Limitations of Patients’ Communication with Mechanically Ventilated Patients: A Scoping Review

Authors

DOI:

https://doi.org/10.20956/icon.v10i2.44513

Keywords:

communication, communication impact, communication strategy, communication content, mechanical ventilated patient

Abstract

Aims: This review aimed to examine the effects of communication barriers, identify effective communication strategies, and determine appropriate interaction content for patients receiving mechanical ventilation.

Methods: A scoping review approach was conducted using four databases: EBSCOhost, Elsevier, PubMed, and ProQuest, selected for their extensive health-related collections. Eligible studies were published between 2015 and 2025, written in English, and utilized quantitative or qualitative designs. The search incorporated keywords related to communication barriers, ventilated patients, intensive care, and critical care. Data was synthesized through systematic collation, summarization, and reporting.

Results: Of 1,239 records identified, 20 studies met the inclusion criteria. Findings indicated that communication challenges affected patients, nurses, and family members, with consequences categorized as psychological and care-related impacts. Two primary communication approaches were identified: unaided and aided methods, with aided strategies further divided into low-technology and high-technology tools. Communication content clustered into three domains: expressing patient needs and desires, conveying complaints, and facilitating care-related interactions.

Conclusion: Communication barriers significantly influence the well-being of patients, nurses, and families in intensive care settings. Both unaided and aided communication strategies can enhance interactions with mechanically ventilated patients. Structured communication focusing on patient needs and desires, concerns, and caregiving elements is essential to promote care quality and support patient well-being.

Author Biography

Widaryati Widaryati, Doctoral Study Program of Medicine and Health Sciences, Universitas Diponegoro, Semarang, Indonesia

Nursing Program, Faculty of Health Science, Universitas Aisyiyah Yogyakarta

References

Alasad, J. A., Abu Tabar, N., & Ahmad, M. M. (2015). Patients’ experience of being in intensive care units. Journal of Critical Care, 30(4), 859.e7-859.e11. https://doi.org/10.1016/j.jcrc.2015.03.021

Albayram, T., & Yava, A. (2020). The determination of the efficiency of visual communication cards developed for the purpose of communication with the intubated patients in the intensive care unit of cardiovascular surgery. Turkiye Klinikleri Cardiovascular Sciences, 32(3), 103–115. https://doi.org/10.5336/CARDIOSCI.2020-77327

Alharbi, S., Al, M., Alzahrani, S., Almatrafi, M., Alharbi, A., Hawsawi, H., Alsaedi, Y., Al-harbi, I., Alamri, A., & Aljahdali, A. (2022). Review of Importance of Nursing Communcation in Critical Care Patient’s Families. Indo American Journal of Phamacuetical Sciences, 09(10), 223–226 https://doi.org/10.5281/zenodo.7276988

Brambilla, S., Ausili, D., Locatelli, G., Di Mauro, S., Bellani, G., & Luciani, M. (2025). Communication difficulties in mechanically ventilated voiceless patients in intensive care units: A qualitative study. Nursing in Critical Care, 30(3), 1–10. https://doi.org/10.1111/nicc.70037

Davidson, J. E., Aslakson, R. A., Long, A. C., Puntillo, K. A., Kross, E. K., Hart, J., Cox, C. E., Wunsch, H., Wickline, M. A., Nunnally, M. E., Netzer, G., Kentish-Barnes, N., Sprung, C. L., Hartog, C. S., Coombs, M., Gerritsen, R. T., Hopkins, R. O., Franck, L. S., Skrobik, Y., … Curtis, J. R. (2017). Guidelines for Family-Centered Care in the Neonatal, Pediatric, and Adult ICU. Critical Care Medicine, 45(1), 103–128. https://doi.org/10.1097/CCM.0000000000002169

Divani, A., Manookian, A., Haghani, S., Meidani, M., & Navidhamidi, M. (2022). Evaluating the use of communication board on cortisol level and physiological parameters in mechanically ventilated patients. In Iranian Journal of Nursing and Midwifery Research (Vol. 27, Issue 3, pp. 198–203). https://doi.org/10.4103/ijnmr.ijnmr_82_21

