Angela Tolotti1, Annamaria Bagnasco2, Gianluca Catania3, Giuseppe Aleo4, Nicola Pagnucci5, Lucia Cadorin6, Milko Zanini7, Gennaro Rocco8, Alessandro Stievano9, Franco A Carnevale10, Loredana Sasso11. 1. Department of Health Sciences, University of Genoa, Via Pastore, 1, 16132 Genoa, Italy. Electronic address: angela.tolotti@unipv.it. 2. Department of Health Sciences, University of Genoa, Via Pastore, 1, 16132 Genoa, Italy. Electronic address: annamaria.bagnasco@unige.it. 3. Department of Health Sciences, University of Genoa, Via Pastore, 1, 16132 Genoa, Italy. Electronic address: gianluca.catania@edu.unige.it. 4. Department of Health Sciences, University of Genoa, Via Pastore, 1, 16132 Genoa, Italy. Electronic address: giuseppe.aleo@edu.unige.it. 5. Department of Clinical and Experimental Medicine, University of Pisa, Italy. Electronic address: gamma97@tin.it. 6. CRO Aviano National Cancer Institute, Via F. Gallini, 2, 22081 Aviano, Italy. Electronic address: lcadorin@cro.it. 7. Department of Health Sciences, University of Genoa, Via Pastore, 1, 16132 Genoa, Italy. Electronic address: milko.zanini@edu.unige.it. 8. Italian Nurses' National Social Security Council (ENPAPI), Via A. Farnese 3, 00192 Rome, Italy. 9. Centro di Eccellenza per la Cultura e la Ricerca Infermieristica, Via G. Cesare 78, 00192 Rome, Italy. 10. Ingram School of Nursing, McGill University, Montreal, Quebec, Canada. Electronic address: Franco.carnevale@mcgill.ca. 11. Department of Health Sciences, University of Genoa, Via Pastore, 1, 16132 Genoa, Italy. Electronic address: l.sasso@unige.it.
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.
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.
Authors: Maureen George; Carme Hernandez; Sheree Smith; Georgia Narsavage; Mary C Kapella; Margaretann Carno; Jill Guttormson; Rebecca T Disler; Diana E Hart; Linda L Chlan; Mary Beth Happ; Zijing Chen; Breanna Hetland; Ana F Hutchinson; Helga Jonsdottir; Nancy S Redeker; Hildy Schell-Chaple; Monica Fletcher; Janelle Yorke Journal: Ann Am Thorac Soc Date: 2020-01