Survey of the success of communications between hospital staff and patients

Patient Access to Medical Information

This paper is the first of a 2-part article. In it, the author discusses issues relevant to patient access to medical records. Research findings suggest that the fear of many health practitioners regarding the harmful effects of such access are unjustified. Access to medical information improves patient-doctor relations, increases patient knowledge and compliance, has positive effects on patients' health, and improves the quality of record keeping. Other suggested advantages are increases in the quality of patient care and health practitioners' work satisfaction, and a decrease in malpractice suits. The hypotheses to be tested in a survey of medical practitioners' attitudes to these issues are discussed.

South Asian patients' lived experience of acute care in an English hospital: a phenomenological study

Studies on utilization of hospital services by South Asian patients in the United Kingdom have consistently demonstrated levels of dissatisfaction with care in relation to meeting religious and cultural needs, although there are few studies on minority ethnic patients' utilization of acute hospital services. This study aimed to describe and interpret from the consumer's view the 'lived experience' of acute hospital care from the perspectives of South Asian patients and their family carers. The purposive sample of 10 patients and six carers consisted of 13 females and three males (five Hindus, six Muslims and five Sikhs) who were interviewed at home 2 to 3 weeks after discharge from hospital. Data were gathered through semi-structured interviews that were tape recorded and transcribed. A phenomenological approach was used, and data were analysed using the principles of Heideggerian hermeneutics. Five themes were identified, ranging from feelings of satisfaction with care, unhappy about the service, fitting-in strategies and post-discharge coping mechanisms. Patients seemed to want to cause as little disruption as possible to the ward environment and tried to fit in to what they refer to as an 'English place'. The findings, although not generalizable, offer important insights into how South Asian patients survive their journey through their hospital stay and have implications for the provision of nursing care for minority ethnic patients.

Psychological and educational support for CAPD patients

Following the development of a small dedicated renal team and the implementation of a new educational and psychological support programme for patients undergoing continuous ambulatory peritoneal dialysis (CAPD), several improvements in outcome measures have become apparent. These changes are also associated with improved patient compliance and overall wellbeing of patients and their families.

An open evening for stroke patients and relatives

A cerebral vascular accident (CVA) can cause fear and anxiety about the future for both sufferer and carers. Returning to the community after having been in the security of a hospital ward for many weeks can be traumatic. Nurses should enhance their health education programmes to prepare stroke patients and relatives for life at home.

The role of the nurse in the medical ward round

Communication between hospital staff and in-patients, especially regarding the provision of information, has been found to be inadequate although improving information-giving has been demonstrated to have a number of beneficial effects. While the ward round might be a particularly valuable setting for communication, few studies have explored the multidisciplinary nature of rounds. This study obtained the views of 33 consultants, 14 nurses and eight patients and observed three ward rounds in order to determine the nature of present round functioning, and the nurse's role in such a round. The results showed that the rounds studied were not being conducted in a democratic fashion: medical staff dominated and other health care professionals had little involvement. Patients received few explanations and had great difficulty understanding the discussion. The functions nurses were seen to perform involved primarily providing information for medical staff. It is recommended that patients are more involved in rounds and are given more explanations and encouraged to ask questions. Nurses should be educated to assert themselves in ward rounds in order to fulfil roles they prescribe for themselves, and all professionals should aim towards more democratic, equal discussion. There is a need for further research to determine the effectiveness of nurse intervention on patient involvement and satisfaction with the round.

Are nurses good patient educators?

Health care demands are rising rapidly as we move towards the year 2000 and effective health education is essential if increasing numbers of patients are to be nursed in the community and the effects of preventable illnesses are to be minimized. It is therefore extremely pertinent to discuss how well nurses are educating their patients at present and what strategies the profession may need to consider in order to meet educational needs of the future. It seems clear that nurses have a responsibility to provide the information that their patients require, although there remains some debate regarding whether they are the most appropriate member of the health care team to do so. Recent studies show that nurses can be effective educators. However, although many recognize the importance of this role, they still often lack the skills, knowledge, motivation and support required to organize and implement an adequate programme of patient education.

