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Dokos M, Schultz R, Gossner JD, Fauth EB. Supporting Persons With Dementia: Perspectives From Certified Nurse's Assistants. Innov Aging 2023; 7:igad049. [PMID: 37476503 PMCID: PMC10355141 DOI: 10.1093/geroni/igad049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Indexed: 07/22/2023] Open
Abstract
Background and Objectives Many persons with Alzheimer's disease or related dementias (ADRD) receive care from paid staff in residential communities. The most common staff in these communities are certified nursing assistants (CNAs). Although CNAs have a high number of interactions with residents, and thus the possibility of engaging in social interactions, evidence suggests that they provide limited social support to persons with ADRD. Little is known about the attitudes of CNAs toward providing social support to persons with ADRD and their perception of components of quality social interactions with these individuals. Research Design and Methods We conducted a thematic analysis of semistructured interviews with 11 CNAs (91% female participants, mean age 23.6) to understand their perceptions about providing social support to persons with ADRD and the components of effective social interactions. Results Our results show that CNAs consider providing social support to be an important part of their role as CNAs. Additionally, participants emphasized the interplay of verbal communication, nonverbal communication, and internal beliefs and attitudes toward persons with ADRD in creating effective social interactions. Participants highlighted multiple barriers to providing residents with social support, including lack of time, lack of training, and the behavioral and psychological symptoms of dementia. Discussion and Implications We offer implications for expanding training for CNAs working with persons with dementia and improving policy based on our results.
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Affiliation(s)
- Malinda Dokos
- Department of Human Development and Family Studies, Utah State University, Logan, Utah, USA
| | - Rebecka Schultz
- Department of Human Development and Family Studies, Utah State University, Logan, Utah, USA
| | - Jacob D Gossner
- Department of Human Development and Family Studies, Utah State University, Logan, Utah, USA
| | - Elizabeth B Fauth
- Department of Human Development and Family Studies, Utah State University, Logan, Utah, USA
- Alzheimer’s Disease and Dementia Research Center, Utah State University, Logan, Utah, USA
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Li X, Fang X, Wang L, Geng X, Chang H. Relationship between emotional intelligence and job well-being in Chinese Registered Nurses: Mediating effect of communication satisfaction. Nurs Open 2021; 8:1778-1787. [PMID: 33656788 PMCID: PMC8186701 DOI: 10.1002/nop2.820] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 12/10/2020] [Accepted: 01/29/2021] [Indexed: 11/11/2022] Open
Abstract
AIM To explore the relationship between emotional intelligence and job well-being among Chinese Registered Nurses, and the mediating role of communication satisfaction in the relationship. DESIGN A descriptive cross-sectional study design was employed. METHODS Random sampling was adopted. The study was conducted from September to December 2019, and 1,475 Registered Nurses from a Chinese hospital provided responses to Wong and Law's emotional intelligence scale, communication satisfaction scale, job well-being scale and general information questionnaire. SPSS25.0 software was used to calculate means, standard deviations and correlations, and AMOS 21.0 software was used to establish the structural equation model. RESULTS The emotional intelligence, communication satisfaction and job well-being of Registered Nurses in China were related to positional rank, work department, monthly income, years of service, night shift work distribution and intensity of work. There were positive correlations among emotional intelligence, communication satisfaction and job well-being. Communication satisfaction partly mediated the relationship between emotional intelligence and job well-being. Improving the level of emotional intelligence and communication satisfaction should be an important strategy to improve nurses' job well-being. Therefore, nursing managers could carry out targeted training on emotional intelligence management and communication between nurses and patients and pay attention to the spiritual needs of nurses and provide psychological guidance on a regular basis.
