Communication experience of individuals treated with home mechanical ventilation.
BACKGROUND
Mechanical ventilatory support seriously affects speaking and communication, and earlier studies show that many ventilator-supported patients experience difficulties and frustration with their speech and voice production. Since there is a growing number of individuals who require mechanical ventilatory support and there is a paucity of studies that examine ventilator-supported communication, this research area needs to be developed to ensure adequate health services for this population. The present study focused on ventilator-supported communication from the point of view of individuals receiving home mechanical ventilation (HMV).


OBJECTIVE
The specific aim was to examine the communication experience of individuals receiving HMV.


METHODS
A qualitative approach was adopted for this study, and data were collected by means of semi-structured interviews. Qualitative content analysis was used to structure, condense and interpret the data. The participants were recruited from the National Respiratory Centre (NRC) in Sweden, and included 19 individuals receiving HMV.


RESULTS
The main theme A long and lonely struggle to find a voice and six subthemes detailing different facets of it emerged from data analysis: Managing changed speech conditions, Prioritising voice, A third party supporting communication, Using communication to get things done, Depending on technology, and Facing ignorance. Important aspects influencing the ventilator-supported individuals' communicative performance (speech, support from others and technological solutions) are discussed.


CONCLUSIONS
The study revealed that healthcare practitioners involved in the care of individuals receiving HMV need to improve their understanding and knowledge of issues related to ventilator-supported communication. Individuals receiving HMV encounter a needlessly long and lonely struggle to achieve effective communication. They face numerous challenges regarding their communication, and they need to be heard in both literal and figurative senses. To overcome these challenges they need support from competent healthcare practitioners and personal assistants, and continuous follow-up by speech and language therapists tailoring communicative solutions to fit individual needs.
Division of Speech and Language Pathology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, SwedenKarolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, National Respiratory Centre, Stockholm, SwedenLund University, The Swedish Institute for Health Sciences (Vårdal Institute), Lund, Sweden.
Katja
K
Laakso
Division of Speech and Language Pathology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, SwedenKarolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, National Respiratory Centre, Stockholm, SwedenLund University, The Swedish Institute for Health Sciences (Vårdal Institute), Lund, Sweden.
Agneta
A
Markström
Division of Speech and Language Pathology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, SwedenKarolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, National Respiratory Centre, Stockholm, SwedenLund University, The Swedish Institute for Health Sciences (Vårdal Institute), Lund, Sweden.
Markus
M
Idvall
Division of Speech and Language Pathology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, SwedenKarolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, National Respiratory Centre, Stockholm, SwedenLund University, The Swedish Institute for Health Sciences (Vårdal Institute), Lund, Sweden.
Christina
C
Havstam
Division of Speech and Language Pathology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, SwedenKarolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, National Respiratory Centre, Stockholm, SwedenLund University, The Swedish Institute for Health Sciences (Vårdal Institute), Lund, Sweden.
Lena
L
Hartelius
D000328:Adult; D000368:Aged; D003142:Communication; D003144:Communication Barriers; D005260:Female; D006699:Home Care Services; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000150:complications / Q000523:psychology*; D009633:Nonverbal Communication / Q000523:psychology*; D026684:Personal Autonomy; D018907:Privacy / Q000523:psychology; D036301:Qualitative Research; D012121:Respiration, Artificial / Q000379:methods / Q000523:psychology*; D012649:Self Concept; D013060:Speech; D014831:Voice