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A Literature Review on Improving Nurse-Patient

Communication Manuscript
Irene Gabbedon
ihgabby@yahoo.com

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Running head: IMPROVING NURSE-PATIENT COMMUNICATION 1

A Literature Review on Improving Nurse-Patient Communication Manuscript

Irene Gabbedon, RN, MSN

University of San Francisco

N749 Qualifying Project

Elena Capella, Ed.D, MSN/MPA, RN, CNL, CPHQ, LNCC

May 13, 2019

IMPROVING NURSE-PATIENT COMMUNICATION 2

A Literature Review on Improving Nurse-Patient Communication Manuscript

Improving Nurse-Patient Communication Skills Through A Toolkit

Irene Gabbedon

University of San Francisco

Email address: ihgabbedon@dons.usfca.edu

The author declares no conflict of interest

IMPROVING NURSE-PATIENT COMMUNICATION 3

Executive Summary

Effective communication happens when the sender of the message sends it, and it is

conveyed and understood by the receiver (Gilbert & Hayes, 2009). Medical errors are the third

leading cause of death in the United States alone (McMains, 2016). The Joint Commission (TJC)

(2019) implemented National Patient Safety Goals (NPSG) in 2002, and improving

communication among caregivers has been a goal that has been frequently revised. Due to

ineffective communication, life-threatening errors are created among healthcare workers. Nurses

play an important role in the communication channel and barriers can be created when there is a

lack of health literacy. Providing nurses with the proper tools to improve their communication

with their patients will enhance their skills and improve the patient experience.
IMPROVING NURSE-PATIENT COMMUNICATION 4

Manuscript

The purpose of this manuscript is to discuss the comprehensive review of the literature

connecting communication between nurses and their patients. Terms that were used in this

systematic search included nurse-patient communication, teaching tools, nurse perception,

effective communication, patient safety, and health literacy. Some of the databases that were

used in this search were CINAHL, Pub Med, Joana Briggs, and OVID. All of the journals that

were selected were evidence-based. Inclusion criteria used were those focusing on interactions

between nurses or healthcare providers and patients. Although the goal was to utilize articles less

than five years old, some were older and still used due to the nature of their connection with

communication and relevance to the topic. Many of the studies shared the perception of either

the healthcare professional and/or the patient.

The John Hopkins Nursing Evidence-Based Practice Research Evidence Appraisal Tool

was used to critically appraise the evidence (Dearholt and Dang, 2012). This tool was used to

score the quality and level of the evidence. The ratings ranged from Level I (weakest) to Level V

(strongest). The most consistent types of evidence found were qualitative in nature. With the use

of this tool, there was proof that recommendations were systematically developed in the

literature. The sources used in the table of evidence were from nationally recognized experts

based on research evidence. (See Appendix A).

Oncology Patients

Of all the evidence found to be the most relevant to nurse-patient communication, there

was only one Randomized Control Trial (RCT) that was done by Rask and colleagues (2009). In

this study, patients were from a cancer unit. They were able to participate and had received

treatment in their clinic regardless of the cancer diagnosis. Nurses were divided into intervention
IMPROVING NURSE-PATIENT COMMUNICATION 5

and control groups over a period of seven months. There were three different questionnaires

distributed that measured the effectiveness of communication training.

Another study conducted by Lam et al., also involved oncology patients. In this

observational study, there was a language barrier between nurses and patients. Patient

satisfaction was measured using verbal and non-verbal cues they received from nurses. Both

studies showed that patients were more satisfied with communication from their nurses regarding

an explanation of procedures. Although patients in both studies had cancer, there were no

specific skills that would improve patient outcomes. However, the nature of the care would need

nurses to provide a more personal relationship for their patients to completely understand what

was being taught.

Chen and Raingruber’s (2013) study also involved oncology patients. These authors

concluded that staff and hospitals would benefit from offering interdisciplinary training that

includes role-playing. This is extremely important in initiating communication surrounding

sensitive topics such as self-care and cancer. In addition to these authors, deLeeuwe et al.,

(2014), Fallowfield et al., (2001) and Isaacson et al., (2018) concluded that on-going

communication training would be beneficial to nurses in improving skills learned.

