Therapeutic Communication Skills Training: An Effective Tool to Improve the Caring Behaviors of ICU Nurses
-
Farzane Zare
,
Jamileh Farokhzadian
,
Monirsadat Nematollahi
,
Sakineh Miri
,
Mohammad Ali Zakeri
,
Golnaz Foroughameri
Abstract
Caring behaviors are crucial in intensive care units (ICU) because patients in these wards require high levels of care. Effective communication with patients is one of the most important factors in caring behaviors of nurses working in ICUs. The aim of this study was to evaluate the effect of therapeutic communication skills training on the caring behaviors of ICU nurese. This experimental pre-test/post-test study was carried out on 105 nurses working in ICUs of hospitals affiliated to Yazd University of Medical Sciences in Iran in 2019. Nurses were randomly assigned into control (52 nurses) and intervention (53 nurses) groups. A two-day therapeutic communication training workshop was conducted for the participants. Data were collected using demographic information questionnaire and caring behaviors questionnaire before and one month after the intervention. The findings showed no significant difference between the control and intervention groups regarding the nurses' caring behaviors in the pretest (P = 0.148). However, after implementation of the training program, a significant difference was observed in the mean scores of caring behaviors between the two groups. In the control group, the mean scores of caring behaviors decreased significantly after the intervention (P = 0.001); whereas, the mean scores of intervention group increased significantly after the intervention (P = 0.001). According to the results, ICU nurses' training in therapeutic communication skills had a positive effect on their caring behaviors. Therefore, we suggest the authorities to prepare and implement educational packages of therapeutic communication skills as a coherent program for other nurses. As a result, the caring behaviors and the quality of cares can be improved for patients.
1. Lori R, Chester R. Many Critical Care Nurses Are Unaware of Evidence-Based Practice. American journal of critical care. 2007;16(9):2.
2. Salimi S, Azimpoor A. Determinants of Nurses’ Caring Behaviors (DNCB): Preliminary Validation of a Scale. Journal of Caring Sciences. 2013;2(4):9.
3. Gusti P, Nissa A, Zulfainda EP, Zaenal A, Alwan R, Ah Y. A Literature Review: Stress Management in The Family of Intensive Care Patients. Indonesian nursing journaof education and clinic. 2018;3(1):8.
4. Suhonen R, Efstathiou G, Tsangari H, Jarosova D, Leino-Kilpi H, Patiraki E, et al. Patients' and nurses' perceptions of individualised care: an international comparative study. journal of clinical nursing. 2012;21(7-8):12.
5. J Ehlers V. Is caring a lost art in nursing or is it a changing reality? Commentary on the editorial written by Juliet Corbin. Int J Nurs Stud. 2008;45(5):802.
6. Shalaby SA, Janbi NF, Mohammed KK, Practice KMA-hoNEa. Assessing the caring behaviors of critical care nurses. 2018;8:9.
7. Woodward V. Professional caring: a contradiction in terms. J Adv Nurs. 1997;26(5):5.
8. Kaur D, Sambasivan M, Kumar N. Effect of spiritual intelligence, emotional intelligence, psychological ownership and burnout on caring behaviour of nurses: a cross-sectional study. Journal of Clinical Nursing. 2013;22:3192.
9. Dithole K, Phil D, Sibanda S, Tshweneagae T. Nurses' communication with patients who are mechanically ventilated in intensive care: the Botswana experience. International Nursing Review. 2016;63(3):6.
10. Sherko E, Sotiri E, Lika E. Therapeutic communication. JAHR-European Journal of Bioethics. 2013;4(7):457-66.
11. wikipedia. Therapeutic relationship. https://enwikipediaorg. 2017.
12. Freeman S, Yorke J, Dark P. Patient agitation and its management in adult critical care: A integrative review and narrative synthesis. Journal of clinical nursing. 2018;27(7):24.
13. Alasad J, Abu Tabar N, Ahmad M. Patients' experience of being in intensive care units. Journal of Critical Care. 2015;3(21).
