Communication Methods Used with Conscious Intubated Patients: Scoping Review

Intubated conscious patients often experience communication difficulties. The present narrative review outlines the current evidence on communication methods adopted and the experience of conscious intubated patients in critical care areas.

To our knowledge, studies have attempted to examine communication with conscious intubated patients. The present review had two objectives: (1) to identify the methods adopted by nurses and conscious intubated patients to ease the communication difficulties faced due to intubation and (2) to identify the experience of nurses and conscious intubated patients with the adopted communication methods.

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist was followed throughout this review. PubMed and ProQuest databases were searched with the terms “intubated conscious patients,” “communication,” and “nurse”, including original research articles published between January 2019 and May 2024 on conscious patients needing intubation. Dissertations, review papers, non-interventional research, and articles written in languages other than English were excluded. Only eight of the original 2,041 studies, which included 137 intubated patients and for 545 nurses, met the inclusion criteria. The authors used the Mixed Method Appraisal tool (MMAT) and the Critical Appraisal Skills Program (CASP) to collect data and assess quality.

After the first search of generated 2041 papers, only eight articles—representing various studies—were able to meet the inclusion requirements. The included studies were six (6) quantitative, one (1) qualitative study and one (1) mixed-method study. Four communication intervention types were identified, namely: (1) Communication boards/charts (two studies), which improved communication and increased patient satisfaction. (2) Gestures and facial expressions (four studies) were reported to be frequently initiated for communication by the nurses with the patients. (3) Multiple methods (three studies) used were found to be insufficient to communicate with the patients. (4) Digital technology program, including Communicative Digital Technology Program was found to be effective means of communication in three such studies.

Results imply that communication techniques may be useful in enhancing patient–nursing professional communication with conscious intubated patients. However, in developing countries with fewer resources, a low-cost communication tool addressing both physical and emotional needs may be developed to aid in communication among patients and nurses.