Seizure and Dementia Patients

Repeating topics, capturing patient needs, and engaging in current patient circumstances

are some communication tools used in a study by Beulow and colleagues (2018), as well as Chao

and colleagues. Utilizing such tools when interacting with patients suffering from dementia or

with a history of seizures enhance the patient-provider interaction while building trusting

relationships.

Diabetes Patients
IMPROVING NURSE-PATIENT COMMUNICATION 6

Al Sayah and colleagues (2014) conducted a study about health literacy on patients with a

chronic disease such as diabetes. The authors found that repeating health information, clarifying

instructions, checking and asking for understanding, and seeking patients perception are all

components in a communication loop. Closing this loop helped to identify the lack of health

literacy that patients may experience. Out of 36 encounters that took place, only four were used

with a complete communication loop. This is relevant in addressing patient needs while

clarifying pertinent information that will improve patient outcomes.

Tools

Addressing patients by their last name and the title Mr. /Ms. rather than their first name is

more formal. Barre (2007) suggests that this form of identification provides symmetrical

communication between them and their healthcare provider. Addressing them as hon or sweety

may give a sense of belittling. This form of asymmetrical communication prevents the patient

from leading the conversation and may not feel their thoughts or feelings are relevant Barre

(2007).

Chu et al., (2018) conducted a study from 2011 through 2014. Implementing

Communication Training Program interventions to a group of 46 nurses and 62 patients, the

attitudes of nurses showed gross improvement after a workshop. Not only were there a decrease

in patient agitation, but also an increase in knowledge from nurses and patients. Quality of Life

(QOL) was also increased. In addition, Gilbert and Hayes (2009) found the communication

strategies that were implemented seemed to be an effective methodology for improving nursing

skills.

In a study conducted by Sethi and Rani (2017), an important point was addressed. In

addition to the skills nurses needed to learn, it was crucial that nurses and patients were in a
IMPROVING NURSE-PATIENT COMMUNICATION 7

desirable environment. Negative impact on nurses’ environments may in fact, create barriers to

communication. Patients could pick up on this energy and not show as much interest in messages

their nurses may be trying to convey. Constant monitoring of skills was recommended as

previously mentioned by deLeeuwe et al., (2014), Fallowfield et al., (2001) and Isaacson et al.,

(2018).

Conclusion

In conclusion the review of the literature brought to light the urgency for improved

communication between nurses and their patients. Regardless of the illness or medical condition

of the patient, there will be variance in communication styles. Although communication barriers

exist in healthcare, it is evident that health literacy is a key factor. Effective communication

improves the relationship through building trust, minimizing patients’ anxiety, guilt, and

reducing pain (Seth & Rani, 2017). Improving patient overall experience can be achieved by

sharpening nurses’ skills that should include a focus on communicating with patients who have

differing levels of health literacy. By providing the tools needed, better patient outcomes are

expected along with an improved quality-of-life.

IMPROVING NURSE-PATIENT COMMUNICATION 8

References

Al Sayah, F., Williams, B., Pederson, J. L., Majumdar, S. R, & Johnson, J. A. (2014). Health

literacy and nurses’ communication with type 2 diabetes patients in primary care setting.

Nursing Research, 63(6), 408-417.

Barrere, C.C. (2007). Discourse analysis of nurse patient communication in a hospital setting;

Implications for staff development. Journal for Nurses in Staff Development, 23(3), 114-

122.

Beulow, J., Miller, W., & Fishman, J. (2018). Development of an epilepsy nursing

communication tool: Improving the quality of interactions between nurses and patients

with seizures. Journal of Neuroscience Nursing, 50(2), 74-80.

Chao, H., Kaas, M., Su, Y., Lin, M., & Wang, J. Effects of the advanced innovative internet-

based communication education program on promoting communication between nurses

and patients with dementia. The Journal of Nursing Research 24(2), 163-172.

Chen, C. H., & Raingruber, B. (2013). Educational needs of inpatient oncology nurses in

providing psychological care. Clinical Journal of Oncology Nursing 18(1), E1-E5.

