CommunicativeProblemsofAdults inIntensive Care Units

Abstract

Each year, millions of individuals are admitted to medical and surgical intensive care units (ICUs). Patient who is admitted to ICU has great stress, worry and anxiety. The inability to communicate in ICUs is a common condition as most of those admitted require mechanical ventilation also some may have pre-existing or acquired cognitive-linguistic impairment that interferes with functional communication (Fowler, 1997). There are many causes which make a person needs care in an ICU, some are common conditions that either bring the patient to the ICU, others develop while the patient is in the unit e.g. :-impaired level of consciousness, acute respiratory failure requiring mechanical ventilation, acute stroke with altered mental status, causes of increased intracranial pressure (ICP) e.g. cerebral edema, brain tumors, and intracranial hemorrhage, general medical conditions e.g. hypertension, hypotension, aspiration pneumonia, sepsis, cardiac arrhythmias, cardiac arrest, pulmonary emboli and renal failure, seizures, post-operative patients requiring hemodynamic monitoring, ventilatory support or extensive nursing care and Coma (metabolic, toxic, anoxic) (Robin et al., 2003). The most common Causes of communicative disorders in adults are stroke, brain tumors and respiratory failure as the patient needs mechanical ventilation. Stroke is the rapid loss of the brain functions due to disturbance in the blood supply to the brain. This can be due to ischemia which is caused by blockage (thrombosis, arterial embolism), or a hemorrhage. Nearly 75% of all strokes occur in people over the age of 65. The risk of having a stroke doubles after the age of 55 (Lugger, 1994).Language disorders that occur after stroke may be variable which include dysphasia, dysarthria and apraxia (O’Sinanovic et al., 2011). Brain tumor is an abnormal growth of tissues in the brain. Unlike other tumors, brain tumors spread by local extension and rarely metastasize (spread) outside the brain.Tumors are either benign or malignant. Benign tumors can cause problems as they can grow very large and press on healthy organs and tissues, but they can’t invade other tissues and can’t spread to other parts of the body (metastasize). In most parts of the body, these tumors are almost never life threatening. But in the brain, even benign tumors can sometimes damage nearby normal brain tissue. This can be disabling and might even be life threatening in some cases (American Cancer Society, 2013).