Analyse comparative de l'influence du tableau de communication et de l'eye tracking sur l'efficacité de la communication du patient ventilé mécaniquement en unité de soins intensifs

Purpose: Communication with patients under mechanical ventilation (MV) in the intensive care unit represents a constant challenge. The aims of the study were (1) to establish an overview of communication difficulties associated with MV, and (2) to compare the effectiveness of low-tech and high-tech alternative communication (AC) devices. Methods: This prospective study included a quantitative descriptive analysis of communication difficulties and a randomized mixed experimental analysis comparing the influence of communication board as low-tech device and eye tracking as high-tech device on the effectiveness of mechanically ventilated patients’ communication.
Results: 101 caregivers and 44 patients from the intensive care units of the Marie Curie Civil Hospital took part in the study. Communication with intubated mechanically ventilated patients appeared difficult in two thirds of the situations. Eye tracking was associated with significantly higher quantity of transmitted messages, success rate and patients’ satisfaction compared to the communication board (p < 0,0001). In fact, the median quantity of messages transmitted by eye tracking reached 4 messages per exchange compared to 2 messages per exchange for the board. The success rate of communication exchanges is equivalent to 80% for the board compared to 100% for eye tracking. Likewise, satisfaction for eye tracking was positive for 100% of patients, in contrast to satisfaction for communication boards which was negative for 68% of patients. The quantity of messages transmitted, success rate and patient satisfaction were not associated with age, gender and severity of disease. The qualitative results revealed 9 themes of content by using eye tracker, 8 themes of content by using board, 5 categories of use difficulties for the eye tracker and 4 categories of use difficulties for the communication board. Conclusion: The high-tech eye tracking interface may improve communication effectiveness of mechanically ventilated patients more than the low-tech communication board, both quantitatively and qualitatively.