qualitative research design. The interpretative phenomenological analysis method was used to examine the data.
Results: Communication, awareness and emotions/thoughts in intensive care unit were the themes identified from the analysis of the interview data. A high-tech prototype has been developed for the communication requirements of individuals who cannot communicate verbally in intensive care units with the data gathered from the communication interaction in the intensive care unit.
Conclusion: The findings highlight the necessity of using a high-tech application in alternative communication of individuals treated in the intensive care unit. Furthermore, this study is, one of the pioneering studies in the field of speech and language therapy in our country, as it is one of the first studies conducted to develop a high-tech alternative and supportive communication system application by benefiting from the experiences of different sample groups.

Keywords

Augmentative and alternative communications systems, intensive care units, communication

Project Number

1919B012002311

References

• Alase, A. (2017). The interpretative phenomenological analysis (IPA): A guide to a good qualitative research approach. International Journal of Education and Literacy Studies, 5(2), 9-19.
• Albayram, T. (2016). Kalp ve damar cerrahi yoğun bakım ünitesinde entübe hastalarla iletişim amacıyla geliştirilen resimli iletişim kartlarının etkinliğinin belirlenmesi [Yüksek Lisans Tezi, Hasan Kalyoncu Üniversitesi]. Sağlık Bilimleri Enstitüsü, Gaziantep.
• American Speech-Language-Hearing Association. (n.d). ASHA. Erişim Tarihi. 23.04.2022. Augmentative and Alternative Communication (AAC). https://www.asha.org/public/speech/disorders/aac/
• Bartlett, G., Blais, R., Tamblyn, R., Clermont, R. J., & MacGibbon, B. (2008). Impact of patient communication problems on the risk of preventable adverse events in acute care settings. Cmaj, 178(12), 1555-1562.
• Baxter, S., Enderby, P., Evans, P., & Judge, S. (2012). Barriers and facilitators to the use of high‐technology augmentative and alternative communication devices: a systematic review and qualitative synthesis. International Journal of Language & Communication Disorders, 47(2), 115-129.
• Broyles, L. M., Tate, J. A., & Happ, M. B. (2012). Use of augmentative and alternative communication strategies by family members in the intensive care unit. American Journal of Critical Care, 21(2), e21-e32.
• Carroll, S. M. (2007). Silent, slow lifeworld: the communication experience of nonvocal ventilated patients. Qualitative Health Research, 17(9), 1165-1177.
• Creswell, J. W. (2014). Research design: Qualitative, quantitative, and mixed methods approaches (4. Baskı). Sage Publications.
• Damico, J. S., & Simmons-Mackie, N. N. (2003). Qualitative research and speech-language pathology.
• Dehzangi, O., & Farooq, M. (2018). Portable brain-computer interface for the intensive care unit patient communication using subject-dependent SSVEP identification. BioMed research international. https://doi.org/10.1155/2018/9796238
• Dithole, K., Sibanda, S., Moleki, M. M., & Thupayagale‐Tshweneagae, G. (2016). Exploring communication challenges between nurses and mechanically ventilated patients in the intensive care unit: a structured review. Worldviews on Evidence‐Based Nursing, 13(3), 197-206.
• Ertürk Yavuz, M. (2018). Bilgisayar temelli iletişim aracının mekanik ventilatöre bağlı hastaların sözel olmayan iletişimlerini sağlamadaki etkinliği [Doktora Tezi, Karadeniz Teknik Üniversitesi]. Sağlık Bilimleri Enstitüsü, Trabzon.
• Ertürk, M. (2013). Parsiyel larenjektomi olan hastaların iletişim rehberine ilişkin değerlendirmeleri [Yüksek lisans tezi, Karadeniz Teknik Üniversitesi]. Sağlık Bilimleri Enstitüsü, Trabzon.
• Güngen, C., Ertan, T., Eker, E., Yaşar, R., & Engin, F. (2002). Standardize mini mental test’in Türk toplumunda hafif demans tanısında geçerlik ve güvenilirliği. Türk Psikiyatri Dergisi, 13(4), 273-281.
• Hafsteindóttir, T. B. (1996). Patient's experiences of communication during the respirator treatment period. Intensive and Critical Care Nursing, 12(5), 261-271.
