Six main categories were identified in the data: (1) communication value/perceived
competence; (2) communication intention; (3) benefits of training; (4) barriers to implementation;
(5) preferences/utilisation of strategies; and 6) leading-following. Perceived value of and
individual competence in communication with nonspeaking patients varied. Nurses prioritised
communication about physical needs, but recognised complexity of other intended patient messages.
Nurses evaluated the BCST as helpful in reinforcing basic communication strategies and
found several new strategies effective. Advanced strategies received mixed reviews. Primary
barriers to practise integration included patients’ mental status, time constraints, and the small
proportion of nurses trained or knowledgeable about best patient communication practices in
the ICU.