Healthcare :: Communication Board Can Ease Frustration Intubated Patients Feel When Trying to Convey Their Needs

Critically ill patients on mechanical ventilation in intensive care units often feel high levels of frustration in communicating their needs to their caregivers – but use of a communication board can change that, a new UCLA study has found.

The study, to be published in the November issue of Applied Nursing Research, found that 69 percent of intubated patients surveyed said that a communication board would have helped them to better express their needs to hospital health care workers.

“It is the responsibility of the health care practitioners to assess and determine an effective means for their patient’s ability to communicate while they are verbally unable to do so,” said Lance Patak, the study’s lead researcher and a critical care nurse at the UCLA Cardiothoracic Intensive Care Unit. Patak invented the communications tool as a result of his first-hand observations with frustrated patients.

“This may mean using a variety of methods throughout the patient’s stay ? after all, patient’s abilities and performance fluctuate,” Patak said. “A communication board is definitely one of those methods.”

Mechanically ventilated patients are unable to express their feelings and needs through verbal communication because the endotracheal tubes running through their vocal cords make speech impossible, contributing to their frustration and anxiety. As a result, the caregiver is forced to interpret the patients’ non-verbal communication such as mouthing, gesticulating, nodding and writing ? which can be difficult for the critically ill patient.

The study gauged patients’ opinion of the Vidatak EZ Board, a light, flexible communication board devised by Patak that is organized so that the patient can easily inform the caregiver of all of his or her conceivable needs. For example, the patient can communicate thirst, cold, hunger, anger or pain; wanting to sit up or exercise; wanting a pillow or a blanket; needing someone to clean his or her mouth or face, or simply wanting to say “thank you.” All require no more effort on the patient’s part than marking a box next to the appropriate selection with an attached wet-erase marker.

This study is an offshoot of a 2004 study probing patients’ overall frustration in communicating their needs to caregivers, which found that 62 percent of intubated ICU patients experienced high levels of frustration in communicating their needs. For both studies, the researchers examined responses from 29 critically ill patients who had been on mechanical ventilation for at least 18 hours and had been extubated within the previous 72 hours, which gave these patients time to experience impaired verbal communication while awake and, after being taken off the ventilator, to have better recall of that experience.

Patients were asked to answer 13 questions, 10 of them open-ended and three using a five-point Likert scale, with one being the least and five being the most. All responses were audiotaped, and the transcriptions were verbatim. Most of the patients (65.5 percent) were male, and had a mean age of 55 years.

Four of the questions pertained to the use of the Vidatak EZ Board. The questions were meant to elicit:

The frustration levels these patients felt in trying to communicate while on mechanical ventilation.
How helpful they thought the communication board would have been to them in communicating their needs.
Features on the board the patients felt would or would not have been helpful to them.
The level of frustration the patients thought they would have experienced in communicating their needs had they had access to the EZ Board.
The researchers found that 12 of the patients (41.4 percent) said the board would have been “extremely helpful” and another eight (27.6 percent) claimed it would have been “very helpful” to them in conveying their needs. Additionally, five patients (17.2 percent) thought it would have been “helpful” and three others (10.3 percent) said it would have been “somewhat helpful” to them while they were in mechanical ventilation. Only one patient didn’t believe the communication board would have been helpful.

Overall, the patients noted the board helped boost both the speed and efficiency with which they communicated with their caregiver. They also suggested ways to make it better ? for instance, making it more concise, minimizing glare and changing some colors for easier reading.

Patak developed the EZ Board in 1999 and, since then, has sold more than 100,000 of them to nearly 1,000 hospitals nationwide as well as in Canada, England and Australia through his company, Vidatak, LLC ( The board has also attracted Hollywood’s attention, having been used as a prop on such popular television shows as “ER,” “Grey’s Anatomy” and “House.”

The EZ Board is available in 16 languages, among them Spanish, Chinese, Korean, Vietnamese and Tagalog. Non-English versions of the board contain English translations of foreign terms.

Study co-authors in addition to Patak include Anna Gawlinski, Lynn Doering and Jill Berg of UCLA; Ng Irene Fung of Kaiser Permanente, Los Angeles, and Elizabeth A. Henneman of the University of Massachusetts, Amherst.

A Sigma Theta Tau, Gamma Tau Chapter, Research Grant funded the study.

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