• Happ, M. B., Garrett, K., Thomas, D. D., Tate, J., George, E., Houze, M., ... & Sereika, S. (2011). Nurse-patient communication interactions in the intensive care unit. American Journal of Critical Care, 20(2), e28-e40.
• Happ, M. B., Garrett, K. L., Tate, J. A., DiVirgilio, D., Houze, M. P., Demirci, J. R., ... & Sereika, S. M. (2014). Effect of a multi-level intervention on nurse–patient communication in the intensive care unit: results of the SPEACS trial. Heart & lung, 43(2), 89-98.
• Happ, M. B., Tuite, P., Dobbin, K., DiVirgilio-Thomas, D., & Kitutu, J. (2004). Communication ability, method, and content among nonspeaking nonsurviving patients treated with mechanical ventilation in the intensive care unit. American Journal of Critical Care, 13(3), 210-218.
• Happ, M. B., Von Visger, T., Weber, M. L., Vermillion, B., Chipps, E., Traughber, B., & Patak, L. (2016). Iterative development, usability, and acceptability testing of a communication app for mechanically ventilated patients. Am J Resp Crit Care Med, 193, A1096.
• Jansson, S., San Martin, T. R., Johnson, E., & Nilsson, S. (2019). Healthcare professionals’ use of augmentative and alternative communication in an intensive care unit: A survey study. Intensive And Critical Care Nursing, 54, 64-70.
• Johnston, S. S., Reichle, J., & Evans, J. (2004). Supporting augmentative and alternative communication use by beginning communicators with severe disabilities. American Journal of Speech-Language Pathology, 13, 20-30.
• Karlsson, V., Bergbom, I., & Forsberg, A. (2012). The lived experiences of adult intensive care patients who were conscious during mechanical ventilation: a phenomenological-hermeneutic study. Intensive and critical care nursing, 28(1), 6-15.
• Khalaila, R., Zbidat, W., Anwar, K., Bayya, A., Linton, D. M., & Sviri, S. (2011). Communication difficulties and psychoemotional distress in patients receiving mechanical ventilation. American Journal of Critical Care, 20(6), 470-479.
• Kılıç, M. (2014). Sağlık Kurumlarında iletişim: hasta-sağlık personeli iletişimi [Yüksek lisans tezi, Beykent Üniversitesi], Sosyal Bilimler, İstanbul.
• Kolçak, B. (2017). Mekanik ventilatör desteği alan hastalarla iletişimde, resimli iletişim materyali kullanımının, anksiyete ve konfor üzerine etkisi [Yüksek lisans tezi, Sağlık Bilimleri Üniversitesi] Gülhane Sağlık Bilimleri Enstitüsü, Ankara.
• Koszalinski, R. S. (2014). Evaluation of Speak For Myself™ with patients who are voiceless [Doktora Tezi, Florida Atlantic University]. Boca Raton.
• Leathart, A. J. (1994). Communication and socialisation (1): an exploratory study and explanation for nurse-patient communication in an ITU. Intensive and Critical Care Nursing, 10(2), 93-104.
• Llenore, E., & Ogle, K. R. (1999). Nurse-patient communication in the intensive care unit: a review of the literature. Australian Critical Care, 12(4), 142-145.
• Magnus, V. S., & Turkington, L. (2006). Communication interaction in ICU—patient and staff experiences and perceptions. Intensive and Critical Care Nursing, 22(3), 167-180.
• Malik, J. S. (2009). Communication Skills–I. Vayu Education of India.
• Marshall, S., & Hurtig, R. R. (2019). Developing a culture of successful communication in acute care settings: Part I. Solving patient-specific issues. Perspectives of the ASHA special interest groups, 4(5), 1028-1036.
• Martinho, C. I. F., & Rodrigues, I. T. R. M. (2016). Communication of mechanically ventilated patients in intensive care units. Revista Brasileira de terapia intensiva, 28, 132-140.
• Menzel, L. K. (1998). Factors related to the emotional responses of intubated patients to being unable to speak. Heart & Lung, 27(4), 245-252.
• Mobasheri, M. H., King, D., Judge, S., Arshad, F., Larsen, M., Safarfashandi, Z., ... & Darzi, A. (2016). Communication aid requirements of intensive care unit patients with transient speech loss. Augmentative and Alternative Communication, 32(4), 261-271.
