Registered nurse-patient communication research: An integrative review for future directions in nursing research

Considering health literacy in communication about medications between nurses and patients with heart failure: A cross sectional observational study

OBJECTIVES

To explore the content, style, and initiation of medication-related discussions between nurses and patients to understand how nurses support patients with heart failure, especially those with inadequate health literacy.

METHODS

A cross-sectional design was conducted to observe medication-related conversations between nurses and patients with heart failure in four Dutch outpatient clinics. Conversations were audio-recorded and analyzed using MEDICODE, focusing on content, communication style (monologue or a dialogue), and initiation of the content themes. Health literacy was assessed using the NVS-D and the SBSQ. Results between health literacy groups were compared with descriptive analyses.

RESULTS

A total of 56 patients and 14 nurses participated in the study. Patients classified by one or both of the instruments as having inadequate health literacy (n = 33; 59 %) were generally older, had lower educational levels, and were more often accompanied by informal caregivers. Key themes discussed in the medication-related conversations included how the medication was identified ('medication designation), its dosage and instruction, main effects, side effects, attitude or emotions and other ('various') themes. The 'medication designation' theme was significantly more frequently discussed in the group with adequate health literacy, whereas 'attitude or emotions' and 'various themes' were more commonly discussed among those with inadequate health literacy. Most conversations were nurse-initiated and tended to be monologues, with nurses mainly serving as information providers.

CONCLUSIONS

Nurses primarily initiated and dominated medication-related discussions with a focus on factual aspects of medication, while patients initiated more discussions about their concerns regarding medication. While there was overlap in the topics discussed, notable differences emerged between patients with adequate and inadequate health literacy.

PRACTICE IMPLICATIONS

Improving communication strategies, such as structuring conversations and adopting dialogic approaches may improve patients' engagement and understanding of medication use, leading to more effective management of their condition, particularly benefiting patients with lower health literacy.

Increasing child involvement by understanding emotional expression during needle procedures: A video-observational intervention study

AIM

To evaluate child-nurse emotional communication during needle procedures using a child-centered intervention versus a control group.

METHODS

A controlled, video-observational study, incorporating 66 children and seven nurses was conducted. Data were collected using video-recordings of child-nurse communication during needle procedures when receiving standard care (control group) or standard care plus the i Can Choose intervention (intervention group).

FINDINGS

Children expressed their unpleasant emotions mostly non-verbally. Compared to children in the intervention group, those in the control group more often expressed vague or unspecified words to describe an emotion (χ2(1) = 14.4, p < 0.001). The nurses' focus and overall communication style varied between the groups. When using i Can Choose, nurses provided more space to children's communication preferences. This seemed to increase children's involvement during the needle procedure.

CONCLUSION

Communicating with the child, the so-called communicative interaction, instead of to the child, can play a critical role in children's handling of fear and pain related to needle procedures.

Perspectives of nurses and patients on the misplacement of supportive care information for type 2 diabetes mellitus: a qualitative study in China

OBJECTIVE

This study aimed to investigate the perspectives of nurses and patients on the misplacement of supportive care information for type 2 diabetes mellitus (T2DM).

METHODS

A descriptive qualitative study was conducted using purposive sampling to recruit elderly individuals diagnosed with T2DM and nurses from a geriatric hospital in the central region of China. Semi-structured interviews were carried out between June and October 2024.

FINDINGS

A total of 21 patients and 12 nurses participated in this study. Five themes were generated: (1) consistent value identity, (2) inadequate information carriers, (3) conflicting subject needs, (4) loose information links, and (5) strong willingness to improve.

CONCLUSION

It was essential for patients and nurses to enhance access to information and establish a robust information support framework. In addition to improving the information support capabilities of nurses, it was equally important to enhance patients' ability to provide feedback on the information they receive.