Dumas, L. (2020). In post-extubated patients what are the preferred methods of communication during their experience of endotracheal intubation with mechanical ventilation (Doctoral dissertation, University of South Florida). University of South Florida. https://digitalcommons.usf.edu/cgi/viewcontent.cgi?article=9700&context=etd

Fager, S. K., Burnfield, J. M., Pfeifer, C. M., & Sorenson, T. (2021). Perceived importance of AAC messages to support communication in rehabilitation settings. Disability and Rehabilitation: Assistive Technology, 16(7), 796–801. https://doi.org/10.1080/17483107.2020.1736652

Fathonah, S., Ernawati, E., & Hakim, M. S. (2024). Communication Experiences of Conscious Indonesian Patients Who Underwent Mechanical Breathing in an Intensive Care Unit: A Phenomenological Approach. In Jordan Medical Journal (Vol. 58, Issue 4, pp. 496–509). https://doi.org/10.35516/jmj.v58i4.1601

Guttormson, J. L., Bremer, K. L., & Jones, R. M. (2015). “Not being able to talk was horrid”: A descriptive, correlational study of communication during mechanical ventilation. Intensive and Critical Care Nursing, 31(3), 179–186. https://doi.org/10.1016/j.iccn.2014.10.007

Handberg, C., & Voss, A. K. (2018). Implementing augmentative and alternative communication in critical care settings: Perspectives of healthcare professionals. Journal of Clinical Nursing, 27(1–2), 102–114. https://doi.org/10.1111/jocn.13851

Happ, M. B., Garrett, K. L., Tate, J. A., DiVirgilio, D., Houze, M. P., Demirci, J. R., George, E., & Sereika, S. M. (2014). Effect of a multi-level intervention on nurse-patient communication in the intensive care unit: Results of the SPEACS trial. Heart and Lung: Journal of Acute and Critical Care, 43(2), 89–98. https://doi.org/10.1016/j.hrtlng.2013.11.010

Happ, M. B., Sereika, S. M., Houze, M. P., Seaman, J. B., Tate, J. A., Nilsen, M. L., van Panhuis, J., Scuilli, A., Paull, B., George, E., Angus, D. C., & Barnato, A. E. (2015). Quality of care and resource use among mechanically ventilated patients before and after an intervention to assist nurse-nonvocal patient communication. Heart and Lung, 44(5), 408-415.e2. https://doi.org/10.1016/j.hrtlng.2015.07.001

Holm, A., & Dreyer, P. (2018). Use of Communication Tools for Mechanically Ventilated Patients in the Intensive Care Unit. CIN - Computers Informatics Nursing, 36(8), 398–405. https://doi.org/10.1097/CIN.0000000000000449

Hosseini, S. R., Valizad-Hasanloei, M. A., & Feizi, A. (2018). The effect of using communication boards on ease of communication and anxiety in mechanically ventilated conscious patients admitted to intensive care units. Iranian Journal of Nursing and Midwifery Research, 23(5), 358–362. https://doi.org/10.4103/ijnmr.IJNMR_68_17

Ijssennagger, C. E., Ten Hoorn, S., Van Wijk, A., Van den Broek, J. M., Girbes, A. R., & Tuinman, P. R. (2018). Caregivers’ perceptions towards communication with mechanically ventilated patients: The results of a multicenter survey. Journal of Critical Care, 48, 263–268. https://doi.org/10.1016/j.jcrc.2018.08.036

Ismail, S., Lahati, N. S., & Morales, J. G. (2024). Family Needs of Patients Admitted in the Intensive Care Unit: a Meta-Synthesis. Jurnal Keperawatan Soedirman, 19(3), 217–225. https://doi.org/10.20884/1.jks.2024.19.3.8242

Ismail, S., Sohilait, H. P. F., & Erawati, M. (2024). The Holistic Nursing Competencies and Instruments for Critically III-Patients: A Scoping Review. Poltekita : Jurnal Ilmu Kesehatan, 18(1), 52–68. https://doi.org/10.33860/jik.v18i1.2617