Chu, C.H., Sorin-Peters, R., Sidani, S., De La Huerta, B., & McGilton, K. S. (2018). An

interprofessional communication training program to improve nurses’ ability to

communicate with stroke patients with communication disorders. Rehabilitation Nursing

43(6), E25-E34.

de Leeuw, J., Prins, J. B., Uitterhoeve, R., Merkx, M. A. W, Marres, H. A. M., & van

Achterberg, T. (2014). Nurse-patient communication in follow-up consultations after

head and neck cancer treatment. Cancer Nursing 37(2), E1-E9.

IMPROVING NURSE-PATIENT COMMUNICATION 9

Dearholt & Dang, D. (2012)). Johns Hopkins nursing evidence-based practice: Model and

guidelines (2nd ed.,)

Ding, M., Bell, A., Rixon, S., Addae-Bosomprah, H., & Simon, J. (2016). Effectiveness of

educational communication interventions for health professionals to improve quality of

care in emergency departments: a systemic review protocol. The Joanna Briggs Institute

10-19.

Fallowfield, L., Saul, J. & Gilligan, B. (2001). Teaching senior nurses how to teach

communication skills in oncology. Cancer Nursing 24(3),185-91.

Gilbert, D. A, & Hayes, E. (2009). Communication and outcomes of visits between older patients

and nurse practitioners. Nursing Research 58(4), 283-293.

Isaacson, M. J., & Minton, M. E. (2018). End-of-life communication. Nurses cocreating the

closing composition with patients and families. Advances in Nursing 41(1), 2-17.

McMains, V. (2016). John Hopkins study suggests medical errors are the third -leading

cause of death in the US. Retrieved from:

https://hub.jhu.edu/2016/05/03/medical-errors-third-leading-cause-of-death/

Rask, M. T., Jensen, M. L., Andersen, J., & Zachariae, R. (2009). Effects of an intervention

aimed at improving nurse-patient communication in an oncology outpatient clinic.

Cancer Nursing 32(1), E1-E11.

Sethi, D., & Rani, M. K. (2017). Communication barriers in health care setting as perceived by

nurses and patient. International Journal of Nursing Education 9(4), 30-35.

The Joint Commission (2019). National patient safety goals. Retrieved from:

https://www.jointcommission.org/standards_information/npsgs.aspx
IMPROVING NURSE-PATIENT COMMUNICATION 10

Appendix A- Evaluation Table

Citation Conceptual Design/ Sample/ Variables Measurement Data Findings Appraisal:

Framework Method Setting Studied and Analysis Worth to
Their Practice
Definitions
Al Sayah, None Qualitative Study took Health literacy Each Two Nurse used complete community loop
F., research place in 3 Scored 1-5, encounter was professiona in only 4 of 36 encounters. Most IIIB
Williams, study Primacy care high scores audio l common component of community
showed low
B., network in
HL.
recorded. transcriptio loop was clarifying health info/instruct
Pederson, J. Canada. 3 screening Each nurse nists and a (58%). Repeating health info was 2nd
L., Between questions used. had at least 2 coding most used (33%). Least used was
Majumdar, 5/2012 thru 5 key encounters manual checking for understanding (81%
S. R, & 4/2013. components that were were used never used) then followed by asking
Johnson, J. used in recorded. Data for this for understanding (42% never used).
A. (2014). 36 Pattients Interaction collection study.
communication
Health 18 y/o and
loop cont. until Coding was Nurses in PC settings rarely used full
Literacy older, had
a) repeating data sat was done communication loop in DM self mgmt.
and Nurses’ Type 2 DM, health info, reached. independen educ. There were missed opportunities
Communica communicatio b) clarifying t. for to enhance patient education and
tion With n in English, instructions, understanding.
Type 2 with no c) asking for Interrater
Diabetes severe mental understanding agreement Health literacy did not affect nurses
Patients in or physical d) checking for done using communication. However, nurses used
Primacy issues were understanding, percentage less jargon with patients with
e) seeking
Care able to agreement inadequate health literacy.
patient
Setting. participate. perception and kappa
Nursing 9 female Use of jargon statistic.
Research, nurses categories
63(6), 408- involved in including
417. Chronic medical and
Disease mismatch
mgmt. language
participated.
IMPROVING NURSE-PATIENT COMMUNICATION 11