Clinical value analysis of integrated care model in reducing bleeding and complications during Da Vinci robot-assisted urology

This study aims to explore the effect of integrated care mode on patients in Da Vinci robot-assisted urology surgery and provide a new nursing scheme for clinic. A total of 93 patients from August 2022 to March 2024 were selected and divided into intervention group (43 cases) and control group (50 cases). The operation time, blood loss, first postoperative exhaust time, time to get out of bed, pain score (visual analog scale), psychological status (self-rating anxiety scale and self-rating depression scale), quality of life score (36-Item Short Form Survey), catheter retention time, patient satisfaction, incision healing, incidence of urinary system infection, nutritional status, and complication rate were compared between the 2 groups. There were no significant differences in baseline data and operative time between the 2 groups (P > .05), but the amount of intraoperative blood loss in the intervention group (250.32 ± 50.23) mL was less than that in the control group (320.56 ± 65.34) mL (P < .05). The first postoperative exhaust time and getting out of bed time in the intervention group were shorter than those in the control group (P < .05), and the pain visual analog scale score was lower than that in the control group (P < .05). The scores of self-rating anxiety scale and self-rating depression scale of mental state were better than those of the control group (P < .05), and the scores of quality of life were higher (P < .05). The retention time of catheter was shorter than that of the control group (P < .05), the patient satisfaction was 93.02% higher than that of the control group 78.00% (P < .05), and the grade A incision healing rate was 90.70% higher than that of the control group 76.00% (P < .05). The incidence of urinary system infection (4.65%) was lower than that of the control group (16.00%) (P < .05), the changes of serum albumin level and body weight were lower than that of the control group (P < .05), and the complication rate of 6.98% was lower than that of the control group (22.00%) (P < .05). Although the integrated medical care model did not significantly shorten the operation time, it was beneficial to the postoperative recovery of patients in many aspects.

Acceptance of Illness and Health-Related Quality of Life in Patients After Myocardial Infarction-Narrative Review

Introduction: Cardiovascular diseases, particularly myocardial infarction (MI), significantly impact patients' lives, causing stress and prompting varied responses to illness. Aim and methods: We conducted a narrative review concerning the acceptance of illness and quality of life in post-MI patients. Based on an extensive search of the available literature, this review consolidates current evidence on the proposed topic. Conclusions and implications: While some patients struggle with acceptance and face emotional distress, others who accept their condition are more likely to engage in treatment and lifestyle changes, leading to an improved health-related quality of life (HRQoL). Following an MI, patients often experience depression, anxiety, and stress, complicating their acceptance of the illness. Risk factors, such as hypertension, diabetes, and smoking, play a significant role in influencing HRQoL in post-MI patients. An accurate assessment of HRQoL is crucial for tailoring effective treatments and support strategies to enhance patient outcomes and identify those most at risk of developing post-MI depression or anxiety. Effective physician-patient and nurse-patient communication and support from family might be helpful in recovery. Cardiac rehabilitation improves patients' outcomes and HRQoL. This review underscores the importance of integrating psychological support with optimal medical care to improve patient prognosis and enhance the HRQoL of individuals recovering from MI. The healthcare system could implement routine psychological assessments for MI patients at admission and discharge to establish a baseline for follow-up. Future research should explore effective psychological interventions, the interplay of CVD risk factors and psychosocial aspects, the emerging role of artificial intelligence in personalized care, and the cost-effectiveness of integrated treatment models.

Evaluating the therapeutic communication skills of nursing students in the clinical setting: The experiences of students, patients and patients' relatives

Background

This study aimed to determine the therapeutic communication skills of nursing students, examine their experiences of communication during care, and evaluate the views of patients and their relatives.

Methods

This study was designed using the convergent parallel mixed method and was conducted in Türkiye. The therapeutic communication skills of 112 nursing students were examined using the Therapeutic Communication Skills Scale. Qualitative data were obtained in focus group interviews with 18 nursing students and in individual interviews with 10 patients and 10 of their relatives. Number, percentage, mean ± standard deviation and minimum-maximum values were calculated from the quantitative data. The thematic method was used to analyze the qualitative data.

Results

The mean scores of the 112 nursing students for Therapeutic Communication Skills 1 (reflecting, summarizing, restating, verbalizing the implied, focusing, and stating the observed) and Therapeutic Communication Skills 2 (active listening, offering self, and asking questions) were 26.18 ± 6.52 and 15.68 ± 3.03, respectively. The mean score for non-Therapeutic Communication Skills (warning, downplaying emotions, advising, vague reassurance/cliché response, changing the subject, defending, and judging) was 18.59 ± 7.60. As a result of the analysis of the qualitative data, three main themes emerged: "challenges in mastering and applying therapeutic communication", "the positive impact of therapeutic communication", and the "patients' and relatives' views of the nursing students' communication skills".

