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Understanding Communication Barriers in Acute Care: A Mixed-Methods Needs Assessment Among Healthcare Providers Caring for Non-Verbal Patients With Spinal Cord Injury and Tracheostomy in the ICU

2026年8月27日 更新者：Jason Chui、University of British Columbia

Communication impairment is common among critically ill patients who are mechanically ventilated, have tracheostomies, or have neurological injuries such as spinal cord injury. In acute care settings, inability to communicate contributes to patient distress, impairs symptom assessment, and may delay care. Although a range of communication supports exist, many are difficult to use in patients with severe weakness, limited endurance, or fluctuating cognition. More advanced assistive communication systems, including eye-tracking and brain-computer interface platforms, have shown promise in chronic neurological populations but have not been well adapted to the practical realities of acute care.

This study will use a sequential exploratory mixed-methods design to better understand communication barriers in acute care from the perspective of frontline healthcare providers. In the qualitative phase, semi-structured interviews will be conducted with nurses and speech-language pathologists working with patients who have spinal cord injury, tracheostomy, or other causes of impaired verbal communication in ICU and related acute care settings. Findings from these interviews will inform development of a structured survey to be distributed to a broader group of nurses and speech-language pathologists. Qualitative and quantitative findings will then be integrated to identify priority communication needs, limitations of current strategies, and practical requirements for future assistive communication tools. Findings will inform development of clinically relevant communication solutions for acute care environments.

調査の概要

状態

まだ募集していません

条件

詳細な説明

This study will employ a two-stage sequential exploratory mixed-methods design. In the first stage, semi-structured interviews (N=10-15) and, where feasible, focus groups will be conducted with ICU clinicians and rehabilitation staff to identify communication barriers and priority use cases for assistive communication in nonverbal patients. Themes emerging from qualitative analysis will inform the development of a structured survey, which will be administered to a broader cohort of clinical staff (N=80-100) to quantify the prevalence and relative importance of identified communication gaps. Findings from the qualitative and quantitative phases will be integrated to generate a clinical requirements framework to inform the future development of assistive communication tools for acute care settings.

研究の種類

観察的

入学 (推定)

100

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

  • 名前：Jason Chui, MBChB, FRCPC
  • 電話番号：66378 604-875-4111
  • メール：jason.chui@ubc.ca

研究連絡先のバックアップ

研究場所

  • カナダ
    • British Columbia
      • Vancouver、British Columbia、カナダ、V5Z 1M9
        • Vancouver General Hospital

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

  • 大人
  • 高齢者

健康ボランティアの受け入れ

はい

サンプリング方法

確率サンプル

調査対象母集団

Care givers to the non-verbal patients with communication barrier

説明

Inclusion Criteria:

  • be a healthcare provider such as physicians, registered nurses, speech-language pathologists, occupational therapists, or physiotherapists;
  • work in ICU, spine, neurosurgical, or related acute care inpatient settings;
  • have experience caring for patients with impaired verbal communication, including patients with tracheostomy, mechanical ventilation, or spinal cord injury; and
  • be able to provide informed consent. A small subset of family caregivers may also be included if they have direct experience supporting communication for patients with impaired verbal communication in these settings.

Exclusion Criteria:

  • Individuals not directly involved in the care of patients with impaired verbal communication in the relevant clinical settings
  • Trainees who are not yet independently practicing, unless they are participating in an independent clinical role
  • Family caregivers without direct experience supporting communication needs in the acute care setting

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか？

デザインの詳細

この研究は何を測定していますか？

主要な結果の測定

結果測定
メジャーの説明
時間枠
High-priority Communication Needs in Acute Care
時間枠：At completion of the 3-5-minute survey on Day 1
Communication needs identified as high priority by healthcare providers based on their ratings of the importance and frequency of communication needs experienced by patients with impaired verbal communication in acute care settings. The survey will also assess which communication functions healthcare providers consider most important for inclusion in future assistive communication interfaces.
At completion of the 3-5-minute survey on Day 1
Priority of Communication Needs in Acute Care
時間枠：Stage 1 interviews and Stage 2 survey; approximately Months 3-4
Healthcare providers' ratings of the importance and frequency of communication needs experienced by patients with impaired verbal communication in acute care settings. Priority communication needs will be identified through thematic analysis of interviews and quantified in the Stage 2 survey using importance and frequency ratings.
Stage 1 interviews and Stage 2 survey; approximately Months 3-4

二次結果の測定

結果測定
メジャーの説明
時間枠
Current Communication Strategies and Perceived Limitations
時間枠：Stage 1 interviews and Stage 2 survey; approximately Months 3-4
Identification and characterization of communication strategies currently used by healthcare providers, including low-technology and augmentative and alternative communication approaches, and perceived limitations or barriers associated with their use. Findings will be derived from qualitative interviews and summarized quantitatively in the survey where applicable.
Stage 1 interviews and Stage 2 survey; approximately Months 3-4
Priority Communication Functions for Bedside Use
時間枠：Stage 2 survey; approximately Month 4
Healthcare providers' prioritization of communication functions considered most appropriate for a simplified bedside assistive communication interface. Participants will select a limited number of communication functions from those identified during the qualitative phase.
Stage 2 survey; approximately Month 4
Workflow and Implementation Feasibility Requirements
時間枠：Stage 1 interviews and Stage 2 survey; approximately Months 3-4
Healthcare providers' perceptions of practical requirements for implementing assistive communication tools in acute care, including acceptable setup time, training requirements, workflow integration, and environmental or clinical barriers.
Stage 1 interviews and Stage 2 survey; approximately Months 3-4

その他の成果指標

結果測定
メジャーの説明
時間枠
Communication System Functional Requirements
時間枠：Stage 1 interviews and Stage 2 survey; approximately Months 3-4
Identification of functional and interface requirements for future assistive communication systems, including required communication tasks, presentation/interface considerations, contextual information, and usability requirements. Requirements will be identified through thematic analysis and prioritized using survey findings.
Stage 1 interviews and Stage 2 survey; approximately Months 3-4

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

University of British Columbia

協力者

Vancouver General Hospital

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (推定)

2026年8月1日

一次修了 (推定)

2027年12月1日

研究の完了 (推定)

2027年12月1日

試験登録日

最初に提出

2026年7月28日

QC基準を満たした最初の提出物

2026年8月27日

最初の投稿 (実際)

2026年8月31日

学習記録の更新

投稿された最後の更新 (実際)

2026年8月31日

QC基準を満たした最後の更新が送信されました

2026年8月27日

最終確認日

2026年8月1日

詳しくは

本研究に関する用語

キーワード

追加の関連 MeSH 用語

その他の研究ID番号

  • H26-01406

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

いいえ

IPD プランの説明

This study involves survey data only. Additional approval is required to share the data.

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米国FDA規制医薬品の研究

いいえ

米国FDA規制機器製品の研究

いいえ

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