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Affiliation(s)
- Xue Li
- College of Nursing, Xinxiang Medical University, Xinxiang City, China
| | - Xiaoxia Fang
- Department of Nursing, Xinxiang Central Hospital, Xinxiang City, China
| | - Lina Wang
- College of Nursing, Xinxiang Medical University, Xinxiang City, China
| | - Xiaosong Geng
- College of Nursing, Xinxiang Medical University, Xinxiang City, China
| | - Hongjuan Chang
- College of Nursing, Xinxiang Medical University, Xinxiang City, China
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Scholz B, Goncharov L, Emmerich N, Lu VN, Chapman M, Clark SJ, Wilson T, Slade D, Mitchell I. Clinicians' accounts of communication with patients in end-of-life care contexts: A systematic review. PATIENT EDUCATION AND COUNSELING 2020; 103:1913-1921. [PMID: 32650998 DOI: 10.1016/j.pec.2020.06.033] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/02/2020] [Accepted: 06/29/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Communication between patients and end-of-life care providers requires sensitivity given the context and complexity involved. This systematic review uses a narrative approach to synthesise clinicians' understandings of communication in end-of-life care. METHODS A systematic, narrative synthesis approach was adopted given the heterogeneity across the 83 included studies. The review was registered prospectively on PROSPERO (ID: CRD42019125155). Medline was searched for all articles catalogued with the MeSH terms "palliative care," "terminal care" or "end-of-life care," and "communication". Articles were assessed for quality using a modified JQI-QARI tool. RESULTS The findings highlight the centrality and complexity of communication in end-of-life care. The challenges identified by clinicians in relation to such communication include the development of skills necessary, complexity of interpersonal interactions, and ways in which organisational factors impact upon communication. Clinicians are also aware of the need to develop strategies for interdisciplinary teams to improve communication. CONCLUSION Training needs for effective communication in end-of-life contexts are not currently being met. PRACTICE IMPLICATIONS Clinicians need more training to address the lack of skills to overcome interactional difficulties. Attention is also needed to address issues in the organisational contexts in which such communication occurs.
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Affiliation(s)
- Brett Scholz
- Medical School, The Australian National University, Canberra, Australia.
| | - Liza Goncharov
- School of Literature, Languages and Linguistics, The Australian National University, Canberra, Australia
| | - Nathan Emmerich
- Medical School, The Australian National University, Canberra, Australia
| | - Vinh N Lu
- College of Business and Economics, The Australian National University, Canberra, Australia
| | - Michael Chapman
- Medical School, The Australian National University, Canberra, Australia; Canberra Health Service, ACT Health, Canberra, Australia
| | - Shannon J Clark
- School of Literature, Languages and Linguistics, The Australian National University, Canberra, Australia
| | - Tracey Wilson
- Medical Intensive Care Unit, University of Maryland, Baltimore, USA
| | - Diana Slade
- School of Literature, Languages and Linguistics, The Australian National University, Canberra, Australia
| | - Imogen Mitchell
- Medical School, The Australian National University, Canberra, Australia; Canberra Health Service, ACT Health, Canberra, Australia
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Abstract
Despite the frequency, complexity, and intensity of communication that occurs between nurses, patients, and families, palliative care nurses often struggle with end-of-life communication. The primary goal of this quality improvement project was to increase nurse confidence and satisfaction engaging in end-of-life communication following the implementation of the COMFORT model; the secondary goal was to improve patient-family satisfaction with care provided in the palliative care unit. Fourteen palliative care nurses attended a 4-hour course to learn the tenets of the COMFORT model and practice through role-play exercises. A repeated-measures design was used to measure nurse confidence and satisfaction precourse, postcourse, and 3 months postcourse. A between-subjects pre-post design was used to compare family satisfaction survey scores in the 3-month period before versus the 3 months after implementation. Analysis revealed a statistically significant increase in all measures of nurse confidence and satisfaction from precourse to postcourse and from precourse to 3 months postcourse. There was no statistical difference between the family satisfaction survey scores before versus after training, although survey results were generally high at baseline and most respondents rated palliative services with the best possible response. This project demonstrates that COMFORT model training increased confidence and satisfaction of palliative care nurses engaged in end-of-life communication and demonstrates potential for use in other clinical areas that do not specialize in end-of-life nursing (eg, critical care) but find themselves in need of the communications skills to address end-of-life care.
