A talking point for intensive care

A stay in an intensive care unit may only be short, but it is a worrying time for all concerned. On top of the anxieties regarding recovery, many patients, with breathing tubes in their throats, are unable to speak. A research project has now developed a computerised system that allows patients to communicate better by choosing sentences from a pre-programmed selection.

“Many patients in intensive care attempt to mouth words, but if they have tubes in their mouth, lip reading is difficult. Weakness can affect the movement of their hands and arms and make writing or gesturing hard too,” explains Professor Ian Ricketts from Dundee University. “The inability to communicate can be upsetting for patients and while nursing staff are highly skilled at anticipating the communication needs of patients, they say it is time consuming and difficult.”

Professor Ricketts has led a team from the Department of Applied Computing that has designed a system which enables patients to speak to staff, relatives and friends through a computer. They can navigate through a database of over 250 phrases using a touch-screen, a mouse or options using a single switch. The computer then uses speech synthesis software to utter the sentence.

“The selection of phrases available are wide ranging,” says Professor Ricketts. “We asked nurses to suggest sentences for particular topics and used their responses, along with observations of patient communication in our local intensive care unit, to compile a core set of phrases.”

Along with these stock phrases the research team devised a way that would supply patients with personalised phrases too. “We have a questionnaire that is completed by a family member and the answers are incorporated into template phrases to personalise them,” explains Professor Ricketts. “A patient can then enquire about a family member by name, for instance.”

The computer interface is simple to use, so patients easily learn how to use it. Phrases are grouped within eight colour-coded topic areas, such as “Family, friends” or “Feelings”. Trials so far show that patients quickly learn to control the system and successfully communicate. Nursing staff overwhelmingly support the concept of computer-assisted communication.

“Preliminary trial results have so far been encouraging, though of course we are still refining our prototype system, especially the navigation of phrases,” Professor Ricketts notes. “At the moment some phrases are hard to find or don’t exist, and we are also looking at incorporating animation into the navigation as research suggests that animation makes interaction with computer systems easier. Our main concern, however, is to make the system much smaller so that it doesn’t obstruct nursing staff or restrict their view of, and access to, the patient. Ideally a small, robust, bedside system will make communication much more natural and take one worry off the minds of patients, staff and relatives alike.”