Triadic communication with teenagers and young adults with cancer: a systematic literature review - 'make me feel like I'm not the third person'

OBJECTIVES

Clinical communication needs of teenagers and young adults with cancer (TYACs) are increasingly recognised to differ significantly from younger children and older adults. We sought to understand who is present with TYACs, TYACs' experiences of triadic communication and its impact. We generated three research questions to focus this review: (1) Who is present with TYACs in healthcare consultations/communication?, (2) What are TYACs' experiences of communication with the supporter present? and (3) What is the impact of a TYAC's supporter being present in the communication?

DESIGN

Systematic review with narrative synthesis.

DATA SOURCES

The search was conducted across six databases: Medline, CINAHL, Embase, PsycINFO, Web of Science and AMED for all publications up to December 2023.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Included papers were empirical research published after 2005; participants had malignant disease, diagnosed aged 13-24 years (for over 50% of participants); the research addressed any area of clinical communication.

DATA EXTRACTION AND SYNTHESIS

Three independent reviewers undertook full-text screening. A review-specific data extraction form was used to record participant characteristics and methods from each included paper and results relevant to the three review questions.

RESULTS

A total of 8480 studies were identified in the search, of which 36 fulfilled the inclusion criteria. We found that mothers were the most common supporter present in clinical communication encounters. TYACs' experiences of triadic communication are paradoxical in nature-the supporter can help or hinder the involvement of the young person in care-related communication. Overall, young people are not included in clinical communication and decisions at their preferred level.

CONCLUSION

Triadic communication in TYACs' care is common, complex and dynamic. Due to the degree of challenge and nuances raised, healthcare professionals need further training on effective triadic communication.

PROSPERO REGISTRATION NUMBER

CRD42022374528.

Educational programs to improve nurses' knowledge, attitude, and practice in adolescent and young adult health: An integrative review

OBJECTIVE

Nurses working in adolescent health often lack educational opportunities to develop their knowledge and practical skills to address the challenges faced by adolescents and young adults. This integrative review synthesised the evidence from peer-reviewed research that focused on educational programs to improve nurses' knowledge, attitude, and practice in adolescent and young adult health.

DESIGN

The five-stage framework by Whittemore and Knafl guided the integrative literature review and was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement.

DATA SOURCES

A single search strategy was replicated across five electronic databases (CINAHL Plus, APA PsycInfo, PubMed, Scopus, and ERIC). Studies of educational interventions or training programs for nurses on adolescent and young adult health, published in English in the last 10 years were included.

REVIEW METHODS

All studies found were reviewed for relevance independently by two authors, who likewise critically appraised the quality using the "Critical appraisal checklist for an article on an educational intervention" adapted from Morrison et al. (1999), with a third author providing consensus. Data were extracted using study specific standardised proforma and thematically analysed.

RESULTS

Seven studies met the inclusion criteria. Topics covered included cancer care, mental health and self-harm, with only one program including general adolescent health. A mix of face-to-face and digital asynchronous mode of delivery was employed in these programs with multi-strategic approaches used to enhance accessibility and engagement. While all studies reported improvement in knowledge and practice, including enhanced communication skills, some studies reported limited change in attitude. Success of the interventions was attributed to the flexibility of programs to accommodate nurses' workloads.

CONCLUSION

Education interventions for nurses delivering care to adolescent and young adults enhance knowledge and skills, however, programs with institutional support for flexibility and accessibility are needed to influence a positive change in attitude.

Effectiveness of a Mobile Technology-Supported Self-Reflective Course in Communication Behaviors for Outpatient Nurses

Background Communication is a core competency for outpatient nurses. This study investigated the effectiveness of a mobile technology-supported self-reflective (MTS) course in communication behaviors among outpatient nurses. Method This quasi-experimental study used a convenience sample of 78 outpatient nurses (experimental group = 39; control group = 39). The experimental group completed the MTS communication course. Communication behaviors were evaluated before, 1 week after, and 1 month after the course. Results There was no significant difference in communication behaviors between the groups before the intervention. One week after the intervention, communication behavior scores significantly increased in both groups without significant between-group differences (p > .05). One month after the intervention, the experimental group showed significantly higher communication behavior scores (p < .05). Both groups demonstrated high learning satisfaction. Conclusion The MTS communication course was successful in promoting effective outpatient nurse-patient communication. Health care facilities may want to incorporate the MTS course into their orientation program. [J Contin Educ Nurs. 2022;53(6):279-288.].

Concept Analysis of Interpersonal Skills in Nursing

Objective: To determine a broad definition of the term interpersonal skills in nursing. Materials and methods: This theoretical study follows Walker and Avant’s method of concept analysis to examine the defining attributes of the concept. A literature search on interpersonal aspects of nursing was conducted in databases, e-books, and institutional repositories to recognize the uses, attributes, antecedents, consequences, and empirical referents of the concept. Experts on professional and relationship skills were consulted between 2009 and 2019. Results: This information was analyzed, concluding that interpersonal skills in nursing are defined as the abilities of professional nurses to express their knowledge, abilities, attitudes, and values in relationships with colleages, patients, and their relatives and achieve a humane and person- centered practice. Conclusion: The concept of interpersonal skills in nursing is limited, given a lack of clarity in practice and research on the indistinct use of terms related to interpersonal skills and interpersonal knowledge. This analysis advances nursing theory towards practice and research.

The Nurse's Role in Prognosis-Related Communication in Pediatric Oncology Nursing Practice

The experiences of pediatric oncology nurses with prognosis-related communication (PRC) remain largely unknown. The purpose of this article is to report results of focus groups wherein 15 pediatric oncology nurses from three Midwestern pediatric cancer programs provided descriptions of PRC and how they experience PRC within their daily practice. Data from focus groups were analyzed via an interpretive descriptive approach, which resulted in three themes: (1) nurses' operational definition of PRC, (2) nurses' roles in PRC, and (3) nurses' preparation for engagement in PRC. From discussions within the focus groups, nurses recognized that PRC occurs across a continuum. Nurses distinguished that the definition of PRC expands beyond simply reporting life expectancy to describing the consequences of cancer- and treatment-related toxicities and effects. When nurses are not actively invited by their physician partners to participate in PRC, nurses will often develop workarounds to ensure that they understand what was said to patients and families. This allows them to function more effectively as supporters, advocates, and informants. Nurses described little preparation to participate in such challenging conversations. Pediatric oncology nurses need to acknowledge and embrace that they are an integral part of PRC. Interprofessional communication training is necessary to enhance the comfort and confidence of nurses engaging in PRC.

Relationship between communication skills and care behaviors of nurses

PURPOSE

In this study, we aimed to determine the relationship between communication competence and patient care behaviors of nurses.

DESIGN AND METHODS

The study was designed as a descriptive relational study and conducted in Akdeniz University Hospital between March 2018 and May 2018. Data of this study were collected from clinical nurses working in Akdeniz University Hospital. The study was carried out with 262 nurses who accepted to agreed participate in the study.

FINDINGS

Of all nurses, 97% were college graduates, 63% were married, and 35% had working experience between 5 and 9 years. There was a moderate positive correlation between communicative competence and care behaviors of nurses (r = 0.5, P < 0.01).

PRACTICE IMPLICATIONS

More training can be implemented to educate nurses about communication barriers to equip them with effective communication skills and strategies. The nursing process is a scientific method of exercising and implementing of nursing care, this is only achieved through dialogue, interpersonal environment, and specific verbal and nonverbal communication skills. In service training of nurses on effective communicative techniques will inevitably have a positive impact rather than reflection on patient care.