Early Speaking Valve in Ventilator Weaning: Effects on Communication, Depression, and Quality of Life

Inclusion Criteria: * Age: ≥18 years old * Consciousness: Glasgow Coma Scale (GCS) score 13-15 (can voluntarily open eyes or respond when called, able to follow instructions to move) * Tracheostomy: Performed ≥24 hours, with no bleeding, pain, subcutaneous emphysema, pneumothorax, or infection * Ventilator Weaning: Trained according to the hospital's Respiratory Care Center standards, able to undergo spontaneous breathing training during the day * Ventilator Settings: FiO2 ≤40% * Vital Signs: Stable: * Heart rate 60-100 beats/min * Respiratory rate 12-20 breaths/min * Systolic blood pressure \<150 mmHg, diastolic blood pressure \<90 mmHg * Blood oxygen saturation 95-100%, no dyspnea complaints * Richmond Agitation-Sedation Scale (RASS) between -1 and +1 * Language: Able to communicate in Mandarin, Taiwanese, or Hakka * Consent: Willing to participate in the study Exclusion Criteria: * Recent surgery, anesthesia, or sedative use affecting consciousness * Severe unstable vital signs or inability to breathe normally * Upper airway obstruction or vocal cord paralysis * High dependence on ventilators or high-concentration oxygen therapy * History of depression or currently taking antidepressant medication