Laura Istanboulian1, Louise Rose2, Franklin Gorospe3, Yana Yunusova4, Craig M Dale5. 1. Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto M5T 1P8, Canada. Electronic address: Laura.istanboulian@utoronto.ca. 2. Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, 57 Waterloo Rd, Lambeth, London SE1 8WA, UK. Electronic address: Louise.rose@kcl.ac.uk. 3. Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto M5T 1P8, Canada. Electronic address: Franklin.gorospe@mail.utoronto.ca. 4. Department of Speech and Language Pathology, University of Toronto, 160-500 University Ave, Toronto M5G 1V7, Canada; Toronto Rehabilitation Institute, University Health Network, 550 University Ave, Toronto M5G 2A2, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Wellness Way, Toronto M4N 3M5, Canada. Electronic address: Yana.yunusova@utoronto.ca. 5. Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto M5T 1P8, Canada; Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Toronto M4N 3M5, Canada. Electronic address: Craig.dale@utoronto.ca.
Abstract
PURPOSE: To identify barriers and facilitators for the use of augmentative and alternative communication (AAC) and voice restorative strategies for adult patients with an advanced airway in the intensive care unit (ICU). MATERIALS AND METHODS: Scoping review searching five databases between 1990 and 2019. We screened 13, 167 citations and included all study types reporting barriers and/or facilitators to using communication strategies in an ICU setting. Two authors independently extracted and coded reported barriers and facilitators to the Theoretical Domains Framework (TDF) domains. RESULTS: Of the 44 studies meeting inclusion criteria 18 (44%) used qualitative, 18 (44%) used quantitative, and 8 (18%) used mixed methods. In total, 39 unique barriers and 46 unique facilitators were identified and coded to the domains of the TDF. Barriers were most frequently coded to the Skills, Environmental Context and Resources, and Emotion domains. Facilitators were most frequently coded to Reinforcement, Environmental Context and Resources, and Social and Professional Roles/Identity domains. Thematic synthesis produced four potentially modifiable factors: context, emotional support, training, and decisional algorithms. CONCLUSIONS: Identified barriers (skills, environment, resources, emotions) and facilitators (reinforcement, resources, roles) to ICU communication strategy use in the literature may be modified through formal training and role support.
PURPOSE: To identify barriers and facilitators for the use of augmentative and alternative communication (AAC) and voice restorative strategies for adult patients with an advanced airway in the intensive care unit (ICU). MATERIALS AND METHODS: Scoping review searching five databases between 1990 and 2019. We screened 13, 167 citations and included all study types reporting barriers and/or facilitators to using communication strategies in an ICU setting. Two authors independently extracted and coded reported barriers and facilitators to the Theoretical Domains Framework (TDF) domains. RESULTS: Of the 44 studies meeting inclusion criteria 18 (44%) used qualitative, 18 (44%) used quantitative, and 8 (18%) used mixed methods. In total, 39 unique barriers and 46 unique facilitators were identified and coded to the domains of the TDF. Barriers were most frequently coded to the Skills, Environmental Context and Resources, and Emotion domains. Facilitators were most frequently coded to Reinforcement, Environmental Context and Resources, and Social and Professional Roles/Identity domains. Thematic synthesis produced four potentially modifiable factors: context, emotional support, training, and decisional algorithms. CONCLUSIONS: Identified barriers (skills, environment, resources, emotions) and facilitators (reinforcement, resources, roles) to ICU communication strategy use in the literature may be modified through formal training and role support.
Authors: Sven Jacobus Gertruda Geelen; Hanneke Corine van Dijk-Huisman; Marike van der Schaaf; Antoine François Lenssen; Robert Adriaan de Bie; Cindy Veenhof; Raoul Engelbert Journal: Syst Rev Date: 2021-11-04