Development, feasibility testing, and preliminary evaluation of the Communication with an Artificial airway Tool (CAT): Results of the Crit-CAT pilot study

Charissa J. Zaga, Catherine S. Papasavva, Graham Hepworth, Amy Freeman-Sanderson, Mary Beth Happ, Jeannette D. Hoit, Brendan A. McGrath, Vinciya Pandian, Louise Rose, Anna Liisa Sutt, Pieter R. Tuinman, Sarah Wallace, Rinaldo Bellomo, Adam P. Vogel, Sue Berney

Research output: Contribution to journalArticlepeer-review


Background: A purpose-built outcome measure for assessing communication effectiveness in patients with an artificial airway is needed. Objectives: The objective of this study was to develop the Communication with an Artificial airway Tool (CAT) and to test the feasibility and to preliminary evaluate the clinical metrics of the tool. Methods: Eligible patients with an artificial airway in the Intensive Care Unit were enrolled in the pilot study (Crit-CAT). The CAT was administered at least twice before and after the communication intervention. Item correlation analysis was performed. Participant and family member acceptability ratings and feedback were solicited. A qualitative thematic analysis was undertaken. Results: Fifteen patients with a mean age of 53 years (standard deviation [SD]: 19.26) were included. The clinician-reported scale was administered on 50 attempts (100%) with a mean completion time of 4.5 (SD: 0.77) minutes. The patient-reported scale was administered on 46 out of 49 attempts (94%) and took a mean of 1.5 (SD: 0.39) minutes to complete. The CAT was feasible for use in the Intensive Care Unit, with patients with either an endotracheal or tracheostomy tube, whilst receiving invasive mechanical ventilation or not, and while using either verbal or nonverbal modes of communication. Preliminary establishment of responsiveness, validity, and reliability was made. The tool was acceptable to participants and their family members. Conclusion: The clinician-reported and patient-reported components of the study were feasible for use. The CAT has the potential to enable quantifiable comparison of communication interventions for patients with an artificial airway. Future research is required to determine external validity and reliability.

Original languageEnglish (US)
Pages (from-to)127-137
Number of pages11
JournalAustralian Critical Care
Issue number1
StatePublished - Jan 2024


  • Artificial airway
  • Communication
  • Intensive care unit
  • Outcome measure
  • Speech
  • Voice

ASJC Scopus subject areas

  • Emergency
  • Critical Care


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