14. Happ MB, Garrett KL, Tate JA, DiVirgilio D, Houze MP, Demirci JR, et al. Effect of a multi-level intervention on nurse-patient communication in the intensive care unit: results of the SPEACS trial. Heart & lung : the journal of critical care. 2014;43(2):89-98.
15. Jackson JM. Hearing is Believing. Methodist Debakey Cardiovasc J. 2017;13(2):89.
16. Tapson K, Sierotowicz W, Maran DM, Thompson TM. ‘It's the hearing that is last to go’: a case of traumatic head injury. British Journal of Nursing. 2015;24(5).
17. McGilton KS, Sorin-Peters R, Rochon E, Boscart V, Fox M, H C. The effects of an interprofessional patient-centered communication intervention for patients with communication disorders. Applied Nursing Research. 2018;39:5.
18. Strandas M, Bondas T. The nurse–patient relationship as a story of health enhancement in community care: A meta-ethnography. Adv Nurs. 2017:12.
19. Selman LE, Hawkins A, Robinson V, Ramsenthaler C, Koffman J. The Effect of Communication Skills Training for Generalist Palliative Care Providers on Patient-Reported Outcomes and Clinician Behaviors: A Systematic Review and Meta-analysis. pain and symptom management. 2017:18.
20. Sheikhbardsiri H, Khademipour G, Nekoei‐Moghadam M, Aminizadeh M. Motivation of the nurses in pre‐hospital emergency and educational hospitals emergency in the southeast of Iran. The International journal of health planning and management. 2018;33(1):255-64.
21. Popa-Velea, Purcărea VL. Issues of therapeutic communication relevant for improving quality of care. Journal of Medicine and Life Volume 7, Special Issue 4. 2014.
22. Mirhaghi A, Sharaf S, Bazzi A, Hasanzadeh F. Therapeutic relationship: Is it still heart of nursing? Nursing Reports. 2017;7:6129:6.
23. Sadeghi Shermeh M, Amiri H, Karimi Zarchi A, Bahari F, Binesh A. Effectiveness of Solution-Focused Communication Training (SFCT) in Nurses’ Communication Skills. Iranian Journal of Military Medicine. 2013;14(4):279-86.
24. Karimi Moonaghi H, Khatoon N, Taheri H, Voshani B, Vaghee S, Yavari M. The Effect of Communication Skills Training on the Quality of Nursing Care of Patients. Quarterly Journal of Evidence-based Care. 2012;2(5):10.
25. Karimi Moonaghi H, Taheri N, Behnam Voshani H, Vaghee S, Yavari M. The Effect of Communication Skills Training on the Quality of Nursing Care of Patients. Quarterly Journal of Evidence-based Care. 2012;2(1):10.
26. Pease A, Chandler J. Body Language: How to Read Others' Thoughts by Their Gestures: Sheldon Press; 2010. 152 p.
27. Cole K. Crystal clear communication. 28, editor. Tehran: Hamoon; 2017.
28. Silverman J, Kertez S, Deraper J. Communication skills with patients. Tehran: Timurzadeh; 2016.
29. Larson P. Important nurse caring behaviors perceived by patients with cancer. Oncol Nurs Forum. 1984;11(6):5.
30. Pashaee S, Lakdizaji S, Rahmani A, Zamanzade V. Priorities of Caring Behaviors from Critical Care Nurses Viewpoints2014. 65-73 p.
31. Gausvik C, Lautar A, Miller L, Pallerla H, Schlaudecker J. Structured nursing communication on interdisciplinary acute care teams improves perceptions of safety, efficiency, understanding of care plan and teamwork as well as job satisfaction. Journal of multidisciplinary healthcare. 2015;8:33.
32. Raingruber B, Teleten O, Curry H, Vang-Yang B, Kuzmenko L, Marquez V, et al. Improving nurse-patient communication and quality of care: the transcultural, linguistic care team. JONA: The Journal of Nursing Administration. 2010;40(6):258-60.
33. Khodadadi E, Ebrahimi H, Moghaddasian S, Babapour J. The effect of communication skills training on quality of care, self-efficacy, job satisfaction and communication skills rate of nurses in hospitals of Tabriz, Iran. Journal of caring sciences. 2013;2(1):27.
