Adult patient communication experiences with nurses in cancer care settings: a qualitative study

The information and communication needs of patients with advanced incurable cancer: A rapid review

OBJECTIVES

This review aimed to collate evidence on the key information and communication needs of patients with advanced incurable cancer and their caregivers. It also sought to identify barriers and facilitators to communicating, understanding and receiving information, with the view of influencing improvements to future practice.

METHODS

This study used a rapid review methodology. Databases were searched on the Ovid platform to identify relevant qualitative data. Methodological quality was assessed, and data extraction was completed. A thematic synthesis approach was used for data analysis.

RESULTS

Findings from 42 articles highlighted that key information should be communicated in accordance with individual needs, including tailoring when and how information is provided. It also highlighted the need for healthcare professionals to provide adequate time, openness, and sensitivity to facilitate understanding of prognosis, treatment and care options. Barriers to receiving, communicating and understanding information relating to healthcare professionals and healthcare systems focus on inadequate time in consultations and a lack of specified point of contact. Patient level barriers included difficulties engaging with and processing challenging information, and inadequate health and death literacy. Facilitators included incremental information provision and early access to palliative care specialists.

CONCLUSIONS

Key communication and information needs identified in the review's synthesised findings should be considered when developing communication strategies alongside the barriers and facilitators.

PRACTICE IMPLICATIONS

HCPs should provide patients and caregivers with bespoke support to improve their health and death literacy, and a direct point of contact. Health service training could focus on personalised and empathetic information delivery.

Competencies of nurses to participate in safe medication management practices for biologics: A scoping review

AIM

To review the existing literature relating to nurse competence in safe medication management practices for biologics, identify evidence, and develop a competency framework to clarify the role of nurses in these practices.

BACKGROUND

With the widespread use of biological agents in disease treatment, ensuring the safe and economical use of high-cost medicines is particularly important. Even though nurses are essential in patient care, detailed knowledge regarding their competence and role in the safe administration of biologics is lacking.

DESIGN AND METHODS

A scoping review was performed following the methodology of Arksey and O'Malley and the PRISMA ScR guidelines. Electronic databases, including PubMed, CINAHL, Embase, Scopus, and Web of Science, were searched using accepted keywords, and relevant articles were identified using inclusion and exclusion criteria.

RESULTS

A total of 3,422 studies were retrieved, 24 of which were eligible for inclusion. The required competencies for nurses were summarized into six areas: clinical specialized knowledge, critical thinking and problem-solving skills, safe medication skills, health education skills, communication and coordination skills, and technological literacy.

CONCLUSION

We provide insights into the competencies of nurses involved in the safe medication management of biologics. These competencies can be used to assess the actual competency level of nurses and facilitate the maximization of biological treatment goals and outcomes. This plays a vital role in optimizing the use of healthcare resources and demonstrating outcomes.

Navigating Language Barriers in Linguistically Complex Settings: A Qualitative Analysis of Paradoxes in Nurse Communication in Acute Care Units in Saudi Arabia

This qualitative study explores how nurses managed communication challenges in linguistically complex Saudi Arabian acute care hospitals. A secondary analysis of transcripts from interviews with 21 nurses in Riyadh revealed the use of informal and creative strategies, including translation apps, non-verbal signaling, family interpreters, and an ad hoc system of sharing translation work among team members. In the absence of formal interpretation services, these strategies were essential but paradoxical, contributing to delays, errors, and team tension. Findings underscore the need for interventions prioritizing inclusivity, formal interpretation services, and clear guidelines, affirming nurse and patient rights to understand and be understood.

Psychometric properties of the Chinese version of the nurses' attitudes towards communication with the patient scale among Chinese nurses

BACKGROUND

Nurses' attitudes towards communication with patients influence the effectiveness of communication, which could reduce patients' negative emotions and improve their adherence to medication and treatment. The aim of this study was to develop a Chinese version of the nurses' attitudes towards communication with the patient (ACO) scale and examined its validity and reliability.

METHODS

The Chinese version ACO scale was generated using the translation-backward translation method and cross-cultural adaption.The psychometric properties of the scale, including item-to-total correlations, discriminative validity, content validity, structural validity, convergent validity, internal consistency reliability and test-retest reliability, were evaluated. Data were collected from a convenience sample of 610 clinical nurses from four hospitals and were analyzed using both exploratory factor analysis and second-order confirmatory factor analysis.

RESULT

The reliability was demonstrated with item-to-total correlations of greater than 0.40, Cronbach's alpha of 0.946 and intraclass correlation coefficients of 0.879. Content validity was acceptable and discriminative validity showed a significant discriminative ability. Exploratory and confirmatory factor analyses revealed a three-factor model. Convergent validity was confirmed by a moderate relation with a measure for nurses' empathy (r = 0.375, P<0.01).The test-retest reliability was satisfactory within a 2-week interval.

CONCLUSION

The ACO is a reliable and valid instrument to assess nurses' attitudes towards communication with patient in Chinese hospitals.