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James S, Desborough J, McInnes S, Halcomb EJ. Nonverbal communication between registered nurses and patients during chronic disease management consultations: Observations from general practice. J Clin Nurs 2020; 29:2378-2387. [DOI: 10.1111/jocn.15249] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 02/06/2020] [Accepted: 03/13/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Sharon James
- School of Nursing University of Wollongong BEGA NSW Australia
| | - Jane Desborough
- Department of Health Services Research and Policy Research School of Population Health College of Medicine, Biology and the Environment Australian National University ACTON ACT Australia
| | - Susan McInnes
- School of Nursing University of Wollongong WOLLONGONG NSW Australia
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McElroy C, Esterhuizen P. Compassionate communication in acute healthcare: establishing the face and content validity of a questionnaire. J Res Nurs 2017. [DOI: 10.1177/1744987116678903] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The National Health Service is committed to measuring the quality of nursing care through adopting a number of indicators which are not nationally standardised. Compassionate communication is one indicator, but it is unclear how this is assessed or demonstrated in practice. This is primarily a methodological paper which aims to establish the face and content validity of a questionnaire to measure nurses’ non-verbal methods of compassionate communication with patients in acute healthcare. An existing questionnaire was amended to meet the study’s requirements. A ‘lay expert sample’ was used to rate the face validity and a ‘research expert sample’ to rate the content validity of the instrument. Modification of one response and adding instructions on how to complete the questionnaire meant that Version 2 potentially has high face validity. The questionnaire demonstrated excellent content validity (Scale-Content Validity Index = 0.85). Recommendations include pilot testing to further investigate the construct of non-verbal compassionate communication in an acute healthcare context. This research can be used to inform the measurement of compassionate communication and promote standardisation nationally.
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Affiliation(s)
- Claire McElroy
- Junior Sister, Cardio-Respiratory Clinical Service Unit, Leeds Teaching Hospitals NHS Trust, UK
| | - Philip Esterhuizen
- Associate Director of Student Education: Curriculum and Assessment, School of Healthcare, University of Leeds, UK
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Doherty M, Thompson H. Enhancing person-centred care through the development of a therapeutic relationship. Br J Community Nurs 2015; 19:502, 504-7. [PMID: 25284187 DOI: 10.12968/bjcn.2014.19.10.502] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
More than ever, district nurses require highly developed communication and interpersonal skills to enable and nurture a therapeutic relationship. The 'shift left'-whereby patients are being assessed and cared for in the community at a much earlier stage of their illness or recovery-has significant implications. The complexity of patient care and the need for collaborative working and shared decision making necessitates a focus on fostering person-centred care and improving the patient experience in practice. District nurses are adept communicators with a specialist body of knowledge and skills. In Northern Ireland, the single assessment tool (NISAT) is used by health professionals and follows a person-centred framework. This case study reflects on the assessment process used by a district nursing student in clinical practice and demonstrates how a therapeutic relationship is developed, thereby supporting person centredness.
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Affiliation(s)
- Michelle Doherty
- District Nursing Student, Grove Health and Wellbeing Centre, Belfast Trust
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Hendricks-Ferguson VL, Sawin KJ, Montgomery K, Dupree C, Phillips-Salimi CR, Carr B, Haase JE. Novice Nurses’ Experiences With Palliative and End-of-Life Communication. J Pediatr Oncol Nurs 2015; 32:240-52. [DOI: 10.1177/1043454214555196] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Health care providers recognize that delivery of effective communication with family members of children with life-threatening illnesses is essential to palliative and end-of-life care (PC/EOL). Parents value the presence of nurses during PC/EOL of their dying child. It is vital that nurses, regardless of their years of work experience, are competent and feel comfortable engaging family members of dying children in PC/EOL discussions. This qualitative-descriptive study used focus groups to explore the PC/EOL communication perspectives of 14 novice pediatric oncology nurses (eg, with less than 1 year of experience). Audio-taped focus group discussions were reviewed to develop the following 6 theme categories: ( a) Sacred Trust to Care for the Child and Family, ( b) An Elephant in the Room, ( c) Struggling with Emotional Unknowns, ( d) Kaleidoscope of Death: Patterns and Complexity, ( e) Training Wheels for Connectedness: Critical Mentors during PC/EOL of Children, and ( f) Being Present with an Open Heart: Ways to Maintain Hope and Minimize Emotional Distress. To date, this is the first study to focus on PC/EOL communication perspectives of novice pediatric oncology nurses.
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Affiliation(s)
| | - Kathleen J. Sawin
- University of Wisconsin-Milwaukee and Children’s Hospital of Wisconsin, Milwaukee, WI, USA
| | | | | | | | - Barb Carr
- St Louis Children’s Hospital, St Louis, MO, USA
| | - Joan E. Haase
- Indiana University, School of Nursing, Indianapolis, IN, USA
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