Conclusion

Despite challenges in applying therapeutic communication techniques, this study highlights the benefits of doing so for both patients/relatives and nursing students. Nevertheless, since the individual and cultural factors affecting the results of this study could not be controlled, further studies in different cultures and further studies are needed. On the basis of the results of this study, educators should support the internalization of students' communication skills by employing methods such as simulated patients, standardized patients, and peer education. It is recommended that the knowledge and skills of nurses working with students in clinical settings be improved to ensure they are able to serve as adequate role models.

How does age impact understanding of epistemic adverbs in health communication?

OBJECTIVE

Not much is known about how one's understanding of words may differ with age. Here we explore how epistemic adverbs - as used in health communication to indicate degrees of uncertainty and risk - are understood by older and younger monolingual speakers of Australian English.

METHODS

We used an online dissimilarity rating task with sentence pairs presented as first and second doctor opinions which differed only with respect to the embedded epistemic adverbs (e.g., This could certainly cause some cramps vs. This could possibly cause some cramps). To evaluate the possible effect of age, we compared the dissimilarity ratings of older and younger Australian English monolinguals (aged ≥55 (n = 24) and aged 18-50 (n = 57), respectively). The data were interpreted using classical Multi-Dimensional Scaling (C-MDS) analysis, complemented by cultural consensus analysis and hierarchical cluster analysis.

RESULTS

Analyses revealed intragroup consensus for each speaker group. Both speaker groups clustered the hearsay adverbs (apparently, presumably, reportedly, and supposedly) similarly, and showed a similar understanding of probably, as reflected in a unique - albeit the least stable - cluster. Interestingly, the speakers differed in their understanding of high confidence adverbs and adverbs of likelihood. While they all clustered likely and possibly together, the older speakers also included certainly.

CONCLUSIONS

Our analysis showed some differences in how epistemic adverbs are understood by older and younger Australian English speakers, suggesting that, between generations, there were subtle changes in the degree of certainty associated with some of the epistemic adverbs (e.g., certainly). When consulting with their patients, health practitioners should be mindful that the meaning they intend when using epistemic adverbs may not be shared by their patients, especially when there is an age gap between interlocutors.

Patient-Nurse Communication in an Oncology Hospital Setting: A Qualitative Study

BACKGROUND

Communication is an important aspect in making patients competent to define, process, and manage their disease condition as well as to intercept and satisfy psychosocial needs. Communication between patient and nurse is central to the learning and orientating process since the nurse has the greatest frequency and continuity of relationship with patients and their families. This study aims to investigate the quality of communication between patient and nurse and the factors that promote or hinder effective communication from the oncology patient's perspective within an inpatient hospital setting.

METHODS

A descriptive qualitative study was conducted with one-to-one semi-structured interviews analyzed using the Framework Analysis methodology. The population consisted of oncologic patients admitted to the Medical Oncology Units of the Regina Elena National Cancer Institute in Rome. Data were analyzed using Ritchie and Spencer's Framework Analysis.

RESULTS

The sample comprised 20 patients, with an average age of 61.35, admitted to the Medical Oncology Units of the Regina Elena National Cancer Institute in Rome. Three themes emerged: positive communication as an element of care, factors fostering communication, and factors hindering communication.

CONCLUSIONS

The sample interviewed deems the quality of communication satisfactory. Familiar communication style, direct language, and caring are factors fostering communication. In contrast, lack of communication between medical and nursing staff, shortage of staff, and lack of time are considered communication barriers. Advanced communication competencies in nurses are crucial for effectively addressing the emotional and psychosocial needs of cancer patients, fostering a more empathetic and supportive care environment.

Development and psychometric testing of the psychological capital questionnaire for nurses

BACKGROUND

Psychological capital (PsyCap) is a positive internal resource for individuals, playing a crucial role in mental health. Evaluating nurses' psychological capital is important for understanding their mental well-being, as they face unique occupational stressors. However, existing PsyCap questionnaires are developed for various other professions such as enterprise employees, teachers, patients, teenagers, and civil servants, making them less suitable for the nursing profession. The main aim of this study is to develop and validate a Psychological Capital Questionnaire specifically tailored to the nursing occupation in Chinese clinical settings.