• Otuzoğlu, M., & Karahan, A. (2014). Determining the effectiveness of illustrated communication material for communication with intubated patients at an intensive care unit. International journal of nursing practice, 20(5), 490-498.
• Patak, L., Gawlinski, A., Fung, N. I., Doering, L., & Berg, J. (2004). Patients’ reports of health care practitioner interventions that are related to communication during mechanical ventilation. Heart & Lung, 33(5), 308-320.
• Patak, L., Gawlinski, A., Fung, N. I., Doering, L., Berg, J., & Henneman, E. A. (2006). Communication boards in critical care: patients' views. Applied Nursing Research, 19(4), 182-190.
• Pennock, B. E., Crawshaw, L., Maher, T., Price, T., & Kaplan, P. D. (1994). Distressful events in the ICU as perceived by patients recovering from coronary artery bypass surgery. Heart & lung: the journal of critical care, 23(4), 323-327.
• Radtke, J. V., Baumann, B. M., Garrett, K. L., & Happ, M. B. (2011). Listening to the voiceless patient: case reports in assisted communication in the intensive care unit. Journal of palliative medicine, 14(6), 791-795.
• Radtke, J. V., Tate, J. A., & Happ, M. B. (2012). Nurses’ perceptions of communication training in the ICU. Intensive and Critical Care Nursing, 28(1), 16-25.
• Rodriguez, C. S., Rowe, M., Koeppel, B., Thomas, L., Troche, M. S., & Paguio, G. (2012). Development of a communication intervention to assist hospitalized suddenly speechless patients. Technology and health care, 20(6), 519-530.
• Rotondi, A. J., Chelluri, L., Sirio, C., Mendelsohn, A., Schulz, R., Belle, S., ... & Pinsky, M. R. (2002). Patients’ recollections of stressful experiences while receiving prolonged mechanical ventilation in an intensive care unit. Critical care medicine, 30(4), 746-752.
• Salem, A., & Ahmad, M. M. (2018). Communication with invasive mechanically ventilated patients and the use of alternative devices: integrative review. Journal of Research in Nursing, 23(7), 614-630.
• Sizemore, J. T. (2014). Augmentative and alternative communication in the intensive care unit [Doktora Tezi, Eastern Kentucky University].
• Smith, J. A. (2004). Reflecting on the development of interpretative phenomenological analysis and its contribution to qualitative research in psychology. Qualitative research in psychology, 1(1), 39-54.
• Smith, J.A., Flowers, P. & Larkin, M. (2009). Interpretative Phenomenological Analysis: Theory, Method And Research. (1. Baskı). SAGE Publications Inc.
• Smith, J. A., & Osborn, M. (2004). Interpretative phenomenological analysis. Doing social psychology research. Oxford: Blackwell.
• Sullivan, A., & Cleave, P. L. (2003). Knowledge of the roles of speech-language pathologists by students in other health care programs. Journal Of Speech Language Pathology and Audiology, 27(2), 98-107.
• Tate, J. A., Devito Dabbs, A., Hoffman, L. A., Milbrandt, E., & Happ, M. B. (2012). Anxiety and agitation in mechanically ventilated patients. Qualitative health research, 22(2), 157-173.
• Tembo, A. C., Higgins, I., & Parker, V. (2015). The experience of communication difficulties in critically ill patients in and beyond intensive care: Findings from a larger phenomenological study. Intensive and Critical Care Nursing, 31(3), 171-178.
• Toğram, B., & Maviş, İ. (2012). Afazi Dil Değerlendirme Testi’nin Geçerlik, Güvenirlik ve Standardizasyon Çalışması. Turk Noroloji Dergisi, 18(3), 96-103.
• Von Visger, T. T., Tate, J. A., Traughber, B., Patak, L., Happ, M. B. (2016). ICU nurses focus group on acceptability testing of Vidatalk™. American Thoracic Society, 193, A7592.
• Wojnicki-Johansson, G. (2001). Communication between nurse and patient during ventilator treatment: patient reports and RN evaluations. Intensive and Critical Care Nursing, 17(1), 29-39.
• Yaman Aktas, Y., Nagórska, M., & Karabulut, N. (2017). Problems in critical care nurse-patient communication: examples of Poland and Turkey. Acta Clinica Croatica, 56(3.), 437-445.
• Yavuz, M. E., Gürsoy, A. (2017). Patient Communication Following Laryngectomy: A Pilot Study Using Visual Communication Guide. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi, 4(3), 74-88.