34. Porter CA, Cortese M, Vezina M, Fitzpatrick JJ. Nurse Caring Behaviors Following Implementation of a Relationship Centered Care Professional Practice Model. International Journal of Caring Sciences. 2014;7:5.
35. Ratanawongsa N, Karter A, Parker M, Lyles C, Heisler M, Moffet H. Communication and medication refill adherence: the Diabetes Study of Northern California. JAMA internal medicine. 2013;173(9):8.
36. Rask M, Jensen M, Andersen J, Zachariae R. Effects of an intervention aimed at improving nurse-patient communication in an oncology outpatient clinic. Cancer Nurs. 2009;32(1):11.
37. Hillen MA, De Haes HCJM, Tienhoven G, Bijker N, Laarhoven H, Vermeulen D, et al. All eyes on the patient: the influence of oncologists’ nonverbal communication on breast cancer patients’ trust. Breast Cancer Res Treat. 2015;153:161.
38. Dawson-Rose C, Cuca C, Webel A, Solís Báez S. Building Trust and Relationships Between Patients and Providers: An Essential Complement to Health Literacy in HIV Care. J Assoc Nurses AIDS Care. 2016;27(5):10.
39. Berman A, S.J, Kozier B, Erb G. Kozier and Erb's Fundamental of Nursing . Newjersey Upper Saddle River: Pearson2010.
40. Movahedi A, Rahnavard Z, Salsali M, Negarandeh R. Exploring Nurse’s Communicative Role in Nurse-Patient Relations: A Qualitative Study. J Caring Sci. 2016;5(4):9.
41. Byrne G, Heyman R. Understanding nurses' communication with patients in accident & emergency departments using a symbolic interactionist perspective. Journal of Advanced Nursing. 1997;26(1):7.
42. Minton C, Batten L, Huntington A. The impact of a prolonged stay in the ICU on patients' fundamental care needs. J Clin Nurs. 2018;27(11):10.
43. Murray B, McCrone S. An integrative review of promoting trust in the patient-primary care provider relationship. . Journal of Advanced Nursing. 2015;71(1):20.
44. Lakdizajee S, Rahmani A, Zamanzade V, S p. The Evaluation Of Nursing Students' Point Of Views Toward Caring Behaviors In Intensive Cares. Educational Development Of Jundishapur. 2014;5(1):52-8.
45. W Reader T, Gillespie A. Patient neglect in healthcare institutions: a systematic review and conceptual mode. Health Services Research. 2013;13:156.
46. Rohleder N, Marin T, Ma R, Miller G. Biologic cost of caring for a cancer patient: dysregulation of pro-and anti-inflammatory signaling pathways. J Clin Oncol. 2009;27(18):15.
2. Salimi S, Azimpoor A. Determinants of Nurses’ Caring Behaviors (DNCB): Preliminary Validation of a Scale. Journal of Caring Sciences. 2013;2(4):9.
3. Gusti P, Nissa A, Zulfainda EP, Zaenal A, Alwan R, Ah Y. A Literature Review: Stress Management in The Family of Intensive Care Patients. Indonesian nursing journaof education and clinic. 2018;3(1):8.
4. Suhonen R, Efstathiou G, Tsangari H, Jarosova D, Leino-Kilpi H, Patiraki E, et al. Patients' and nurses' perceptions of individualised care: an international comparative study. journal of clinical nursing. 2012;21(7-8):12.
5. J Ehlers V. Is caring a lost art in nursing or is it a changing reality? Commentary on the editorial written by Juliet Corbin. Int J Nurs Stud. 2008;45(5):802.
6. Shalaby SA, Janbi NF, Mohammed KK, Practice KMA-hoNEa. Assessing the caring behaviors of critical care nurses. 2018;8:9.
7. Woodward V. Professional caring: a contradiction in terms. J Adv Nurs. 1997;26(5):5.
8. Kaur D, Sambasivan M, Kumar N. Effect of spiritual intelligence, emotional intelligence, psychological ownership and burnout on caring behaviour of nurses: a cross-sectional study. Journal of Clinical Nursing. 2013;22:3192.