Palliative Care Practices and Knowledge of Home Care Nurses in Saudi Arabia: A Cross-Sectional Study

Palliative Care (PC) is an interdisciplinary specialty focused on relieving symptoms and optimizing quality of life for people living with serious illnesses and their families. A great need for PC exists in Saudi Arabia due to its aging population and prevalence of cancer and other chronic diseases. Home healthcare can make PC more accessible to patients, but clinicians must be equipped with the PC knowledge and skills to perform their roles. This study was a descriptive, correlational examination of PC practices and knowledge of home care nurses recruited from military hospitals in Saudi Arabia. We surveyed participants using the Palliative Care Quiz for Nursing (PCQN) and the Modified Global Home Health Nursing Care Assessment Questionnaire. The mean PCQN score was 8.40, indicating low levels of PC knowledge. A nurses' demographic and physical, spiritual, religious, cultural, linguistic, ethical, and legal aspects of care revealed significant associations. Given the low levels of PC knowledge and skills, we recommend focusing on education, training, and research. Universities should review their curriculum to ensure PC content. Hospitals should provide training programs focused on all aspects of PC, specifically emotional and spiritual, without limiting training to physical aspects of care. Future research is also needed to inform policy in this area.

Bridging Communication Gaps: A Study on Effective Patient Communication Among Respiratory Therapy Students and Interns

Introduction Effective communication in healthcare plays a pivotal role, significantly impacting patient experiences and outcomes. While much of the current literature focuses on communication dynamics among physicians and nurses, a gap exists in understanding these dynamics within allied health professions such as respiratory therapy. This study explores the knowledge, attitudes, and awareness of patient communication among respiratory therapy students and interns. Methods This descriptive cross-sectional study investigated the knowledge, attitudes, and awareness of effective communication methods with patients among respiratory therapy students and interns in Jeddah, Saudi Arabia. Using a validated self-administered questionnaire, the study surveyed 350 individuals from three universities and associated hospitals. Results The analysis involved 350 participants, with females comprising 55.1%. The study found that the highest level of agreement (mean 4.6±0.62) was regarding essential knowledge related to introducing respiratory therapists to patients during communication. Female students demonstrated significant proficiency in concluding patient interviews (P=0.033), while male students excelled in comprehending communication methods with unconscious patients (P=0.010). Interns exhibited the most comprehensive understanding of patient communication skills, particularly in employing open-ended questions (P=0.009) and allowing adequate time for patients to express their concerns (P=0.020). Gender and academic progression were identified as factors influencing patient communication skills in respiratory therapy students and interns. Conclusion This study highlights the need for tailored communication training for respiratory therapy students and interns. It emphasizes the importance of enhancing proficiency in this vital field by addressing knowledge gaps and identifying areas for improvement.

Factors Impacting on Patient-Centered Communication Skills and Their Opportunities to Be Involved in Decision-making From the Perspective of Patients With Cancer, Informal Caregivers, and/or Healthcare Professionals: A Systematic Review

BACKGROUND

Active participation of cancer patients and their caregivers in decision-making, along with high-quality communication, is crucial in patient-centered cancer management. Although numerous factors affecting patients' communication and decision-making involvement have been identified, it is still unclear which ones are the most prevalent and critical.

OBJECTIVE

To identify factors that contribute to high-quality patient-centered communication and decision-making participation from the perspectives of cancer patients, informal caregivers, and/or healthcare professionals.

METHODS

A systematic review was conducted, using 9 databases to retrieve primary research articles published from 2010 to February 17, 2023, updated on December 13, 2023. Methodological quality was assessed using the Mixed Methods Appraisal Tool (version 18). The socioecological model of communication was utilized as analytical framework for summarizing the results.

RESULTS

Fifty-two studies were included. The most frequently reported factors were predominantly articulated at the individual, interpersonal, and societal levels. Although the patients' lack of knowledge and limited language proficiency were the frequent patient-level barriers, the perceived lack of knowledge and lack of training of professionals were the crucial and current professional-level barriers, as reported in studies published in 2016 onward. To circumvent these factors, it is critical to enhance professionals' knowledge, communication skills, and patient relationships.

CONCLUSIONS

Recognizing barriers and facilitators could help in the development of strategies to overcome these barriers and enhance patient participation in clinical communication.

IMPLICATION FOR PRACTICE

The findings could guide the development of programs to enhance patient-professional communication skills. Further cross-cultural studies are needed to understand culture's impact on communication effectiveness and decision-making participation.

Exploring communication apprehension in nursing and healthcare education: A scoping review

Communication among healthcare professionals is critical to optimizing patient outcomes, and communication education is incorporated into the educational programs of healthcare professions students. Communication can be a source of stress for new healthcare professionals, however, there is a lack of research on communication apprehension (CA) in healthcare students, especially in nursing education. This scoping review sought to explore CA and factors associated with CA among healthcare professions students. This scoping review report was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (Tricco et al., Annals of Internal Medicine, 2018, 169, 467-473). Twenty studies of healthcare professions students were included for analysis. The percentage of health professions students with high CA ranged from 0.7% to 27%. Five out of seven intervention studies demonstrated a significant decrease in CA after the intervention. This review identified inconsistent associations between CA and various individual and educational factors. More research is needed utilizing rigorous research designs, designs employing qualitative methodology, and studies to investigate the impact of language on CA in health professions students who speak English as a second language.