Citation Conceptual Design/ Sample/ Variables Measurement Data Findings Appraisal:

Framework Method Setting Studied and Analysis Worth to
Their Practice
Definitions
Barrere, Social Small Conducted in Interactions Focusing on Notes Nurse was interactionally dominant.
C.C. construction- convenience two were audio symmetry vs. transcribed. Two modes of discourse used, the
(2007). ist theory sample was Northeastern recorded with asymmetry Notes were nurse used patients first vs. last name. III B
Discourse used hosp. 20 mini- nature of simultaneo Most use title of Mr./Mrs. Of eight
analysis of nurse-patient microphone nurse-patient usly read first time nurse-patient interactions,
nurse pairs on as they communicatio and listened only once was patient asked how
patient medical/surgi occurred n related to to. patient preferred to be addressed.
communica cal or during day gender of Transcripti
tion in a telemetry and eve shifts nurse and on protocol Nurses referred to patients as honey or
hospital units patient was used. hun. giving sense of asymmetrical
setting; All interaction. Identificati communication.
implication participants There were 11 on of the
s for staff were modes of initial Nurses need to not to always lead the
developmen Caucasian and discourse: categories conversation, but be a participant in
t. Journal spoke Address, and themes, the conversation.
for Nurses English. focused then re-read
in Staff There were 4 assessment, to
Developme groups: teaching/infor determine
nt, 23(3), 5 Male/male mation final modes
114-122. 5 male/female sharing, of
5 fem/fem negotiation of discourse.
5 fem/male personal and
gendered
medical,
pairings. Ages
sick/depend,
of nurses 23-
reassurance,
47yrs.
departure,
Patients ages
overlooked,
from 40-88yr.
personal self
disclosure,
negotiation of
act &
ideological
IMPROVING NURSE-PATIENT COMMUNICATION 12

Citation Conceptual Design/ Sample/ Variables Measurement Data Findings Appraisal:

Framework Method Setting Studied and Analysis Worth to
Their Practice
Definitions
Beulow, J., None Qualitative There were 8 10 nurses Tool was Results indicated that the nurse found
Miller, W., research nurses An ENCT rated the tool reviewed in the tool to be useful, easy to use, and
& Fishman, design recruited 7 (Epilepsy for having 3 phases. In acceptable. III B
J. (2018). had expertise Nursing clinical last phase
Developme in epilepsy, Communcatio usability and scores were Tool provided assistance in repeating
nt of an one was an n Tool) was feasibility. tallied with topics from memory loss, capturing
epilepsy expert in developed in This was done further patient needs, enhancing patient-
nursing patient 3 phases. thru a web- revisions. provider communication, which could
communica communicatio Open ended based digital Tool given improve the quality of interactions
tion tool: n. Tool is survey platform. 5 back to 8 between patients and their providers to
Improving designed to questions point Likert nurse ensure optimal management of
the quality help nurses were created . scale used 1- experts for epilepsy.
of without (strongly final
interactions epilepsy disagree) thru - comments.
between training to 5 (strongly
nurses and have a more agree).
patients thorough and
with constructive
seizures. conversation
Journal of with patiens
Neuroscien with epilepsy.
ce Nursing,
50(2), 74-
80.
IMPROVING NURSE-PATIENT COMMUNICATION 13

Citation Conceptual Design/ Sample/ Variables Measurement Data Findings Appraisal:

Framework Method Setting Studied and Analysis Worth to
Their Practice
Definitions
Chao, H., None Quasi- Study was Changes Statistical Study shows that AIICE program
Kaas, M., Su, experimenta done between Evaluation of assessed over analysis improves nurses communication
Y., Lin, M., l design. 7/2010 and an Advanced time across used was knowledge, frequency to assess II B
& Wang, J.
Convenienc 5/2011. Innovative three points: SPSS 17. 0 patients communication capacity,
(2017).
Effects of the e sample Internet-based baseline, 4th One sample communication performance.
advanced used Nurses Communicati week posttest, t-test was Alleviates memory and behavior-
innovative recruited from on Education and 16th week used for related problems and depressive
internet- long term care (AIICE) posttest. initial symptoms of pts. Training is
based facilities in program. analysis, recommended.
communicati Southern Testing and general
on education Taiwan. nurses estimating There was significant improvement
program on
RN or LVN communicatio equations over baseline by 4th to 16th week post-
promoting
communicati with at least 3 n knowledge, used to test. (p< .01)
on between months attitudes, compare
nurses and experience frequency of changes
patients with with caring assessing over time.
dementia. for people patient Bonferroni
The Journal with dementia communicatio used for
of Nursing and have n capacity, pairwise
Research
access to the and comp of
24(2), 163-
172. internet communicatio outcomes
n perform in
context of
care of
dementia.
IMPROVING NURSE-PATIENT COMMUNICATION 14

Citation Conceptual Design/ Sample/ Variables Measurement Data Findings Appraisal:

Framework Method Setting Studied and Analysis Worth to
Their Practice
Definitions
Chen, C. Qualitative 26 inpatient 8 conference Likert-type Cross Hospitals would benefit from offering
H., & None research oncology calls were questions were tabulations interdisciplinary training that includes
Raingruber, design nurses made as used in the used to role-playing to initiate sensitive topics. III B
B. (2013). participated reminders to survey. Also calculate
Educational from an staff for open-ended age and Self care should be covered during
needs of academic participation questions we education. training
inpatient medical included. T-test was
oncology center used.
nurses in
providing
psychologic
al care.
Clinical
Journal of
Oncology
Nursing
18(1), E1-
E5.
IMPROVING NURSE-PATIENT COMMUNICATION 15

Citation Conceptual Design/ Sample/ Variables Measurement Data Findings Appraisal:

Framework Method Setting Studied and Analysis Worth to
Their Practice
Definitions
Chu, C.H., Quasi- Study done IP (Inter- Pre-post Data Nurses’ attitudes and knowledge
Sorin-Peters, None experimenta between 3/2011 professional measures analysis improved 3mths after workshop.
R., Sidani, l and 3/2014. Communicati IP surveys used Knowledge improved significantly, II B
S., De La 46 nurses
on Training conducted at 3 STATA. Attitudes also continued to improve
Huerta, B., & participated. 62
McGilton, K. patients Program) stages: prior to Repeated but not to significant degree.
S. (2018). An participated. developed. IP training, 3 measures
interprofessio Groups divided Initial training months after hierarchical Increase in Quality Of Life and
nal into control and done in 1 8hr workshop, and regression decrease in patient agitation noted
communicati intervention. day, Booster 1 year follow used
on training Study done on 2 training done up after booster account for Minimal literature r/t nursing and
program to in-patient stroke in ½ day 8 workshop. missing patient communication in rehab setting
improve rehab units in
months later. CIQ (Comm. values. of stroke recovery. Knowledge gap
nurses’ Ontario
ability to Canada. Nurses On-going Impairment a<0.05
communicate were FT, PT support from Quest) was applied
with stroke RNs, Patients speech measures for all stats
patients with had to have language nurses attitudes test to
communicati stroke related pathologist toward accept 5%
on disorders. moderate- for 1 year communicate chance of
Rehabilitatio severe with pts. Type I
n Nursing communication
4 point Likert Error.
43(6), E25- disorder.
E34. scale used
(1 poor- 4
excellent)
IMPROVING NURSE-PATIENT COMMUNICATION 16

Citation Conceptual Design/ Sample/ Variables Measurement Data Findings Appraisal:

Framework Method Setting Studied and Analysis Worth to
Their Practice
Definitions
de Leeuwu, Descriptive Total sample Scale was 17 video Medical Nurses adequately responded to
J., Prins, J. A bio- observationa of 16 people. developed for recordings Interview approximately 25% of patient and
B., psychosocial l study There were 10 oncologic were captured Aural partners cues III B
Uitterhoeve,
model patient and 6 setting. At from 10 pts. Rating
R., Merkx,
M. A. W, partners. time of All interactions Scale 75% of all cues were responded to
Marres, H., Study done recordings, lasted between (MIARS) using distancing behaviors known to
A., M., & between patients were 20-30 minutes. was used to reduce space.
van March and 2-8 months code video
Achterberg, Sept 2010 in post-treatment recordings. Majority of questions were answered
T. (2014). outpatient and disease adequately.
Nurse-patient clinic in free. Outcome Specialized
communicati
Netherlands. ranges were software Amount of cue responding remained
on in follow-
up All nurses from -1 to 1. called below 0 for nurses.
consultations attended short Observer
after head training XT 9.0 Ongoing professional training and
and neck workshop of 2 clinical supervision may be helpful for
cancer 3-hr sessions. nurses to further improve
treatment. communication skills.
Cancer
Nursing
37(2), E1-E9.
IMPROVING NURSE-PATIENT COMMUNICATION 17

Citation Conceptual Design/ Sample/ Variables Measurement Data Findings Appraisal:

Framework Method Setting Studied and Analysis Worth to
Their Practice
Definitions
Fallowfield, Qualitative 129 nurses 2 day Courses Questionnaires Compariso Most common problem identified was
L., Saul, J. None design participated were taught in were ns were dealing with colleagues was confirmed
& Gilligan, Nurses had to small hotel administered using non- by 39% of nurses. Other highest - III B
B. (2001). be a minimum away from before and parametric ranking problems were information
Teaching of 2 years hospital over immediately Wilcoxon giving/ eliciting informed consent 27%
senior post a 2 year after course. matched of nurses.
nurses how registration to period. After 3 months pairs,
to teach enroll in Small groups another 91% of the nurses had altered their
signed rank
communica course. of 4 or less questionnaire teaching as result of the course. 85%
test. All
tion skills people. was mailed to initiated new communication teaching
in 32 item see if any areas show skill learned.
oncology. questionnaire teaching a
Cancer for initiatives were statistically There is increasing need to provide
Nursing demographic started significant more resources for effective training is
24(3), 185- purposes and improveme pt care is to improve.
91. analog to rate nt in
own confidence.
confidence in
dealing with
communicatio
n difficulty in
oncology and
teaching.
IMPROVING NURSE-PATIENT COMMUNICATION 18

Citation Conceptual Design/ Sample/ Variables Measurement Data Findings Appraisal:

Framework Method Setting Studied and Analysis Worth to
Their Practice
Definitions
Gilbert, D. None Qualitative Statewide Video Roter Mixed Communication strategies were
A, & study sample of 31 recordings Interaction model implemented as an effective
Hayes, E. NP and 155 were used for Analysis regression methodology for nurses III B
(2009). older pts. In the visits. System (RIAS) was used communication skills.
Communica New England Patients had used to until
tion and state. Only to rate on a measure verbal predictors
outcomes female NPs Consumer activities. of p<0.05.
of visits were included Assessment Intercoder
between of Health reliability has Data was
older Care average of r = analyzed
patients and Providers 0.85 using
nurse Survey. Scale mixed –
practitioner ranged from 1 model
s. Nursing (worst care regression
Research possible) thru of SAS 9.1.
58(4), 283- 10 (best care
293. possible)
IMPROVING NURSE-PATIENT COMMUNICATION 19

Citation Conceptual Design/ Sample/ Variables Measurement Data Findings Appraisal:

Framework Method Setting Studied and Analysis Worth to
Their Practice
Definitions
Isaacson, Relevant Hermeneutic 10 hospice Semi- Over 2 month . Qualified Specialized end of life training for pre-
M. J., & theory. al analysis nurses structured period themes transcriptio licensure students result in improved
Minton, M. A participated interviews were gathered, nist was knowledge and attitude toward care of III B
E. (2018). COMFORT Employees were used that cases and used to the dying.
End-of-life model, were female, lasted 45 – 60 shared analyze the Post-licensure training in ongoing
communica which is a between 30 & minutes. Was meanings. narratives communication is needed for accurate,
tion. Nurses patient- 60 y/o. Had recorded and timely and sensitive issues regarding
cocreating centered, 10 to over 30 transcribed patients.
the closing palliative years exp. 5 verbatim.
compositio care rural nurses Nurse and patient influence each
n with communicati cared for others communication
patients and on patients in Communication matured from training
families. framework homes, acute through the ELNEC curriculum
Advances in designed to care, and
Nursing address SNF.
41(1), 2-17. communicati 5 urban
on nurses cared
challenges for patients in
across the hospice house
health care
continuum.
IMPROVING NURSE-PATIENT COMMUNICATION 20