9. Dithole K, Phil D, Sibanda S, Tshweneagae T. Nurses' communication with patients who are mechanically ventilated in intensive care: the Botswana experience. International Nursing Review. 2016;63(3):6.
10. Sherko E, Sotiri E, Lika E. Therapeutic communication. JAHR-European Journal of Bioethics. 2013;4(7):457-66.
11. wikipedia. Therapeutic relationship. https://enwikipediaorg. 2017.
12. Freeman S, Yorke J, Dark P. Patient agitation and its management in adult critical care: A integrative review and narrative synthesis. Journal of clinical nursing. 2018;27(7):24.
13. Alasad J, Abu Tabar N, Ahmad M. Patients' experience of being in intensive care units. Journal of Critical Care. 2015;3(21).
14. Happ MB, Garrett KL, Tate JA, DiVirgilio D, Houze MP, Demirci JR, et al. Effect of a multi-level intervention on nurse-patient communication in the intensive care unit: results of the SPEACS trial. Heart & lung : the journal of critical care. 2014;43(2):89-98.
15. Jackson JM. Hearing is Believing. Methodist Debakey Cardiovasc J. 2017;13(2):89.
16. Tapson K, Sierotowicz W, Maran DM, Thompson TM. ‘It's the hearing that is last to go’: a case of traumatic head injury. British Journal of Nursing. 2015;24(5).
17. McGilton KS, Sorin-Peters R, Rochon E, Boscart V, Fox M, H C. The effects of an interprofessional patient-centered communication intervention for patients with communication disorders. Applied Nursing Research. 2018;39:5.
18. Strandas M, Bondas T. The nurse–patient relationship as a story of health enhancement in community care: A meta-ethnography. Adv Nurs. 2017:12.
19. Selman LE, Hawkins A, Robinson V, Ramsenthaler C, Koffman J. The Effect of Communication Skills Training for Generalist Palliative Care Providers on Patient-Reported Outcomes and Clinician Behaviors: A Systematic Review and Meta-analysis. pain and symptom management. 2017:18.
20. Sheikhbardsiri H, Khademipour G, Nekoei‐Moghadam M, Aminizadeh M. Motivation of the nurses in pre‐hospital emergency and educational hospitals emergency in the southeast of Iran. The International journal of health planning and management. 2018;33(1):255-64.
21. Popa-Velea, Purcărea VL. Issues of therapeutic communication relevant for improving quality of care. Journal of Medicine and Life Volume 7, Special Issue 4. 2014.
22. Mirhaghi A, Sharaf S, Bazzi A, Hasanzadeh F. Therapeutic relationship: Is it still heart of nursing? Nursing Reports. 2017;7:6129:6.
23. Sadeghi Shermeh M, Amiri H, Karimi Zarchi A, Bahari F, Binesh A. Effectiveness of Solution-Focused Communication Training (SFCT) in Nurses’ Communication Skills. Iranian Journal of Military Medicine. 2013;14(4):279-86.
24. Karimi Moonaghi H, Khatoon N, Taheri H, Voshani B, Vaghee S, Yavari M. The Effect of Communication Skills Training on the Quality of Nursing Care of Patients. Quarterly Journal of Evidence-based Care. 2012;2(5):10.
25. Karimi Moonaghi H, Taheri N, Behnam Voshani H, Vaghee S, Yavari M. The Effect of Communication Skills Training on the Quality of Nursing Care of Patients. Quarterly Journal of Evidence-based Care. 2012;2(1):10.
26. Pease A, Chandler J. Body Language: How to Read Others' Thoughts by Their Gestures: Sheldon Press; 2010. 152 p.
27. Cole K. Crystal clear communication. 28, editor. Tehran: Hamoon; 2017.
28. Silverman J, Kertez S, Deraper J. Communication skills with patients. Tehran: Timurzadeh; 2016.
29. Larson P. Important nurse caring behaviors perceived by patients with cancer. Oncol Nurs Forum. 1984;11(6):5.
30. Pashaee S, Lakdizaji S, Rahmani A, Zamanzade V. Priorities of Caring Behaviors from Critical Care Nurses Viewpoints2014. 65-73 p.