Karlsen, M. M. W., Holm, A., Kvande, M. E., Dreyer, P., Tate, J. A., Heyn, L. G., & Happ, M. B. (2023). Communication with mechanically ventilated patients in intensive care units: A concept analysis. Journal of Advanced Nursing, 79(2), 563–580. https://doi.org/10.1111/jan.15501

Karlsen, M. M. W., Ølnes, M. A., & Heyn, L. G. (2019). Communication with patients in intensive care units: a scoping review. In Nursing in Critical Care (Vol. 24, Issue 3, pp. 115–131). Blackwell Publishing Ltd. https://doi.org/10.1111/nicc.12377

Kolcak, B., Ayhan, H., & Tastan, S. (2023). The effect of using illustrated materials for communication on the anxiety and comfort of cardiac surgery patients receiving mechanical ventilator support : A randomized controlled trial. Heart & Lung, 59, 157–164. https://doi.org/10.1016/j.hrtlng.2023.02.005

Kuruppu, N., Chaboyer, W., Tobiano, G., Abayadeera, A., & Ranse, K. (2024). Evaluating the feasibility of a communication board to enhance communication interactions of mechanically ventilated patients in Sri Lankan intensive care units: A pilot randomised controlled trial. Australian Critical Care, 37(October 2024), S22. https://doi.org/10.1016/j.aucc.2024.07.066

Kuruppu, N. R., Chaboyer, W., Abayadeera, A., & Ranse, K. (2023). Augmentative and alternative communication tools for mechanically ventilated patients in intensive care units: A scoping review. Australian Critical Care, 36(6), 1095–1109. https://doi.org/10.1016/j.aucc.2022.12.009

Kuyler, A., Heyns, T., & Johnson, E. (2024). Critical care nurses' experiences of communication-vulnerable patients in the intensive care unit and the influence on rendering compassionate care. The Southern African journal of critical care : the official journal of the Critical Care Society, 40(1), e750. https://doi.org/10.7196/SAJCC.2024.v40i1.750

Kyranou, M., Cheta, C., & Pampoulou, E. (2022). Communicating with mechanically ventilated patients who are awake. A qualitative study on the experience of critical care nurses in Cyprus during the COVID-19 pandemic. In PLoS ONE (Vol. 17, Issue 12 December). https://doi.org/10.1371/journal.pone.0278195

Leung, C. C. H., Pun, J., Lock, G., Slade, D., Gomersall, C. D., Wong, W. T., & Joynt, G. M. (2018). Exploring the scope of communication content of mechanically ventilated patients. Journal of Critical Care, 44, 136–141. https://doi.org/10.1016/j.jcrc.2017.10.044

Levac, D., Colquhoun, H., & O’Brien, K. K. (2010). Scoping studies: Advancing the methodology. Implementation Science, 5(1), 1–9. https://doi.org/10.1186/1748-5908-5-69

Mak, S., & Thomas, A. (2022). Steps for Conducting a Scoping Review. Journal of Graduate Medical Education, 14(5), 565–567. https://doi.org/10.4300/JGME-D-22-00621.1

Momennasab, M., Ardakani, M. S., Rad, F. D., Dokoohaki, R., Dakhesh, R., & Jaberi, A. (2019). Quality of nurses’ communication with mechanically ventilated patients in a cardiac surgery intensive care unit. Investigacion y Educacion En Enfermeria, 37(2). https://doi.org/10.17533/udea.iee.v37n2e02

Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. The BMJ, 372. https://doi.org/10.1136/bmj.n71

Pina, S. F. de M., Canellas, M., Prazeres, R., Lopes, J., Marcelino, T., Reis, D., & Ferrito, C. (2020). Augmentative and Alternative Communication in Ventilated Patients: A Scoping Review. Revista Brasileira de Enfermagem, 73(5), 1–6. https://doi.org/10.1590/0034-7167-2019-0562

Prime, D., Arkless, P., Fine, J., Winter, S., Wakefield, D. B., & Scatena, R. (2016). Patient experiences during awake mechanical ventilation. Journal of Community Hospital Internal Medicine Perspectives, 6(1), 30426. https://doi.org/10.3402/jchimp.v6.30426

Rustam, J.S., Kongsuwan, W., & Kitrungrote, L. (2018). Comfort in Patients Receiving Mechanical Ventilation: A Literature Review. Critical Care Nursing.