METHODS

This is a multi-stage, cross-sectional study conducted between March 2022 and May 2023. Preliminary items of the scale were generated through a literature review, theoretical research, and the Delphi method. The final questionnaire was validated through two rounds of data collection. In the first stage, 236 nurses were selected using purposive sampling for item analysis, exploratory factor analysis (EFA)and reliability testing. In the second stage, data were collected from 494 nurses using convenience sampling to conduct confirmatory factor analysis (CFA).

RESULTS

The final questionnaire contains 30 items, with six factors extracted by EFA, accounting for 77.59% of the total variance. The confirmatory factor analysis showed good model fit, with the following indices: χ²/df = 4.052, GFI = 0.836, CFI = 0.938, TLI = 0.926, NFI = 0.919, RMSEA = 0.079, RMR = 0.030. The reliability measures were high, with a Cronbach's α of 0.976, split-half coefficient of 0.976, and test-retest reliability of 0.941 and 0.963.

CONCLUSIONS

The Psychological Capital Questionnaire for Nurses exhibits strong psychometric properties, making it a valuable tool for assessing the psychological capital of nurses in Chinese clinical settings.

Effectiveness of nursing interventions on patient experiences with health care: A systematic review and meta-analysis

AIM

To synthesize and evaluate the effects of nurse-led or nursing-focused interventions for improving patient experience with health care in hospitals.

BACKGROUND

Patient experiences have increasingly been highlighted as a key healthcare quality indicator in many countries with highly developed healthcare systems. It is critical to learn about the effectiveness of previously conducted nursing interventions since nursing care is reported to be the primary driver of patient experience.

METHODS

This systematic review and meta-analysis was conducted in accordance with the JBI Manual for Evidence Synthesis and followed the PRISMA statement guidelines. The PubMed, Web of Science, Embase, Cochrane Library, and CINAHL databases were systematically searched in May 2023. Randomized controlled trials and quasi-experimental studies that were led by nurses or focused on nursing care strategies were included. The JBI critical appraisal checklists were employed to assess methodological quality.

RESULTS

A total of 15 761 records were identified; 11 studies met the inclusion criteria. Nursing interventions focused on optimizing the approach to nursing rounds, enhancing communication with patients, improving patient education, and increasing interaction with patients. The meta-analysis showed that nursing interventions increased top-box responses in the communication about medicines and discharge information dimensions, as well as the overall experience dimension, including the overall hospital rating and willingness to recommend the hospital.

CONCLUSIONS

Although few studies were included, this meta-analysis showed that nursing interventions improved patients' experiences in communication about medicines and discharge information, as well as their overall experience. More rigorous studies are needed to better understand the effect of nursing interventions and examine which components may be most effective for improved outcomes.

IMPLICATIONS FOR NURSING PRACTICE AND NURSING POLICY

Owing to the powerful influence of nursing, strategies to engage nurses are a means of improving patient experiences. More attention should be given to patients' experiences of communication with doctors and nurses, and more randomized controlled trials are needed to provide high-quality evidence.

An in-depth analysis of the personal factors and their pathways in shaping self-directed learning abilities among undergraduate nursing students

Background

Developing self-directed learning in undergraduate nursing students affects not only their learning and their lives, but also their future professional development and the quality of their future practice in clinical nursing. Hence, it is paramount to prioritize and cultivate self-directed learning capabilities among undergraduate nursing students, as this not only enhances their academic pursuits but also equips them with essential lifelong learning skills crucial for the dynamic healthcare landscape.

Objective

To delve into the intricate relationship between metacognitive abilities and self-directed learning practices among nursing students, while concurrently examining the mediating roles of psychological capital and interpersonal communication in this interconnected framework. This exploration aims to provide insights into how these factors interplay to influence the self-directed learning capabilities of nursing students.

Methods

A total of 662 undergraduate nursing students from one university in China were selected as participants in the survey, utilizing stratified random sampling between September 2023 and December 2023. Of these, an impressive 639 students (96.52%) provided valid responses. The Metacognitive Assessment Inventory, Adolescent Sense of Psychological Capital Scale, Supportive Communication Scale, and Self-Directed Learning Ability Scale were employed to comprehensively assess the metacognitive abilities, psychological capital, interpersonal communication skills, and self-directed learning capacities of nursing students. Pearson correlation analysis was subsequently utilized to delve into the related relationships among these variables. To test the mediating effects, the Bootstrap method, specifically Model 6 of the SPSS-Process package devised by Hayes, was applied.

