Abstract：
BACKGROUND: Patients in the intensive care unit (ICU) are commonly on mechanical ventilation, either through endotracheal intubation or tracheostomy, which usually leaves them nonverbal. Low-technology augmentative and alternative communication (AAC) strategies are simple and effective ways to enhance communication between patients and their communication partners but are underutilised.
OBJECTIVE: The aim of this study was to systematically review current evidence regarding the effectiveness, experience of use, and usability of low-technology AAC with nonverbal patients and their communication partners in the ICU.
METHODS: This review included quantitative, qualitative, and mixed-methods studies of adult ICU patients aged 18 or older who were nonverbal due to mechanical ventilation and their communication partners. Studies using low-technology AAC, such as communication boards and pen and paper, were included. Six databases were searched, and the review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A convergent segregated approach was used for data synthesis.
RESULTS: Thirty-two studies were included. Low-technology AAC improved patient satisfaction, facilitated communication, and met patients\' physical and psychological needs. Communication boards with mixed content (e.g., pictures, words, and letters) were preferred but were used less frequently than unaided strategies due to patients\' medical status, tool availability, and staff attitudes. Boards should be user-friendly, tailored, include pen/paper, and introduced preoperation to increase patient\'s comfort when using them postoperatively.
CONCLUSIONS: Existing evidence support low-technology AAC\'s efficacy in meeting patients\' needs. Better usability hinges on proper implementation and addressing challenges. Further research is crucial for refining communication-board design, ensuring both user-friendliness and sophistication to cater to ICU patients\' diverse needs.
BACKGROUND: The review protocol was registered in the International Prospective Register of Systematic Reviews, with registration number CRD42022331566.
OBJECTIVE: The aim of this study was to systematically review current evidence regarding the effectiveness, experience of use, and usability of low-technology AAC with nonverbal patients and their communication partners in the ICU.
METHODS: This review included quantitative, qualitative, and mixed-methods studies of adult ICU patients aged 18 or older who were nonverbal due to mechanical ventilation and their communication partners. Studies using low-technology AAC, such as communication boards and pen and paper, were included. Six databases were searched, and the review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A convergent segregated approach was used for data synthesis.
RESULTS: Thirty-two studies were included. Low-technology AAC improved patient satisfaction, facilitated communication, and met patients\' physical and psychological needs. Communication boards with mixed content (e.g., pictures, words, and letters) were preferred but were used less frequently than unaided strategies due to patients\' medical status, tool availability, and staff attitudes. Boards should be user-friendly, tailored, include pen/paper, and introduced preoperation to increase patient\'s comfort when using them postoperatively.
CONCLUSIONS: Existing evidence support low-technology AAC\'s efficacy in meeting patients\' needs. Better usability hinges on proper implementation and addressing challenges. Further research is crucial for refining communication-board design, ensuring both user-friendliness and sophistication to cater to ICU patients\' diverse needs.
BACKGROUND: The review protocol was registered in the International Prospective Register of Systematic Reviews, with registration number CRD42022331566.
摘要：
背景：重症监护病房（ICU）的患者通常使用机械通气，通过气管插管或气管造口术，这通常让他们没有语言。低技术增强和替代沟通（AAC）策略是增强患者与其沟通伙伴之间沟通的简单有效方法，但未得到充分利用。
目的：本研究的目的是系统回顾当前关于有效性的证据，使用经验,低技术AAC与非语言患者及其在ICU中的沟通伙伴的可用性。
方法：本综述包括定量，定性，和18岁或以上因机械通气而非语言的成年ICU患者及其沟通伙伴的混合方法研究。使用低技术AAC的研究，如通讯板、笔和纸，包括在内。搜索了六个数据库，审查是根据系统审查和荟萃分析（PRISMA）指南的首选报告项目进行的。一种收敛的分离方法被用于数据合成。
结果：纳入32项研究。低技术AAC提高了患者满意度，促进沟通，并满足患者的生理和心理需求。具有混合内容的通信板(例如，图片,单词,和字母)是首选，但由于患者的医疗状况，使用频率低于非辅助策略，工具可用性，和员工的态度。董事会应该是用户友好的，量身定做,包括笔/纸，并引入术前，以增加患者术后使用它们时的舒适度。
结论：现有证据支持低技术AAC在满足患者需求方面的功效。更好的可用性取决于正确的实施和应对挑战。进一步的研究对于完善通信板设计至关重要，确保用户友好性和复杂性，以满足ICU患者的多样化需求。
背景：审查方案已在国际前瞻性系统审查登记册中注册，注册号为CRD42022331566。
目的：本研究的目的是系统回顾当前关于有效性的证据，使用经验,低技术AAC与非语言患者及其在ICU中的沟通伙伴的可用性。
方法：本综述包括定量，定性，和18岁或以上因机械通气而非语言的成年ICU患者及其沟通伙伴的混合方法研究。使用低技术AAC的研究，如通讯板、笔和纸，包括在内。搜索了六个数据库，审查是根据系统审查和荟萃分析（PRISMA）指南的首选报告项目进行的。一种收敛的分离方法被用于数据合成。
结果：纳入32项研究。低技术AAC提高了患者满意度，促进沟通，并满足患者的生理和心理需求。具有混合内容的通信板(例如，图片,单词,和字母)是首选，但由于患者的医疗状况，使用频率低于非辅助策略，工具可用性，和员工的态度。董事会应该是用户友好的，量身定做,包括笔/纸，并引入术前，以增加患者术后使用它们时的舒适度。
结论：现有证据支持低技术AAC在满足患者需求方面的功效。更好的可用性取决于正确的实施和应对挑战。进一步的研究对于完善通信板设计至关重要，确保用户友好性和复杂性，以满足ICU患者的多样化需求。
背景：审查方案已在国际前瞻性系统审查登记册中注册，注册号为CRD42022331566。
