Communication Strategies for Mechanically Ventilated Patients in Intensive Care Units

NCT ID: NCT05651984

Last Updated: 2022-12-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

44 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-02-09

Study Completion Date

2019-06-27

Brief Summary

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This prospective study consisted of (1) a descriptive cross-sectional part describing communication difficulties related to mechanical ventilation as experienced by intensive care professionals and patients, and (2) an experimental randomized crossover part comparing the use of a conventional low-tech communication board and a high-tech eye tracking technology-based device to improve communication effectiveness of intensive care mechanically ventilated patients.

Detailed Description

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Sample size:

The health professionals sample size is estimated by convenience to 100 professionals based on the accessible population in the study site (i.e., 95% of the health professionals from the study site). The patients sample size is estimated to 44 patients based on statistical calculation (with a type 1 error rate of 5%, a type 2 error rate of 10% and an allocation ratio of 1), including two groups of 22 patients.

Intervention:

The cross-sectional part involved the healthcare professionals through the "state of the art questionnaire" and the patients through the "ease of communication scale". The crossover part then randomized the patients from the cross-sectional part into two groups and the communication interfaces were divided into two time periods: group A received eye tracking/communication board sequence and group B received communication board/eye tracking sequence. For each period, the communication interfaces were evaluated through the "intervention form". The communication board provides simple messages based on orthographic and iconic content. The eye tracking computer-based system enables the production and construction of simple or complex messages (including word processing with spelling suggestions and voice synthesis), also based on orthographic and iconic content.

Statistical analysis:

The numerical data will be analyzed quantitatively using R software (version 2016 3.5.3). The Gaussian distribution will be estimated by mean/median comparison, histogram symmetry, quantile-quantile distribution and shapiro-wilk test. Statistical analysis of the crossover variables (treatment-period interaction, period effect, and treatment effect) will be performed using the Mann-Whitney (ordinal variables) and chi-square (binary variables) nonparametric tests. A p-value less than 0.05 was considered significant. The non-numerical data will be analyzed qualitatively by thematization and categorization.

Ethics approval and consent to participate:

The study protocol was approved by the Ethics Committee of the Hospital of Liège as Central Committee and the Hospital of Charleroi as Local Committee (number: B70720183767, reference: 2018/268). The information and consent documents intended for healthcare professionals and patients were validated by both Ethics Committees. Written informed consent was obtained from all participants (healthcare professionals and patient's legal representative) included in this study. All procedures performed through this study were in accordance with the 1964 Helsinki Declaration and its later amendments.

Conditions

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Mechanical Ventilation Complication Communication, Nonverbal

Keywords

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Intensive care unit Mechanical ventilation Alternative communication Eye tracking Communication board

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Intra-individual comparison of 2 "treatments" divided into 2 time periods, so as to constitute 4 experimental conditions. The order of the treatments allocation, organised according to 2 sequences (A-B and B-A), induces a randomisation of the included patients into 2 groups. The wash-out period between the 2 periods is not applicable in this study.
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Communication board

The communication board consists of a printed paper interface with a size of 42 x 30 cm.

Group Type ACTIVE_COMPARATOR

Comparison between communication board and eye tracking

Intervention Type DEVICE

The comparison between the communication board and eye tracking, conducted as a crossover, generates a randomization of the patients (from the cross-sectional part) into two groups and the communication interfaces were divided into two time periods: group A received eye tracking/communication board sequence and group B received communication board/eye tracking sequence.

Eye tracking

The eye tracking device combines a laptop computer with a screen size of 29 x 16 cm, an eye tracker (PCEye Mini, Tobii dynavox, Danderyd, Sweden), an interface generated by a communication software (Communicator 5, Tobii dynavox) and a telescopic support.

Group Type EXPERIMENTAL

Comparison between communication board and eye tracking

Intervention Type DEVICE

The comparison between the communication board and eye tracking, conducted as a crossover, generates a randomization of the patients (from the cross-sectional part) into two groups and the communication interfaces were divided into two time periods: group A received eye tracking/communication board sequence and group B received communication board/eye tracking sequence.

Interventions

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Comparison between communication board and eye tracking

The comparison between the communication board and eye tracking, conducted as a crossover, generates a randomization of the patients (from the cross-sectional part) into two groups and the communication interfaces were divided into two time periods: group A received eye tracking/communication board sequence and group B received communication board/eye tracking sequence.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Working in the intensive care unit (study site).


* Being hospitalized in the intensive care unit (study site),
* Awake with a Richmond Agitation-Sedation Scale (RASS) between "restless" (+1) and "drowsy" (-1),
* Age of 18 years or older,
* French speaker.

Exclusion Criteria

* Lack of consent.


* Lack of consent,
* Severe visual impairment (e.g., blindness).
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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CHU de Charleroi

OTHER

Sponsor Role collaborator

University Hospital, Tours

OTHER

Sponsor Role collaborator

University of Liege

OTHER

Sponsor Role lead

Responsible Party

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Emilie Szymkowicz

ICU nurse

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Stephan Ehrmann, MD, PhD

Role: STUDY_DIRECTOR

University hospital and University of Tours

Laetitia Bodet-Contentin, MD, PhD

Role: STUDY_DIRECTOR

University hospital and University of Tours

Yoann Marechal, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

University hospital of Charleroi

Emilie Szymkowicz, MSc

Role: PRINCIPAL_INVESTIGATOR

University of Liege

Locations

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University of Liège

Liège, , Belgium

Site Status

Countries

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Belgium

References

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Ten Hoorn S, Elbers PW, Girbes AR, Tuinman PR. Communicating with conscious and mechanically ventilated critically ill patients: a systematic review. Crit Care. 2016 Oct 19;20(1):333. doi: 10.1186/s13054-016-1483-2.

Reference Type BACKGROUND
PMID: 27756433 (View on PubMed)

Garry J, Casey K, Cole TK, Regensburg A, McElroy C, Schneider E, Efron D, Chi A. A pilot study of eye-tracking devices in intensive care. Surgery. 2016 Mar;159(3):938-44. doi: 10.1016/j.surg.2015.08.012. Epub 2015 Sep 8.

Reference Type BACKGROUND
PMID: 26361099 (View on PubMed)

Bodet-Contentin L, Gadrez P, Ehrmann S. Eye-tracking and speech-generating technology to improve communication with intubated intensive care unit patients: initial experience. Intensive Care Med. 2018 May;44(5):676-677. doi: 10.1007/s00134-018-5093-0. Epub 2018 Mar 3. No abstract available.

Reference Type BACKGROUND
PMID: 29502253 (View on PubMed)

Miglietta MA, Bochicchio G, Scalea TM. Computer-assisted communication for critically ill patients: a pilot study. J Trauma. 2004 Sep;57(3):488-93. doi: 10.1097/01.ta.0000141025.67192.d9.

Reference Type BACKGROUND
PMID: 15454792 (View on PubMed)

Maringelli F, Brienza N, Scorrano F, Grasso F, Gregoretti C. Gaze-controlled, computer-assisted communication in Intensive Care Unit: "speaking through the eyes". Minerva Anestesiol. 2013 Feb;79(2):165-75. Epub 2012 Nov 22.

Reference Type BACKGROUND
PMID: 23174919 (View on PubMed)

Other Identifiers

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B707201837671

Identifier Type: -

Identifier Source: org_study_id