Results

The findings revealed a robust positive correlation among metacognitive ability, psychological capital, interpersonal communication ability, and self-directed learning ability, with all associations reaching statistical significance at P < 0.01. Notably, the mediating roles of psychological capital and interpersonal communication in the relationship between metacognitive ability and self-directed learning were significant, as evidenced by the analysis (R2 = 0.347, F = 67.278, P < 0.001). Furthermore, the results indicated that metacognitive ability exerts an indirect influence on self-directed learning through a sequential chain of mediation involving psychological capital and interpersonal communication ability.

Conclusions

This finding highlights the intricate interplay between these factors, suggesting that enhancing nursing students' metacognitive abilities may indirectly bolster their self-directed learning by first fortifying their psychological capital and then fostering stronger interpersonal communication skills.

Recovery environments in places of daily living: a scoping review and conceptual analysis

BACKGROUND

Owing to advances in medical technology and the promotion of at-home medical care, patients are more frequently being treated in their places of daily living after discharge from acute care hospitals. As medical care and lifestyle are closely linked, the quality of life of the patient and their families therefore depends on the adequate preparation of the recovery environment. Hence, modifying this environment to ensure that the patient's lifestyle and medical care are complementary is often vital. This study aimed to clarify the concept of recovery environments in places of daily living.

METHODS

The literature search and selection of articles were based on a scoping review conducted in Scopus and PubMed, while data extraction and analysis were based on conceptual analysis. Thirty-two articles met the inclusion criteria.

RESULTS

Our analysis of these articles allowed us to classify four types of recovery environments in places of daily living: physical environments appropriate to the health status of the recovering patient, collaborative environments in which intra-family roles are empowered, community environments in which recovering patients are accepted, and service environments in which the required services can be accessed. We also noted the main roles of medical professionals for building relationships with patients: providing decision-making support in places of daily living, creating an environment that empowers patients and their families, and modifying the service environment.

CONCLUSIONS

For patients, the main aims of recovery environments in places of daily living are to make them physically comfortable, maintain their identity, and improve their quality of life. Although this study is only a first step towards conceptualizing recovery environments in places of daily living and the final results are tentative, we are nonetheless confident that it will be important for advancing the field of home healthcare research.

Psychometric properties of the Chinese version of the nurses' attitudes towards communication with the patient scale among Chinese nurses

BACKGROUND

Nurses' attitudes towards communication with patients influence the effectiveness of communication, which could reduce patients' negative emotions and improve their adherence to medication and treatment. The aim of this study was to develop a Chinese version of the nurses' attitudes towards communication with the patient (ACO) scale and examined its validity and reliability.

METHODS

The Chinese version ACO scale was generated using the translation-backward translation method and cross-cultural adaption.The psychometric properties of the scale, including item-to-total correlations, discriminative validity, content validity, structural validity, convergent validity, internal consistency reliability and test-retest reliability, were evaluated. Data were collected from a convenience sample of 610 clinical nurses from four hospitals and were analyzed using both exploratory factor analysis and second-order confirmatory factor analysis.

RESULT

The reliability was demonstrated with item-to-total correlations of greater than 0.40, Cronbach's alpha of 0.946 and intraclass correlation coefficients of 0.879. Content validity was acceptable and discriminative validity showed a significant discriminative ability. Exploratory and confirmatory factor analyses revealed a three-factor model. Convergent validity was confirmed by a moderate relation with a measure for nurses' empathy (r = 0.375, P<0.01).The test-retest reliability was satisfactory within a 2-week interval.

CONCLUSION

The ACO is a reliable and valid instrument to assess nurses' attitudes towards communication with patient in Chinese hospitals.

Advancing Research, Writing, and Publishing in Nursing: Addressing Challenges and Improving Standards

