Using Eyetracking to Enable Cervical Spinal Cord Injured Mechanically Ventilated Patients to Report on Pain, Needs, and Appraisals

Cervical spinal cord injury (CSCI) resulting in tetraplegia and subsequent permanent artificial ventilation leads to an inability to communicate orally and often also inhibits gestures and mimics. This is due to level of injury, which leads to immobility of all extremities and the destruction of the phrenic nerve, which innervates the diaphragm. The autonomous respiratory activity (also very important for verbal communication) is suspended. Patients with CSCI have been a neglected group within research. This thesis investigates the use of eyetracking (ET) technology as an option for CSCI patients to effectively report their subjective pain perception, needs and appraisals during acute critical illness in the intensive care unit. After familiarizing themselves with the use of the ET (in a practice phase), the device was calibrated and the actual test phase began. Questions about basic needs or the subjective perception of pain were shown on the display of the ET and also read aloud by the ET device. The patients answered the questions by keeping their gaze fixed on one of the proposed answer options (e.g. "Yes"/"No"). In three journal manuscripts the effectiveness of the ET could be demonstrated. The first study examined how people with CSCI cope with the current condition and future limitations. Patients were able to give multifaceted reports of their current state, such as feeling trapped or unsafe. The second study evaluated the perceptions of wearing a tracheostomy tube in critically ill individuals with acute and chronic spinal cord injury (aCSCI, cSCI). It emphasized the importance of regularly assessing the subjective perception of critically ill tracheotomized individuals in the daily routine of an intensive care unit (ICU). The third study examined the relationship of pain and pain perception in CSCI patients with reported needs and appraisals. Contrary to previous research, results suggest that pain is not a dominating factor in needs and appraisals. This thesis shows that it is possible to support communication of ICU patients who cannot communicate orally, and how. The faceted reports on pain, needs and appraisals furthermore underline the relevance of ET usage as well as potential benefits of further research on ET-based communication in ICU patients.

Zitieren

Zitierform:
Zitierform konnte nicht geladen werden.

Zugriffsstatistik

Gesamt:
Volltextzugriffe:
Metadatenansicht:
12 Monate:
Volltextzugriffe:
Metadatenansicht:

Rechte

Nutzung und Vervielfältigung:
Alle Rechte vorbehalten