Effectiveness, experience, and usability of low-technology augmentative and alternative communication in intensive care: A mixed-methods systematic review

Alodan, Hissah A., Sutt, Anna-Liisa, Hill, Rebekah, Alsadhan, Joud and Cross, Jane L. ORCID: https://orcid.org/0000-0002-7003-1916 (2024) Effectiveness, experience, and usability of low-technology augmentative and alternative communication in intensive care: A mixed-methods systematic review. Australian Critical Care. ISSN 1036-7314

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Abstract

Background: Patients in the intensive care unit (ICU) are commonly on mechanical ventilation, either through endotracheal intubation or tracheostomy, which usually leaves them nonverbal. Low-technology augmentative and alternative communication (AAC) strategies are simple and effective ways to enhance communication between patients and their communication partners but are underutilised. Aim: The aim of this study was to systematically review current evidence regarding the effectiveness, experience of use, and usability of low-technology AAC with nonverbal patients and their communication partners in the ICU. Methods: This review included quantitative, qualitative, and mixed-methods studies of adult ICU patients aged 18 or older who were nonverbal due to mechanical ventilation and their communication partners. Studies using low-technology AAC, such as communication boards and pen and paper, were included. Six databases were searched, and the review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A convergent segregated approach was used for data synthesis. Results: Thirty-two studies were included. Low-technology AAC improved patient satisfaction, facilitated communication, and met patients' physical and psychological needs. Communication boards with mixed content (e.g., pictures, words, and letters) were preferred but were used less frequently than unaided strategies due to patients' medical status, tool availability, and staff attitudes. Boards should be user-friendly, tailored, include pen/paper, and introduced preoperation to increase patient's comfort when using them postoperatively. Conclusion: Existing evidence support low-technology AAC's efficacy in meeting patients' needs. Better usability hinges on proper implementation and addressing challenges. Further research is crucial for refining communication-board design, ensuring both user-friendliness and sophistication to cater to ICU patients' diverse needs. Registration: The review protocol was registered in the International Prospective Register of Systematic Reviews, with registration number CRD42022331566.

Item Type: Article
Additional Information: Funding Information: This review received no specific funding. HA is funded by a PhD studentship provided from King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Uncontrolled Keywords: effectiveness,experience,intensive care,low-technology augmentative and alternative communication,usability,emergency,critical care ,/dk/atira/pure/subjectarea/asjc/2900/2907
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Health Promotion
Faculty of Medicine and Health Sciences > Research Groups > Dementia & Complexity in Later Life
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Depositing User: LivePure Connector
Date Deposited: 20 Jun 2024 10:30
Last Modified: 08 Jul 2024 07:32
URI: https://ueaeprints.uea.ac.uk/id/eprint/95644
DOI: 10.1016/j.aucc.2024.04.006

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