Nurses constitute nearly 50% of the worldwide health workforce, and the World Health Organisation has advocated for an enlargement of their roles to guarantee fair health care and address the increasing need for services. The growing specialization in nursing practice has led to a rise in educational options for nurses, including the growth of PhD programs. These programs play a crucial role in preparing nurse researchers and educators. This growth underlines the importance of evidence-based practice and high-quality academic writing in nursing. The article highlights the importance of nurses' involvement in creating evidence-based practice guidelines. The active engagement of nurses in developing evidence-based practice recommendations is essential to ensure the practicality, relevance, and grounding of these guidelines in real-world clinical experiences. The advancement of nursing depends mainly on using rigorous research procedures to generate, analyze, and disseminate knowledge and data. The current article discusses essential research methodologies, including interviews, surveys, and bibliometric and altmetric analyses. It also aims to tackle concerns about inadequate writing skills, plagiarism, and insufficient comprehension of ethical norms in research and publishing. The recommended strategies to promote nursing research and publications encompass enhancing writing skills through specialized education, embracing open-access publishing, and utilizing social media for broader distribution following publication. Implementing these approaches would increase the quality and impact of nursing publications and reinforce nursing's role in defining health policy and enhancing the care of patients.

Impact of narrative nursing cognition, self-efficacy, and social support on the practices of registered nurses in China: a structural equation modeling analysis

BACKGROUND

Narrative nursing is a novel approach according with humanistic care, which has been shown to be effective in improving health outcomes for both patients and nurses. Nevertheless, few studies have investigated the status of narrative nursing practice among nurses, and a comprehensive understanding of factors influencing this practice remains elusive.

DESIGN

This was an observational, cross-sectional study using convenience sampling method.

METHODS

After obtaining the informed consent, a total of 931 registered nurses from three hospitals in China were investigated. Data were collected using the Social Support Rating Scale, the General Self-efficacy Scale, and the Knowledge-Attitude-Practice Survey of Clinical Nurses on Narrative Nursing. All the scales were validated in the Chinese population. The questionnaire results were verified by an independent investigator. Factors influencing narrative nursing practice were determined through a series of analyses, including independent sample t-tests, one-way ANOVA, and Pearson correlations. Subsequently, path analysis was performed and a structural equation model was established.

RESULTS

The score of narrative nursing practice in this study was 30.26 ± 5.32. The structural equation model showed a good fit, with a Root Mean Square Error of Approximation (RMSEA) of 0.007 (90%CI: 0.000, 0.047). Both social support and narrative nursing attitude could directly affect narrative nursing practice (βsocial support = 0.08, P < 0.001; βattitude = 0.54, P < 0.001) and indirectly influence it via self-efficacy (βsocial support = 0.04, P < 0.001; βattitude = 0.06, P < 0.001). In addition, narrative nursing knowledge (β = 0.08, P < 0.001) and the nurses' growth environment (β=-0.06, P < 0.001) also affected the practice of narrative nursing.

CONCLUSION

Narrative nursing in China is at a medium level and could be influenced by several personal and environmental factors. This study highlighted the critical role of nursing management in the advancement of narrative nursing practices. Nurse managers should prioritize specialized training and cultivate supportive environments for nurses to improve their narrative nursing practices.

Association between nurse-child communication and family caregivers' global ratings to hospital: a retrospective study

PURPOSE

Effective nurse-child communication is a fundamental aspect of delivering pediatric nursing care. Family caregivers' global ratings to hospital are considered a proxy-reported measure for assessing a child's inpatient stay experience. We investigate the associations between nurse-child communication and family caregivers' global ratings to hospital.

DESIGN AND METHODS

A retrospective analysis of a national child patient experience survey data was conducted. Patient experience with nurse-child communication and the family caregivers' global ratings of hospital were measured using the Child Hospital Consumer Assessment of Healthcare Providers and Systems. Hierarchical linear models were constructed to examine the association between nurse-child communication measures and family caregivers' global ratings to hospital.

RESULTS

Data from 1010 patients at six National Regional Centers for Pediatric in China were collected. The overall rating of hospitals and the willingness to recommend the hospital showed increasing trends as the nurse-child communication score increased. How often nurses encourage children to ask questions was significantly associated with family caregivers' overall ratings of hospital and the family caregivers' willingness to recommend the hospital.

CONCLUSIONS

Effective communication by nurses with the child is associated with significantly higher global ratings to the hospital by family caregivers during inpatient care. Encouraging children to ask questions is a promising contributor to caregivers' global ratings to hospital.

PRACTICE IMPLICATIONS

Pediatric nurses should emphasis encouraging children to ask questions for effective communication in nursing practice. Future research is also needed to develop more targeted strategies to assist pediatric nurse to communicate with child better.

Health communication and shared decision-making between nurses and older adults in community setting: An integrative review

AIM

To explore the role of health communication in Shared Decision-Making (SDM) between nursing staff and older people in the community setting.

