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Effectiveness of Sign Board on Experiences of Mechanically Ventilated

Patients Admitted in Selected Hospitals

Article · January 2014

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 Research & Reviews: Journal of Medicine
ISSN: 2249-8648 (online), ISSN: 2348-7917 (print)
Volume 4, Issue 3
www.stmjournals.com

Effectiveness of Sign Board on Experiences of

Mechanically Ventilated Patients Admitted
in Selected Hospitals
Thakur Deepika*, N. Sembian, Kumari Vinay
Medical Surgical Nursing Department, M.M University, Mullana, Haryana 133207, India

Abstract
The objective of the study was to assess and compare the experiences of mechanically
ventilated patients with and without the use of sign board. 37 conscious mechanically
ventilated patients were selected through purposive sampling technique. In view of nature
of the problem and to accomplish the objectives of the study, structured mechanical
ventilator experience scale was prepared to assess the experiences of patients (in terms of
communication of needs/problems) during mechanical ventilation. Validity was ensured
in the field of nursing and medical departments. Reliability of the tool was tested by split
half method, which was found to be 0.72 (acceptable limit is (0.7–0.9). Both descriptive
and inferential statistics were used. Results showed that maximum number of needs
communicated with the use of sign board were in the physical domain. Chi square values
applied to compare the experimental and comparison group with respect to levels of
experiences in terms of communication of needs. The chi square value (χ2=33.4,
p=0.01*) found to be highly significant at ≤0.05 level of significance. The study also
depicted no significant association of levels of experience with selected variables in
experimental and comparison group. The findings suggest that experiences of patients in
experimental group were better than the comparison group with the use of sign board.

Keywords: sign board, mechanically ventilated patients.

*Author for Correspondence E-mail: deepikthakur@yahoo.com

INTRODUCTION can be conveyed and decisions, wishes, and

Mechanical ventilation is indicated when the
patients spontaneous ventilation is inadequate
to maintain life [1]. Common medical
indications for use include; Hypoxemia, acute
lung injury, trauma, Apnea with respiratory
arrest, respiratory distress, chronic obstructive
pulmonary disease (COPD), neurological
diseases such as muscular dystrophy [2].
Patients who are connected to a mechanical
ventilator are unable to communicate
effectively with significant others. These
patients experience physical and emotional
stress, which is related to the unfamiliar
surroundings and the limitations caused by the
process of ventilation [3]. The inability to can
be a traumatic life event that reduces patient
participation in care and decision-making and
impairs pain and symptom assessment [4].
Communicating effectively with ventilator-
dependent patients is essential so that various
basic physiological and psychological needs
desires about the plan of care and end-of-life
decision making can be expressed. Numerous
methods can be used to communicate,
including gestures, head nods, mouthing of
words, writing, use of letter/picture boards and
common words or phrases tailored to meet
individualized patients' needs [5].
MATERIALS AND METHODS
An experimental research approach and Quasi
experimental nonequivalent control group
posttest design was used. 37 patients, who
were conscious on mechanical ventilator, were
selected through purposive sampling
technique. In view of nature of the problem
and to accomplish the objectives of the study,
structured mechanical ventilator experience
scale was prepared to assess the experiences of
patients (in terms of communication of
needs/problems) during mechanical
ventilation. Validity was ensured in the field