Effect of information leaflets on knowledge in patients with gastrointestinal diseases

Twelve patient information leaflets concerning common gastrointestinal diseases were produced by the British Digestive Foundation and evaluated to determine whether patients knew more about their disease if they received a leaflet. Eleven hundred and fifty patients attending gastroenterology clinics in the United Kingdom were assessed by postal questionnaire of whom half had received a leaflet relevant to their diagnosis six weeks before assessment. Seven hundred and fifty one replied (398 leafleted, 353 non-leafleted). Most patients found the leaflets helpful and easy to understand; few found them worrying. They were regarded as a better source of information than doctors, particularly for information about the characteristics of the illness and side effects of treatment. In all diagnostic groups assessed the patients' knowledge of their disease was significantly greater if they had received a leaflet than if they had not. Individual responses by patients without leaflets showed that fundamental misconceptions persisted about digestive diseases. The British Digestive Foundation leaflets are an effective means of imparting disease related information to patients.

Patient education: a literature review

The literature review has been carried out to examine the role of nurses as patient teachers. It attempts to determine why patient education is necessary and why it should be part of the nurse's role. Included is an account of the abilities required by the nurse in order to function in that role. It is generally agreed that it is part of the nurse's role to educate patients but this is often not carried out in reality. Where it is done it is mostly unplanned and haphazard in manner and the effectiveness uncertain. There are many reasons cited why this is the case and many of these reasons relate to the inadequate education and training of nurses for this role. Registered nurses are responsible for the nursing care of patients which should include their education. In order to be able to provide the necessary education nurses must have the opportunity to be taught to develop the appropriate skills during basic training. As a result, a study is now underway to attempt to determine the extent to which student nurses are being prepared for their role as patient educators during basic training.

Meta-analysis of satisfaction with medical care: description of research domain and analysis of overall satisfaction levels

Consumer satisfaction with medical care was examined in a meta-analysis of 221 studies. For each study, (1) a coding form was filled out that described sample characteristics, design, and instrument methodology, and (2) the study sample's overall satisfaction level was transformed to a 0.00-1.00 scale. This article summarizes the study attributes as compiled from the coding form, presents grand satisfaction means over all studies, and tests for differences in satisfaction between studies that employed different methods of research.

The effects of physician communications skills on patient satisfaction; recall, and adherence

An understanding of means to improve patient adherence to the therapeutic regimen is a subject of increasing concern in medical care. This study examined the effects of physician interpersonal skills and teaching on patient satisfaction, recall, and adherence to the regimen. We studied the ambulatory visits of 63 patients to five medical residents at a teaching hospital in Baltimore. It was found that quality of interpersonal skills influenced patient outcomes more than quantity of teaching and instruction. Secondary analyses found that all the effects of physician communication skills on patient adherence are mediated by patient satisfaction and recall. These findings indicate that the physician might pay particular attention to these two variables in trying to improve patient adherence, and that enhancing patient satisfaction may be pivotal to the care of patients with chronic illness.

Receipt of prescription drug information by the elderly

Analysis of responses of 267 elderly subjects to a telephone survey dealing with communications between patients and health professionals about prescribed medications indicated several age-related differences. Results showed that elderly patients received less general information and less drug-specific information than younger patients did. This occurred in both pharmacist and physician encounters.

Professional communications in cancer care: a Delphi survey of hospital nurses

Although good communications are generally agreed to be an essential component of effective nursing care of cancer patients, little research has been done on nurses' perception of communication problems, and less on their suggestions for resolving them. A Delphi-type survey among nurses in the North of England revealed that the main areas of comment were: dealing with patients' questions and fears; the communication implications of pain control; and relationships with other professional groups both inside and outside the hospitals. Numerous suggestions were made for improving communications.