Faculty Research
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Mary
Beth Happ, PhD, RN
| Department: |
Acute & Tertiary Care |
| Location: |
336 Victoria Building |
| Email: |
mhapp@pitt.edu |
| Phone: |
412-624-2070 |
Keywords:
- Communication with Voiceless Patients
- Decision Making at End of Life
- Technology
Current Funded Research:
Happ, M
09/01/03-06/30/09
NICHD
Improving Communication with Nonspeaking ICU Patients
Critically ill patients are often unable to speak as a result of respiratory tract intubation for airway management and mechanical ventilation, which can be a traumatic life event that is frightening, reduces patient participation in care and decision-making, and impairs pain and symptom assessment. No large scale communication intervention studies have been conducted in the intensive care unit (ICU) setting.
To date, no studies have tested the effectiveness of teaching nurses to be facilitative communication partners of temporarily nonspeaking patients in ICU settings. The specific aims of this study are to: 1) test the impact of two experimental interventions: (a) communication skills training (BCST) for nurses and (b) AAC techniques and education for nurses with individualized speech language pathologist consultation (AAC/SLP), on the ease, quality, frequency, and success of communications between nurses and nonspeaking ICU patients. 2) Compare the effects of BCST and AAC-SLP training with a control (usual care) cohort. This study is a prospective field experiment using a quasi-experimental cohort design conducted in two intensive care units, medical ICU and cardiothoracic ICU. The sample will be equally distributed between units. Three cohorts of 30 patient participants each and their respective nurse caregivers will be enrolled as participants (10 RNs for each cohort; 30 total nurses, and 90 total nurse-patient dyads).
Conditions will be implemented in sequential order (control, BCST, AAC-SLP) to prevent contamination from other intervention conditions and to systematically investigate the effect of the intervention components. Trained observers will measure the frequency of nurse facilitative behaviors (quality), number of communication exchanges (frequency), number of successful exchanges, and rate communication ease across 4 observation sessions (2 per day) with each nurse-patient dyad. Primary covariates include severity of illness, level of consciousness, and physical restraint use. Statistical analysis will involve hierarchical generalized linear modeling (HGLM) by outcome groups and planned group comparisons using linear contrasts within the context of the HGLM.
Happ, M
04/01/07-03/31/10
NINR
Symptom Management, Patient Caregiver Communication Outcomes in ICU
Using an adaptation of the Revised Symptom Management Model (Dodd et al, 2001) and building on data from an existing R01 clinical trial, Project 1 will examine relationships between nurse-patient communication performance (difficulty, quality, successfulness), symptom management (symptom experience and treatment), and clinical outcome variables (ventilator-free days, length of ICU stay, hospital LOS). Project 2 will describe (1) families’ perceptions of patient communication difficulty during critical illness, (2) families’ involvement with assisted communication strategies, and (3) patient-family communication performance when ICU patients receive an assistive communication device and/or speech language pathologist (AAC-SLP) consultation intervention. This award will help develop an intervention to improve family caregivers’ communication with ICU patients who are unable to speak. Testing associations between communication performance and symptom management will provide a theoretical structure for future biobehavioral research in critical illness. Investigator development will include consultation and training experiences with multi-site investigators and experts in symptom measurement with nonspeaking ICU patients as well as attendance at the NIH Summer Institute in Clinical Trials Research.
Co-Investigator:
Happ, M
09/30/06-07/31/09
NCI
NIH/NCI, R01, “Palliative Care for Hospitalized Cancer Patients,” (Principal Investigator: R. Arnold, Mt. Sinai, School of Medicine)
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