31. Gausvik C, Lautar A, Miller L, Pallerla H, Schlaudecker J. Structured nursing communication on interdisciplinary acute care teams improves perceptions of safety, efficiency, understanding of care plan and teamwork as well as job satisfaction. Journal of multidisciplinary healthcare. 2015;8:33.
32. Raingruber B, Teleten O, Curry H, Vang-Yang B, Kuzmenko L, Marquez V, et al. Improving nurse-patient communication and quality of care: the transcultural, linguistic care team. JONA: The Journal of Nursing Administration. 2010;40(6):258-60.
33. Khodadadi E, Ebrahimi H, Moghaddasian S, Babapour J. The effect of communication skills training on quality of care, self-efficacy, job satisfaction and communication skills rate of nurses in hospitals of Tabriz, Iran. Journal of caring sciences. 2013;2(1):27.
34. Porter CA, Cortese M, Vezina M, Fitzpatrick JJ. Nurse Caring Behaviors Following Implementation of a Relationship Centered Care Professional Practice Model. International Journal of Caring Sciences. 2014;7:5.
35. Ratanawongsa N, Karter A, Parker M, Lyles C, Heisler M, Moffet H. Communication and medication refill adherence: the Diabetes Study of Northern California. JAMA internal medicine. 2013;173(9):8.
36. Rask M, Jensen M, Andersen J, Zachariae R. Effects of an intervention aimed at improving nurse-patient communication in an oncology outpatient clinic. Cancer Nurs. 2009;32(1):11.
37. Hillen MA, De Haes HCJM, Tienhoven G, Bijker N, Laarhoven H, Vermeulen D, et al. All eyes on the patient: the influence of oncologists’ nonverbal communication on breast cancer patients’ trust. Breast Cancer Res Treat. 2015;153:161.
38. Dawson-Rose C, Cuca C, Webel A, Solís Báez S. Building Trust and Relationships Between Patients and Providers: An Essential Complement to Health Literacy in HIV Care. J Assoc Nurses AIDS Care. 2016;27(5):10.
39. Berman A, S.J, Kozier B, Erb G. Kozier and Erb's Fundamental of Nursing . Newjersey Upper Saddle River: Pearson2010.
40. Movahedi A, Rahnavard Z, Salsali M, Negarandeh R. Exploring Nurse’s Communicative Role in Nurse-Patient Relations: A Qualitative Study. J Caring Sci. 2016;5(4):9.
41. Byrne G, Heyman R. Understanding nurses' communication with patients in accident & emergency departments using a symbolic interactionist perspective. Journal of Advanced Nursing. 1997;26(1):7.
42. Minton C, Batten L, Huntington A. The impact of a prolonged stay in the ICU on patients' fundamental care needs. J Clin Nurs. 2018;27(11):10.
43. Murray B, McCrone S. An integrative review of promoting trust in the patient-primary care provider relationship. . Journal of Advanced Nursing. 2015;71(1):20.
44. Lakdizajee S, Rahmani A, Zamanzade V, S p. The Evaluation Of Nursing Students' Point Of Views Toward Caring Behaviors In Intensive Cares. Educational Development Of Jundishapur. 2014;5(1):52-8.
45. W Reader T, Gillespie A. Patient neglect in healthcare institutions: a systematic review and conceptual mode. Health Services Research. 2013;13:156.
46. Rohleder N, Marin T, Ma R, Miller G. Biologic cost of caring for a cancer patient: dysregulation of pro-and anti-inflammatory signaling pathways. J Clin Oncol. 2009;27(18):15.
| Files | ||
| Issue | Vol 61 No 5 (2023) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/acta.v61i5.13486 | |
| Keywords | ||
| Therapeutic communication Caring behaviors Education Intensive care units Nurse | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Zare F, Farokhzadian J, Nematollahi M, Miri S, Zakeri MA, Foroughameri G. Therapeutic Communication Skills Training: An Effective Tool to Improve the Caring Behaviors of ICU Nurses. Acta Med Iran. 2023;61(5):294-296.
