有口難言－與加護病房插管病人之溝通

Communication with Intubated Patients in the ICU

馬瑞菊(Jui-Chu Ma) ； 鄭婉如(Wan-Ju Cheng) ； 古瑞霞(Jui-Hsia Ku) ； 李秀玲(Shin-Ling Li)

《馬偕護理雜誌》 5卷1期 (2011/01) Pp. 15-21

https://doi.org/10.29415/JMKN.201101_5(1).0002

摘要

加護病房約1/3以上的病人置放氣管內管，而插管病人常因無法順利表達需求而產生溝通不良的問題。而護病溝通不良易造成病人感到挫折，進而情緒沮喪、尊嚴受損、焦慮，嚴重時甚至發生自拔管路造成復原時間及住院天數的延長。在臨床照護中，護理人員與插管病人溝通之能力不足，且缺乏輔助溝通技巧，故本文參考國內外有關護理人員與插管病人溝通之相關文獻，針對「溝通」之概念、加護病房常見溝通內容、護理人員與插管病人溝通之重要性、影響護病有效溝通之因素、輔助溝通策略運用作為探討重點，並針對如何增進有效護病溝通方法提出建議，期望能提供護理人員與插管病人溝通之相關方法，將有助於發展臨床病患之照護計畫，提升加護病房護病溝通之品質。

關鍵字

加護病房 ； 插管 ； 非語言溝通 ； 護病溝通 ； 輔助溝通

並列摘要

Over a third of patients in the ICU are intubated, so that they often cannot successfully express their needs. Nurse-patient miscommunication often results in the patient becoming frustrated, depressed, or anxious and feeling a loss of dignity. Some individuals may even respond by removing their tubes themselves, which may worsen their condition, prolonging recovery and hospitalization. Having cared for intubated patients, I am well aware of the potential for miscommunication and the lack of resources to address the problem. I review both the domestic and international literature relating to communication with intubated patients. Topics considered include the meaning of communication, common content of communication in the ICU, the particular importance of communication with intubated patients, factors impacting effective nurse-patient communication, and application of augmentative communication strategies. Recommendations are made for improving nurse-patient communication in the ICU, particularly to enhance the quality of communication with intubated patients.

並列關鍵字

intensive care unit ； intubation ； nonverbal communication ； nurse-patient communication ； augmentative and alternative communication