Citation Conceptual Design/ Sample/ Variables Measurement Data Findings Appraisal:

Framework Method Setting Studied and Analysis Worth to
Their Practice
Definitions
Lam, W., None Observation 25 RNs and A Questionnaires SPSS Patient receiving admission
Wong, al study 94 oncology demographic in Chinese version 24 procedures were significantly more
F.Y., & patients were sheet was were used used for satisfied with communication with III B
Chan. recruited from used, a analysis. their nurses compared with those who
(2018). 1 unit. checklist with Descriptive were more concerned about impact of
Factors patients stats. the disease on self-care.
affecting concerns,
the levels of checklist of
satisfaction non-verbal
with nurse- cues used by
patient nurses and
communica patients,
tion among Likert scale
oncology on patients
patients. level of
Cancer satisfaction.
Nursing
00(0), 1-11.
IMPROVING NURSE-PATIENT COMMUNICATION 21

Citation Conceptual Design/ Sample/ Variables Measurement Data Findings Appraisal:

Framework Method Setting Studied and Analysis Worth to
Their Practice
Definitions
Rask, M. None Controlled 24 nurses in Nurses 3 different ANOVA This study was unable to support the
T., Jensen, trial an oncology assessed at Questionnaire was a hypothesis that nurse communication
M. L., Randomly were baseline, 1 package given measure of skills training would be associated IA
Andersen, stratified organized into week after to patient and the effect with improved nurse/patient outcomes.
J., & assigned 3 teams and communicatio returned in of
Zachariae, intervention equally n skills sealed nurse/patie Analyses of which pt needs and
R. (2009). and control represented in training, and envelope and nt expectations the nurse/pt relationship
Effects of group. intervention again 3 deposit in communica in cancer care has to fulfill, as well as
an 413 patients and control months after. locked box tion skills of the specific communication
intervention participated groups. Total training interaction and patterns identified.
aimed at in the study time of study Patients could
improving was 7 months. participate if Further studies needed to address these
nurse- 18 and issues.
patient received
communica treatment in
tion in an clinic
oncology regardless of
outpatient CA dx or
clinic. stage
Cancer
Nursing
32(1), E1-
E11.
IMPROVING NURSE-PATIENT COMMUNICATION 22

Citation Conceptual Design/ Sample/ Variables Measurement Data Findings Appraisal:

Framework Method Setting Studied and Analysis Worth to
Their Practice
Definitions
Sethi, D., & None Cross 50 nurses and Nurses quest Two separate Descriptive Barriers found were language,
Rani, M. K. sectional 50 patients of had 44 items. questionnaires and environmental, cultural, overload of
(2017). descriptive two private Patient for nurses and inferential nurses work schedules III B
Communica study. hospitals in questions had patients. Tool stats used
tion barriers Simple 2016. 30 items. divided into 3 in SPSS 16. Raising the awareness of nurses and
in health random Medical, Each had 5 categories: P value ≤ to patient and creating desirable
care setting sampling surgical, options: none, patient related 0.05 environment
as ICU/CCU, little, average, factor. Nurse considered
perceived and ER wards high, and NA. related factor, statistically Nurses must be trained in
by nurses were included and common significant communication skills and constant
and patient. Barriers factors monitoring of skills to support
Internation divided into 4 between nurse encouragement
al Journal categories and patient
of Nursing
Education
9(4), 30-35.

*Johns Hopkins Hospital/The Johns Hopkins University (2012). Appendix E: Research evidence appraisal tool. In S. L. Dearholt & D. Dang. (Eds.). Johns Hopkins nursing
evidence-based practice: Model and guidelines (2nd ed.,)