The implications of nursing diagnosis: impaired verbal communication to the client of high complexity in intensive care - Systematic Literature Review

Raquel de AP e Souza, Isabel CF da Cruz


Abstract: The unconscious or comatose patient is a challenge to effective communication; the patient’s neurological status creates doubts about the level of hearing and sensory perception and limits the communication of nurses. Objective: To identify the scientific production of nursing, the best evidence for nursing care in the sensory stimulation of the unconscious patient unable to communicate their needs verbally. Method: Literature review from electronic search in databases and virtual libraries. Data collection occurred between March and June 2014. It was selected 10 scientific studies for the sample to be analyzed. The results analyzed were of the thematic study and evidence-based practice. Results: The evidence resulted in conflicting findings about the effects of stimulation in unconscious patients. According to researchers, communication with unresponsive patients is described as limited, essentially related to nursing interventions to be performed only. However, there are sufficient evidences to support the assumption that there is an increasing mental activity and emotional awareness in unconscious patient stimulated. Findings described in the literature also clearly indicate a correlation between auditory stimulus and increases in arterial blood pressure, heart rate, respiratory rate, intracranial pressure, body and facial movement. Conclusion: The literature review revealed a lack of studies that investigated what nurses actually say to their patients, emerging the need for additional empirical research. The available studies suggest that intensive care nurses do not provide enough verbal communication to their patients and highlight several points of concern.


Unconsciousness; Communication; Coma; Nurse–Patient Relations

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