Reliability and Validity of a Tool to Assess Oncology Nurses' Experiences With Prognosis-Related Communication

Development and validation of the questionnaire to analyze the communication of nurses in nurse-patient therapeutic communication

OBJECTIVE

The purpose of this study was to develop and analyze the psychometric properties of an instrument that could analyze the communication of nursing professionals in nurse-patient therapeutic communication.

METHODS

A literature review and a panel of experts were used (N = 10) to develop the questionnaire to analyze the communication of nurses in nurse-patient therapeutic communication. The final version of the questionnaire was composed of 49 items and applied to a convenience sample of 370 nurses.

RESULTS

The construct validity was assessed by an exploratory factor analysis (EFA) and the reliability using Cronbach's Alpha. Three dimensions were identified that determine therapeutic communication: professional, contextual and/or situational and patient. The Cronbach's α total coefficient was 0.90, ranging from 0.71 to 0.81 for the dimensions.

CONCLUSION

The questionnaire to analyze the communication of nurses in nurse-patient therapeutic communication represents a valid and reliable questionnaire to measure nurses' communication with patients in the clinical setting.

IMPLICATIONS FOR PRACTICE

The use of the questionnaire enables the analysis of elements that interfere with effective communication. This can assist in developing interventions to improve nurses' therapeutic communication with patients.

Reports of Sharing and Withholding Cancer-Related Information by Patients With Gynecologic Cancer and Their Supporters

PURPOSE

To examine patients' with gynecologic cancer and supporters' reports of sharing and withholding cancer-related information during oncology visits, with a focus on navigating communication encounters more effectively.

PARTICIPANTS & SETTING

18 women who were recently diagnosed with gynecologic cancer and their supporters (N = 16) were recruited from the Rutgers Cancer Institute of New Jersey in New Brunswick.

METHODOLOGIC APPROACH

Data were collected via audio-recorded semistructured interviews and analyzed to determine the types of information that patients and supporters share or withhold during oncology visits.

FINDINGS

Thematic analyses revealed two major themes.

IMPLICATIONS FOR NURSING

Probing patients and supporters separately on topics that they may not feel comfortable discussing can help nurses to identify unaddressed concerns and better assist patients and their supporters during oncology visits.

La técnica Delphi para el rediseño y validación de un instrumento que mide la comunicación enfermera-paciente

Introducción: La evaluación de la comunicación entre la enfermera y el paciente da cuenta de la dimensión interpersonal en la calidad del cuidado. Esta relación ha sido estudiada desde diversos enfoques con énfasis en algunos aspectos, como el diseño y validación de instrumentos. Objetivo: Rediseño y validación de contenido de un instrumento que mide comunicación enfermera-paciente, con base en la técnica Delphi. Metodología: Se enfoca al rediseño y validación de un instrumento, con la aplicación de la técnica Delphi, con la participación de enfermeras expertas, sensibles a la relación terapéutica; se realizaron tres rondas con integración de contenidos por las coordinadoras y la aplicación de los coeficientes de validación de contenido por reactivo (CVR) y validación de contenido integral (CVI). Resultados: El CVI del instrumento en cuestión (CECOP-23) en la primera ronda fue 0.84, posterior a ello se eliminaron cuatro reactivos y se sustituyeron dos que fueron sugeridos por los expertos. En la segunda ronda el instrumento alcanzó un CVI de 0.95, el grupo sugirió la utilización de términos más sencillos que propiciaran la cercanía con el paciente. En la tercera ronda se obtuvo un CVI de 0.96. El CECOP quedó integrado por 21 reactivos, diez que exploran empatía y once que exploran respeto. Conclusiones: El trabajo con los expertos permitió analizar los reactivos del CECOP-23, obteniendo el CECOP-21, con reactivos de mayor calidez y exploración más precisa, cumpliendo con el objetivo de diseñar un instrumento que explore ambas dimensiones manteniendo el equilibrio entre la empatía y el respeto.

Instrumentos que miden la comunicación enfermera-paciente

Introducción: Por la importancia que tiene la comunicación al ofrecer un cuidado de calidad, las enfermeras se han preocupado por la evaluación de la interacción con su paciente en el ejercicio de su práctica profesional. Objetivo: Identificar instrumentos que midan la interacción enfermera paciente, por el valor que puede implicar para la evaluación de la calidad de la atención en la dimensión interpersonal. Metodología: Se revisó la literatura y consultaron las bases de Scielo, Medline, Redalyc, BVS y, CINHAL. De acuerdo con el propósito enunciado se seleccionaron 25 artículos que investigan sobre el diseño, validación, aplicación y adaptación de instrumentos que miden la comunicación enfermera-paciente en diversos servicios y niveles de salud.                    Resultados: Los artículos seleccionados se clasificaron en tres grupos: a) aplicación y validación de instrumentos; b) adaptación y validación de instrumentos; c) diseño y validación de instrumentos. Nueve hacen referencia a la aplicación y validación de instrumentos, 10 tanto a la adaptación como la validación, por último, seis al diseño y validación. Conclusiones: Aunque se han diseñado, validado, aplicado y ajustado instrumentos, aún existen retos en este campo de investigación, con el fin de ofrecer nuevas estrategias que diagnostiquen y brinden alternativas específicas, para mejorar la comunicación enfermera-paciente en la práctica diaria de enfermería.

Pediatric Oncology Nurses' Experiences With Prognosis-Related Communication

OBJECTIVES

To examine nurses' experiences of prognosis-related communication (PRC) with parents of children with cancer.

SAMPLE & SETTING

Cross-sectional, correlational study in the pediatric oncology setting involving 316 members of the Association of Pediatric Hematology/Oncology Nurses.

METHODS & VARIABLES

Online survey regarding individual nurse factors, PRC, interprofessional collaboration, moral distress, and perceived quality of care.

RESULTS

Nurses strongly agreed that prognostic disclosure is critical for decision making, but they are challenged in determining their role. Nurses with more years of experience and training in PRC, those working in an outpatient setting, and those with higher levels of nurse-physician collaboration reported more positive experiences with PRC. Positive experiences with PRC and collaboration were significantly associated with higher nurse-perceived quality of care and reduced nurse moral distress.

IMPLICATIONS FOR NURSING

Nurses should work to be active participants in the process of PRC by collaborating with physician colleagues. When nurses sense that prognostic discussions have been absent or unclear, they should feel confident in approaching physician colleagues to ensure parent understanding and satisfaction with communication.

Palliative Care Communication in the ICU: Implications for an Oncology-Critical Care Nursing Partnership

OBJECTIVES

To describe the development, launch, implementation, and outcomes of a unique multisite collaborative (ie, IMPACT-ICU [Integrating Multidisciplinary Palliative Care into the ICU]) to teach ICU nurses communication skills specific to palliative care. To identify options for collaboration between oncology and critical care nurses when integrating palliation into nursing care planning.

DATA SOURCES

Published literature and collective experiences of the authors in the provision of onco-critical-palliative care.

CONCLUSION

While critical care nurses were the initial focus of education, oncology, telemetry, step-down, and medical-surgical nurses within five university medical centers subsequently participated in this learning collaborative. Participants reported enhanced confidence in communicating with patients, families, and physicians, offering emotional support and involvement in family meetings.

IMPLICATIONS FOR NURSING PRACTICE

Communication education is a vital yet missing element of undergraduate nursing education. Programs should be offered in the work setting to address this gap in needed nurse competency, particularly within the context of onco-critical-palliative care.