Evaluation of the Effectiveness of Training in Basic and Assisted Communication Techniques for Intensive Care Nurses: A Quasi-experimental Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 180
- 试验地点
- 2
- 主要终点
- Level of pain
研究概览
简要总结
The aim of this quasi-experimental study is to find out whether the effectiveness of a communication intervention based on basic and assisted communication techniques improves the psycho-emotional effects of critical patients admitted to an ICU. The nurses' knowledge of BCS and CAA and their usefulness in daily practice will also be investigated. The main questions to be answered are:
Does effective communication based on BCS and CAA reduce pain, anxiety and stressful impact of the critically ill in the ICU? Do nurses who apply these communication techniques believe that they are useful in their daily practice?
The researchers will compare the communicative intervention called 'CONECTEM' with the usual nurse-patient communication process to observe whether CBT and CCT are effective in decreasing the psycho-emotional effects of these patients.
Participants will:
Participants will be classified into 3 groups according to the Glasgow Coma Scale, for each group different communicative strategies based on scientific literature will be applied. In each strategy, different theories such as Carkkuff, Light and different levels of support (no technology, low technology) will be used. The intervention has a minimum duration of 15 minutes and before and after the 3 variables studied will be evaluated. The intervention will be carried out during the first 72 hours after admission.
Prior to the intervention, a formal training in BCS and ACC will be given to the nurses who will then apply the intervention.
详细描述
CONECTEM Training Programme: This programme is aimed at nurses in the intensive care unit who will carry out communicative intervention with critically ill patients. It consists of 4 blocks, with a theoretical part and a practical part, in which the nurses acquire knowledge, skills and attitudes related to basic and assisted communication with the critically ill. The theoretical part is based on the theories of R Carkuff (2008)(1), and the Augmentative Assistive Communication model (2,3), and the practical part consists of a series of verbal and non-verbal communication exercises, and of experiencing communication simulations with the critically ill patient using the appropriate techniques and material.
The training programme also explains how the CONECTEM Communicative Intervention is carried out in Phase II. This training programme consists of two 2-hour sessions and will be evaluated by means of a theoretical-practical test to see if the nurses who carry out the intervention in phase II are able to carry it out.
CONECTEM Communication Intervention: This consists of applying basic and assisted communication techniques, already validated by experts (4) to the critical patient admitted to the ICU. The intervention is divided into 3 strategies according to the level of patient awareness. Each strategy presents both verbal and non-verbal communication skills and appropriate material for patients with communication difficulties (physical or cognitive). Each strategy includes details of the specific communication techniques to be used by the therapists and a description of how they are to be used.
Procedure and data collection Phase I: Procedure for the selection of participants. Depending on the participation of the ICU nurses of the study hospital who meet the inclusion/exclusion criteria, they will be given a folder made up of: a) full information and informed consent, b) a form to collect socio-demographic variables c) forms to collect the variables of knowledge on communication with the critically ill. Of all the nurses participating in this phase, 16 nurses will be selected by agreement to participate in phase II, who will be assigned to the control group or the intervention group. Training in the CONECTEM programme will be given to the 8 nurses who form part of the intervention group. Once the training has been completed, a test will be used to assess whether the nurses are able to carry out the CONECTEM Communicative Intervention with critical patients . The questionnaire on perceived satisfaction with the training programme will also be completed . All these data will be collected by the research team.
Phase II:
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- Single (Investigator)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Critical patients admitted to the ICU's of the Hospital Vall d'Hebron who accepted to participate in the study on their own volition or by delegation of the family member, previously informed in writing.
排除标准
- •Patients who do not understand Catalan or Spanish, critically ill patients admitted to the ICU for less than 24 hours and/or diagnosed with a psychiatric disorder prior to admission.
结局指标
主要结局
Level of pain
时间窗: VAS: Pre-post intervention (0 -30 minutes), Pre-post Nursing care (0-30 minutes). Glasgow >9. BPS: Pre-post intervention (0 -30 min), Pre-post Nursing care (0-30 min). Glasgow <9
VAS Visual Analògic scale for mesuring pain for responsable patients Consists of a 10-centimetre horizontal line, at the ends of which are the extreme expressions of a symptom. On the left is the absence of the symptom and on the right the highest intensity. The patient is asked to indicate on the line what intensity of the symptom is present. Behabiour Pain Scale for unresponsable patients. It is divided into 5 items that assess facial expression and motor movements. Each item is scored from 0 to 2 in a graded manner. The sum of all the items gives a score that indicates the state of the pain according to whether it is mild, moderate or intense, with 0 being painless and 12 being the maximum intensity of pain.
Level of anxiety for responsable patients
时间窗: Pre post intervention 0-30 minutes, pre post nursing usual care 0-30 minutes. Glasgow >9
the STAI Scale short version (Perpiña-Galvañ 2013), which consists of 6 items that are divided into 2 categories; present anxiety and absent anxiety.
Level of sedation and agitation
时间窗: Pre-post intervention 0 -30 minutes , Pre post nursing usual care 0-30 minutes ( glasgow <9)
RASS (sedation and agitation scale), which consists of 9 items ranging from -5 to 4 and assesses the agitation and degree of sedation of the patient under mechanical ventilation. From -5 to -1 the patient is sedated, the lower the number the less negative the degree of sedation will be. 0 is alert and calm, and from 1 to 4 the patient is agitated, anxious with possible acute psychological disorders. The higher the value, the more intense the scale, with 1 being restless and 4 combative
level of post-traumatic stress symptoms
时间窗: Pre post intervention 0-30 minutes , pre post nursing usual care 0-30 minutes. Gasgow >9
Stressor Impact Scale (EIE) (Badia-Castelló 2006), which is made up of 15 items: 6 measure intrusiveness, 8 avoidance and 1 hyperarousal. The score for each item is measured from 0 to 5, being 0 never, 1 sometimes, 3 often, 5 frequently. From the total score it is established that PTE LLEU\<8,5 PTE moderate 8,5-19 and PTE severe \>19
level of consciousness
时间窗: Baseline
Glasgow Coma Scale (Tesdale 1974). The scale is divided into three independently scorable groups that evaluate eye opening over 4 points, verbal response over 5 points and motor response over 6 points, with the maximum score (conscious and oriented) being 15 and the minimum 3.
次要结局
- perception of the usefulness of the CONECTEM intervention(3 month post data collection)
研究者
Marta Prats Arimon
Principal Investigator
University of Barcelona