BACKGROUND

Society and healthcare services are marked by an exponentially ageing population, leading to a significant proportion of patients being older adults with highly demanding care needs. Scientific literature supports shared decision-making as a process that engages patients in their care. However, the increasing use of technology and the consequences of the COVID-19 pandemic have influenced how nurses communicate with older patients. Therefore, it is crucial to understand how to develop health communication to reach effective, shared decision-making processes.

METHODS

Whittemore and Knafl's integrative review method, the literature search comprised five databases: PubMed, CINALH, Web of Science, Scopus and PsycINFO.

RESULTS

The 12 included studies were synthesised into three study patterns: (1) nurse-older patient health communication relationship, (2) older patients' perspectives and (3) nontherapeutic communication in end-of-life care.

CONCLUSION

This review underscored the crucial role of effective health communication in shaping SDM dynamics between nursing staff and older people in the community setting. Key elements included transparent information exchange, establishing trust and maintaining communication channels with informal caregiving networks. SDM actions were aligned with preserving older people's autonomy, but communication challenges persisted, particularly in end-of-life situations. Advanced care planning was recommended to address these shortcomings and improve communication among older people, healthcare professionals and families.

IMPLICATIONS

Implementing educational measures based on verbal and nonverbal health communication in nursing training could be beneficial. Nursing research could continue to develop and refine specific communication strategies adapted to the social determinants of health for diverse clinical situations regarding older adults in the community setting.

REPORTING METHOD

The authors have adhered to relevant EQUATOR guidelines through the PRISMA 2020 checklist. No Patient or Public Contribution.

Parents' Experiences of Communicating With Children About Their Diagnosis of Nonterminal Cancer and Its Related Issues: A Systematic Review of Qualitative Studies

BACKGROUND

Many children experience serious symptoms when they are diagnosed with and treated for cancer. Through appropriate parent-child communication, parents were able to identify children's physical and psychological problems, adjust their behavior, and help them cope with the disease.

OBJECTIVE

This study aimed to systematically search for and integrate evidence from qualitative studies on communication between parents and children with nonterminal cancer from parents' perspectives.

METHODS

A thorough systematic review and metasynthesis of qualitative studies were conducted. Articles were searched from PubMed/MEDLINE, EMBASE, Web of Science, CINAHL, PsycINFO, and PsycArticles from the database inception to November 6, 2022. After screening and quality appraisal, 14 articles were finally included in the metasynthesis.

RESULTS

Three themes and 11 subthemes were identified: (1) communication content, including diagnosis, treatment, health management, health risk, and emotion; (2) factors influencing communication, including ages of children, parents' experience of communication, parents' awareness of protection, and culture; and (3) children's responses, including acceptance and resistance.

CONCLUSIONS

This systematic review found that parents were influenced by various factors during the decision-making process of parent-child communication about childhood cancer and its related issues. Parents tended to adjust their communication content and style to protect their children.

IMPLICATIONS FOR PRACTICE

Future research should be conducted to explore children's experiences of communicating with their parents and analyze the similarities and differences between the communication needs of parents and children. Healthcare professionals should provide professional communication guidance to facilitate the parent-child relationship and improve the mental health of both children and their parents.

Interaction between telenurses and callers - A deductive analysis of content and timing in telephone nursing calls

OBJECTIVES

To explore the content and timing of verbal interaction between telephone nurses and callers, and to suggest areas for improvement.

METHODS

Transcribed telephone conversations (n = 30) to a national nurse-led advisory service were analyzed using deductive content analysis. Categorization of data was based on components of interaction in the Interaction Model of Client Heath Behavior (IMCHB): health information, affective support, decisional control, and professional-technical competencies. The content was described both quantitatively, based on word count, and qualitatively, using descriptions and exemplars. Transcripts were also coded according to five phases in the conversation process: opening, listening, analyzing, motivating, and ending. The distribution of interaction components among phases was explored.

RESULTS

Interaction primarily focused on health information, particularly during the listening and analyzing phases. Telenurses based their advice on medical facts and guided callers through the conversation process. Callers' emotions and reflections on advice were rarely discussed.

CONCLUSIONS

Health information dominate conversations. Interaction can be further developed, particularly with respect to acknowledging callers' emotional responses, their reactions to advice, and ensuring clarity in exchange of health information.