Salem, A., & Ahmad, M. M. (2018). Communication with invasive mechanically ventilated patients and the use of alternative devices: integrative review. Journal of Research in Nursing, 23(7), 614–630. https://doi.org/10.1177/1744987118785987

Sharpe, B., & Hemsley, B. (2016). Improving nurse-patient communication with patients with communication impairments: Hospital nurses’ views on the feasibility of using mobile communication technologies. Applied Nursing Research, 30, 228–236. https://doi.org/10.1016/j.apnr.2015.11.012

Sidhu, S., Kaur, K., Kaur, A., Charan, G. S., & Kaur, M. (2024). Effectiveness of Communication Board on Level of Satisfaction among Mechanically Ventilated Patients at Intensive Care Unit in a Tertiary Hospital. International journal of applied & basic medical research, 14(4), 284–289. https://doi.org/10.4103/ijabmr.ijabmr_351_24

Shin, J. W., Happ, M. B., & Tate, J. A. (2021). VidaTalkTM patient communication application “opened up” communication between nonvocal ICU patients and their family. Intensive and Critical Care Nursing, 66, 103075. https://doi.org/10.1016/j.iccn.2021.103075

Szymkowicz, E., Bodet-Contentin, L., Marechal, Y., & Ehrmann, S. (2024). Comparison of communication interfaces for mechanically ventilated patients in intensive care. Intensive and Critical Care Nursing, 80(May 2023). https://doi.org/10.1016/j.iccn.2023.103562

Tate, J. A., Dabbs, A. D., Hoffman, L. A., Milbrandt, E., & Happ, M. B. (2012). Anxiety and Agitation in Mechanically Ventilated Patients. Qualitative Health Research. https://doi.org/10.1177/1049732311421616

Tembo, A. C., Higgins, I., & Parker, V. (2015). The experience of communication difficulties in critically ill patients in and beyond intensive care: Findings from a larger phenomenological study. Intensive and Critical Care Nursing, 31(3), 171–178. https://doi.org/10.1016/j.iccn.2014.10.004

ten Hoorn, S., Elbers, P. W., Girbes, A. R., & Tuinman, P. R. (2016). Communicating with conscious and mechanically ventilated critically ill patients: A systematic review. Critical Care, 20(1), 1–14. https://doi.org/10.1186/s13054-016-1483-2

Ull, C., Hamsen, U., Weckwerth, C., Schildhauer, T. A., Gaschler, R., Waydhas, C., & Jansen, O. (2022). Approach to the basic needs in patients on invasive ventilation using eye-tracking devices for non-verbal communication. Artificial Organs, 46(3), 439–450. https://doi.org/10.1111/aor.14082

Wallander Karlsen, M.-M., Finset, A., Hegdal, K., & Heyn, L. G. (2022). Caught between ideals and reality: Phenomenological-hermeneutic study of healthcare providers’ experiences while interacting with mechanically ventilated patients. Journal of Interprofessional Care, 36(4), 492–499. https://doi.org/10.1080/13561820.2021.1967303

Zaga, C. J., Freeman-Sanderson, A., Happ, M. B., Hoit, J. D., McGrath, B. A., Pandian, V., Quraishi-Akhtar, T., Rose, L., Sutt, A. L., Tuinman, P. R., Wallace, S., Bellomo, R., Berney, S., & Vogel, A. P. (2023). Defining effective communication for critically ill patients with an artificial airway: An international multi-professional consensus. Intensive and Critical Care Nursing, 76(October 2022), 103393. https://doi.org/10.1016/j.iccn.2023.103393

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Published

2026-02-17

How to Cite

Widaryati, W., Ismail, S., Retnaningsih, R., Margawati, A., & Subu, M. A. (2026). Limitations of Patients’ Communication with Mechanically Ventilated Patients: A Scoping Review. Indonesian Contemporary Nursing Journal (ICON Journal), 10(2), 242–266. https://doi.org/10.20956/icon.v10i2.44513
Received 2025-06-20
Accepted 2026-01-03
Published 2026-02-17

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