Abstract: Aims. To explore nurses’ perceptions of their patient communication in practice and to identify their ways of communicating.
Background. Nurse theorists and clinicians are aware of the importance of nurse–patient communication in providing patientcentred
care. However, barriers remain that prevent nurses from implementing quality/effective communication, and time is
often viewed as a critical variable. Continuous emphasis on efficiency contravenes patient-centred care, warranting a
re-examination of nurses’ perception of time in nurse–patient communication.
Design. Focus group interviews were adopted. Thirty-nine registered nurses participated. Interviews were tape-recorded,
transcribed and translated, and data were analysed using thematic analysis to identify codes, categories and themes/patterns.
Results. Three themes were identified regarding nurses’ perception of communication with time: (1) Patterns of communication.
(2) Routine scheduled communication vs. meeting individuals’ needs. (3) Saving time through communication. Patterns of
communication, based on participants’ criteria such as the purpose, who initiated it, the nature of communication, expectation
to perform, therapeutic value and relation with time were explicated. By integrating communication into routines as intended
actions, nurses demonstrate that communication and relationship building with patients take no extra time. Good communication
and good relationships help nurses save time.
Conclusions. Nurses’ communication behaviour is closely related to their perception of communication. This study suggests the
need for a paradigm shift in thinking about communication as requiring time. Additionally, nurses should recognise the value of
short, iterative interaction and chit-chat as quality communication for knowing their patients and providing patient-centred
care.
Relevance to clinical practice. Nurses should think beyond time in the discourse of effective nurse–patient communication, as it
often relates to manpower. An understanding of how nurses perceive their time availability for nurse–patient communication
and their use of time for this aspect contribute to the discourse regarding how to improve patient-centred care.
Key words: China, Hong Kong, interaction, nurse–patient communication, patient-centred care, time
Abstract: This study explored the perceptions of staff in an interprofessional team based on a medical rehabilitation ward for older people, following the introduction of a service improvement programme designed to promote better teamworking. The study aimed to address a lack of in-depth qualitative research that could explain the day-to-day realities of interprofessional teamworking in healthcare. All members of the team participated, (e.g. nurses, doctors, physiotherapists, social worker, occupational therapists), and findings suggest that interprofessional teamworking improved over the 12-month period. Four themes emerged from the data offering insights into the development and effects of better interprofessional teamworking: the emergence of collegial trust within the team, the importance of team meetings and participative safety, the role of shared objectives in conflict management and the value of autonomy within the team. Reductions in staff sickness/absence levels and catastrophic/major patient safety incidents were also detected following the introduction of the service improvement programme.
Abstract: Integration of patient views in mental health service planning is in its infancy despite service provision being clearly dominated by narratives from professional consultations and medical records. We wished to clarify perceptions of uncertainty about mental health conditions from a range of provider and user perspectives (patients, carers, parents, mental health service providers) and understand the role of narratives in mental health research.
Abstract: This is the first in a three-part series on the physiological effects of bedrest. It discusses what happens to the cardiovascular, respiratory and haematological systems when a person is bedridden. Other articles in the series will cover the effects of immobility on the digestive, endocrine, renal, nervous, immune and musculoskeletal systems and will examine the effects of bedrest on the skin.
Abstract: This article is the second in a three-part series discussing the effects of long periods of bedrest on the body. It explores what happens to the gastrointestinal, endocrine and renal systems when a person is confined to bed. The effects on the reproductive and nervous systems are also covered. Part 1 examined the effects on the cardiovascular, respiratory and haematological systems.
Abstract: Strongly worded directives regarding the need for increased patient participation during nursing interaction with patients have recently appeared in a range of 'best-practice' documents. This paper focuses on one area of nurse-patient communication, the hospital admission interview, which has been put forward as an ideal arena for increased patient participation. It uses data from a total of 27 admission interviews, extensive periods of participant observation and analysis of nursing records to examine how hospital admission interviews are performed by nurses and patients. Analysis shows that topics discussed during admission closely follow the layout of the admission document which nurses complete during the interview. Whilst it is tempting to describe the admission document as a 'super technological power' in influencing the interaction and restricting patient participation, this analysis attempts a more rounded reading of the data. Findings demonstrate that, whilst opportunities for patient participation were rare, admission interviews are complex interactional episodes that often belie simplistic or prescriptive guidance regarding interaction between nurses and patients. In particular, issue is taken with the lack of contextual and conceptual clarity with which best-practice guidelines are written.
Abstract: This is the third article in the series exploring the adverse effects of prolonged bedrest and immobility. In this final article, the effects on the musculoskeletal and immune systems, skin and self-perception are examined.
Abstract: In recent years new modes of nursing work have been introduced globally in response to radical changes in healthcare policies, technology and new ideologies of citizenship. These transformations have redefined orthodox nurse-patient relationships and further complicated the division of labour within health-care. One distinctive feature of the work of registered nurses has been their initial assessment of patients being admitted to hospital, and it is of interest that this area of nursing practice remains central to the registered nurse's role at a time where other areas of practice have been relinquished to other occupational groups. This qualitative study, drawing on conversation analysis and ethnographic techniques, explores this area of everyday nursing work. Initial nursing assessments have attracted considerable interest in the nursing literature, where it is clearly stated that assessments should be patient centred and seen as the important first step on the road to a therapeutic nurse-patient relationship. Results from this study lead to the conclusion that the actual nursing practice of patient assessment on admission to hospital is at odds with the recommendations of the literature and that a more routinised, bureaucratic form of work is devised by nurses as a means of expediting the process of admission.
Abstract: To understand student nurse-patient interaction better and to assess the effectiveness of a teaching and learning resource consisting of tapes and transcriptions of actual nurse-patient interaction.
Abstract: In this paper, we aim to explore the benefits of triangulation and to expose the positive contribution of using 'triangulation for completeness' within a study of a complex concept, namely patient participation during healthcare interaction.
Abstract: As governmental priorities worldwide continue to emphasise the inclusion of patients in healthcare consultations, there is a pressing need for a research approach that accurately captures the contribution of both participants within nurse-patient interaction. With this in mind, this paper examines, via selective data extracts, the contribution that conversation analysis (CA) could make to this area of nursing research. In the United Kingdom (UK) over the last two decades, CA has been neglected as a method for exploring nurse-patient communication, and a case is made here for its entry into the mainstream of nursing research. The case is made particularly persuasive in the light of conversation analysts' use of naturally occurring research data, a form of data that is regrettably lacking in much of the published research on nurse-patient interaction.
Abstract: AIMS OF THE STUDY/PAPER: To explore the meaning of nursing time, both as it is represented in the literature and interpreted within nursing practice. To explore how nursing time may be better conceptualized through exploring non-nursing literature and the use of theory derivation.
