Mechanically ventilated patients' Experiences of communication using eye-tracking technology: A qualitative descriptive study.

Background: Effective communication with mechanically ventilated awake patients in the intensive care unit (ICU) is a major challenge. Invasive mechanical ventilation deprives patients of their ability to communicate and hinders nurse-patient communication. Effective communication is an important step in building the nurse-patient relationship. Communication tools such as eye-tracking devices have the potential to improve communication between ICU nurses and patients. Objective: The aim of this paper was to explore the use of eye-tracking technology for nurse-patient communication with mechanically ventilated patients in the ICU, and to inform its improved implementation in this setting. Methods: Using a descriptive qualitative design and following the Consolidated Criteria for Reporting Qualitative Research (COREQ). Semi-structured interviews were conducted from February to May 2025 with 16 mechanically ventilated patients who communicated using eye-tracking devices at least three times during their hospitalization at a hospital in Henan Province. Thematic analysis was employed, guided by the framework developed by Braun and Clarke. Results: Three themes were identified: Technical interaction experience, Psychological experience, and the Barriers to using the device. This paper found that eye-tracking devices were feasible in communicating basic needs and provided psycho-emotional benefits. Patients were able to regain a sense of engagement, engage in emotionally supportive interactions, and feel psychologically safe. However, factors such as physiologic fatigue and environmental conditions created barriers to optimal use of the devices. Conclusion: Eye-tracking technology can serve as a valuable supportive tool for nurse-patient communication in the ICU. It empowers patients to participate in their daily care and facilitates emotionally supportive interactions. However, barriers to implementation must be addressed to optimize its effectiveness. Future efforts should focus on refining these communication tools based on these findings to ensure that critically ill patients can fully benefit from them. Implications for clinical practice: Eye-tracking devices are used as communication aids to help intubated or tracheostomy patients express basic needs and participate in their own care. To ensure communication effectiveness, clinical practice needs to be optimized in various ways, such as optimizing device performance and providing systematic training and support for caregivers to deal with barriers to device use.