PRACTICE IMPLICATIONS

Findings offer valuable guidance for future development of interaction in telenursing.

Changes in evidence-based practice self-efficacy among nursing students and the impact of clinical competencies: Longitudinal descriptive study

INTRODUCTION

Evidence-based practice (EBP) is essential to ensure patient safety and improve the quality of nursing care. Nursing students' self-efficacy in employing EBP is crucial for the formation of a culture of EBP in healthcare organizations.

OBJECTIVE

This study aimed to investigate the changes in nursing students' self-efficacy in employing EBP and the extent to which clinical performance affects these changes.

METHODS

This study was a longitudinal descriptive study. Participants were nursing students who had received education on EBP theory and had clinical practice experience. Convenience sampling was used to select nursing students in their third year of study at a nursing college located in the southern region of Korea in 2020. The researcher measured EBP self-efficacy and clinical competence using an online survey tool at three time points (second semester of third year, first semester of fourth year, and second semester of fourth year). Multilevel modeling was used to identify factors affecting changes in EBP self-efficacy.

RESULTS

The results showed that nursing students' EBP self-efficacy increased over time. Nursing leadership (p = .022), nursing skills (p = .028), communication (p < .001), and nursing process (p = .003) were significant factors that affected the changes in EBP self-efficacy. Individual differences in initial levels and change rates were still observed.

CONCLUSION

Systematic education on EBP theory and practical training should be provided to nursing students from the beginning of their studies to graduation to deepen their EBP and clinical competence.

The patient's first point of contact (PINPOINT) - protocol of a prospective multicenter study of communication and decision-making during patient assessments by primary care registered nurses

BACKGROUND

A major challenge for primary care is to set priorities and balance demands with available resources. The registered nurses in this study are practice nurses working in primary care offices, playing a large role in initial assessments. The overall objective of this research is to investigate practices of communication and decision-making during nurses' initial assessment of patients' health problems in primary care, examine working mechanisms in good practices and develop feasible solutions.

METHODS

Project PINPOINT aims for a prospective multicenter study using various methods for data collection and analysis. A purposive sample of 150 patient‒nurse consultations, including 30 nurses and 150 patients, will be recruited at primary care centers in three different geographic areas of southwest Sweden. The study will report on outcomes of communication practices in relation to patient-reported expectations and experiences, communication processes and patient involvement, assessment and decision-making, related priorities and value conflicts with data from patient questionnaires, audio-recorded real-time communication, and reflective interviews with nurses.

DISCUSSION

This research will contribute to the knowledge needed for the guidance of first-line decision-making processes to best meet patient and public health needs. This knowledge is necessary for the development of assessments and decisions to be better aligned to patients and to set priorities. Insights from this research can empower patients and service providers and help understand and enhance feasible person-centered communication strategies tailored to patients' level of health literacy. More specifically, this research will contribute to knowledge that can strengthen nurses' communication, assessments, and clinical decision-making in primary care. In the long term, this will contribute to how the competencies of practice nurses and other professionals are organized and carried out to make the best use of the resources within primary care.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT06067672.

An integrative review of communication in a professional-parental relationship provided in child health services: An authoritarian or guiding approach

OBJECTIVES

Early parental support, provided by nurses within child health services, aims to strengthen parents in their parenthood. The aim of this integrative review is to describe communication in parental support in encounters between child health nurses and parents in child health services.

METHODS

An integrative review was conducted. The databases Cinahl+ , MedLine, Psych Info, and Scopus were searched, 312 articles were screened, and 16 articles were found to be eligible.

RESULTS

The studies included qualitative and quantitative methods, using interviews, focus group interviews, and observations. The findings show an overarching theme: The significance of mutuality in communication in a professional-parental relationship, further described in the following categories, 1) Authoritarian approach: a controlling manner, a neglecting manner, and a teaching manner; 2. Guiding approach: a counselling manner and a compliant manner.

CONCLUSIONS

The communication between nurses and parents can be understood as having several layers; the organisational context, the professional skills, knowledge, and experiences, and parents' knowledge, expectations, and needs. There is a lack of studies of authentic communication between nurses and parents; thus, future research is warranted.

PRACTICE IMPLICATIONS

The authoritarian and guiding approaches in parental support show the required skills a nurse is expected to have, but sufficient organizational prerequisites are also crucial.