RRJoM (2014) 9-11 © STM Journals 2014. All Rights Reserved Page 9
Effect of Sign Board on Mechanically Ventilated Patients
of Nursing and medical departments.
Reliability of the tool was tested by split half
method, which was found to be 0.72
(acceptable limit is (0.7–0.9) for mechanical
ventilator experience scale (42 items). Both
descriptive and inferential statistics were used.
RESULTS
Results showed that maximum number of
needs communicated with the application of
Sign board were in the physical domain. Chi
square values applied to compare the
Table 1: Chi Square Showing Comparison of Levels of Experiences in Terms of Need/Problems
Communicated in Experimental and Comparison Group among Mechanically Ventilated Patients.
Experimental Group
Levels of Experiences
(n=17) f (%)
Good experience (>75%) 1 (5.88)
Average experience (50–75%) 7 (41.1)
Poor experience (25–50%) 9 (52.9)
Very Poor experience (0–25%) 0 19 (95)
χ² (35) =2.000; * Significant (p≤0.05).
DISCUSSION
The study findings are discussed with
consistent and inconsistent findings. In present
study majority of patients (62%) were males
(75%) were married and mean duration on
mechanical ventilation was 8.14 days.
Similarly, Khalaila Rabia who assessed
communication difficulties and
psychoemotional distress in patients receiving
mechanical ventilation and Lance Patak et al.
on communication boards in critical care
stated that majority of patients on mechanical
ventilation were males (55.3%; n=65) [6];
(65.5%; n=29) [7]; and married (68%) and
mean duration on mechanical ventilation was
6.8 days, respectively. Some of the
inconsistent findings are also there. In present
study most of the patients (37.83%) had
diagnosis related to gastrointestinal system and
only 5% of patient had previous history related
to mechanical ventilation. while in study by
Khalaila Rabia most of the patients (29%;
n=65) had diagnosis related to respiratory
system and infections. The reason for change
in diagnosis may be due to the change in the
setting. One fourth (25%; n=65) of the patients
had previous history related to mechanical
ventilation reason for this may be due to large
age difference i.e. 18 to 92 years. In present
RRJoM (2014) 9-11 © STM Journals 2014. All Rights Reserved
Thakur et al.
experimental and comparison group with
respect to levels of experiences in terms of
communication of needs. The chi square value
(χ2=33.4, p=0.01*) found to be highly
significant at ≤0.05 level of significance. The
study also depicted no significant association
of levels of experience with selected variables
in experimental and comparison group. The
findings suggest that experiences of patients in
experimental group were better than the
comparison group with the use of sign board.
(N=37)
Comparison Group
Chi/Yates df p value
(n=20) f (%)
0
0
33.4 3 0.01*
1 (5)
study experiences of patients were collected in
terms of needs/problems communicated. In
present study mean percentage of needs
communicated in experimental group was
50.53% and comparison group 10.25% after
showing sign board. Study conducted by
Lance Patak et al. showed that Most patients
(69%; n=20) perceived that a communication
board would have been helpful for
communicating with others during mechanical
ventilation. After showing sign board in
experimental group experiences of patients
were assessed in terms of levels of needs
communicated and study findings report that
in experimental group 41.1% patients in
experimental group had average experience
and 52.9% had poor experience, while in
comparison group 5% had poor experience
and 95% had very poor experience. Another
study conducted to show the satisfaction of
mechanically ventilated patients with three
techniques of communication i.e. conventional
communication method, communication board
A (words and letters) and communication
board B (pictures and letters) respectively.
Study result showed significant difference in
communication with communication board B
(pictures and letters) [8]. Though we have not
studied satisfaction but satisfaction with
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 Research & Reviews: Journal of Medicine
Volume 4, Issue 3
ISSN: 2249-8648 (online), ISSN: 2348-7917 (print)
communication board means that more needs
were communicated with communication
board B (pictures and letters). In our study we
had evaluated the experiences (in terms of
needs communicated) of patients with or
without the use of communication board.
CONCLUSION
The study concluded that sign board was
effective in communicating the needs of
mechanically ventilated patients in
experimental group. Sign board was effective
in communicating the needs of patients in all
domains i.e. physical, social and
psychological.
REFERENCES
1. American Thoracic Society. [Internet].
[Cited 2013 Jul 9]. Available from:
www.thoracic.org/clinical/critical./mechan
ical-ventillator
2. Aden JK .Mechanical Ventilation
Indications [Internet]. 2008 Aug [Cited
2013 Jul 12]. Availablefrom:http://www.g
hs.org/upload/docs/Medical%20Education
/IM%20UME/MECHANICAL_VENTIL
ATION.pdf
3. Jordan Portia J, van Rooyen Dalena,
Strumpher Johanita. The Lived Experience
of Patients on Mechanical Ventilation.
[Internet]. 2002 [Cited 2013 Jul 8].
Available from: www.researchgate.net/.../
47787475.
RRJoM (2014) 9-11 © STM Journals 2014. All Rights Reserved
View publication stats
4. Mary Beth Happ, Kathryn L. Garrett,
Tricia Roesch. Critical Issues and
Preliminary Research [Internet]. 2003
[Cited 2013 Jul 14]. Available from:
http://aac.unl.edu/drb/as03/aac-icu.pdf.
5. Grossbach I, Stranberg S, Chlan L.
Promoting Effective Communication for
Patients Receiving Mechanical
Ventilation. [Internet]. 2010 Aug [Cited
2013 Jul 8]. Available from:
http://www.ncbi.nlm.nih.gov/pubmed
6. Khalaila Rabia, Zbidat Wajdi, Anwar
Kabaha, et al. Communication Difficulties
and Psychoemotional Distress in Patients
Receiving Mechanical Ventilation.
[Internet]. 2011 [Cited 2013 Jul 13].
Available from: http://www.medscape.co
m
7. Lance Patak, Anna Gawlinski, Irene Fung,
et al. Communication Boards in Critical
Care. [Internet]. 2006 [Cited 2013 Jul 8].
Available from: www.hopkinsmedicalprod
ucts.com/.../CommunicationBoardsCritical
Care.pdf
8. Borzabadi Farahani, et al. Comparison of
Mechanically Ventilated Patients with
Three Types of Communication Methods.
[Internet]. 2012 [Cited 2013 Jul 14].
Available http://journals.sbmu.ac.ir/index.
php/jnm/article/view/4102.
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