Communication Skills and Professional Practice: Does It Increase Self-Efficacy in Nurses?

The effectiveness of communication skills training on professional performance and quality of work life of pre-hospital emergency medical staff: An experimental study in Iran

AIM

Communication skills are one of the components that influence the performance of pre-hospital emergency staff who provide services to patients. This study aimed to determine the effectiveness of communication skills training on the professional performance and quality of work life of pre-hospital emergency staff.

METHODS

This experimental study with pretest-posttest design was conducted on 150 pre-hospital emergency staff in Iran from March 2022 to May 2023. The participants were randomly assigned into two control (n = 75) and experimental (n = 75) groups. The intervention included 4 sessions (3 h each) of communication skills training, weekly. The data gathering scales were Stamm's quality of work life questionnaire and Patterson's job performance questionnaire, which were used at start point, 4 and 8 weeks after that.

RESULTS

The mean score professional performance in experimental group increased significantly to 42.4 ± 0.70 in the second stage and to 44.5 ± 0.55 in the third stage (P < 0.05). The mean score of the quality of work life was also 96.9 ± 0.9 and 99.8 ± 0.9 in the 4th and 8th weeks after the intervention, which was significantly more than control group (P < 0.05).

CONCLUSIONS

The results showed the communication skills training improves professional performance and increases the quality of work life of pre-hospital emergency staff.

Validation of the Self-Efficacy Questionnaire (SE-12-Gr) Assessing the Healthcare Professionals' Self-Reported Communication Skills with Older Healthcare Users in Greece

Patients' satisfaction with their interaction with the healthcare providers has been found to correlate with adherence to therapeutic plans and better health outcomes. Healthcare providers are experiencing barriers when communicating with specific population subgroups, such as people with low health literacy, low education, and older age. Enhancing the communication skills of the healthcare providers working with older adults could facilitate their interaction with the patients. This study presents the validation of the Self-efficacy-12 (SE-12) in Greek. This is an instrument measuring healthcare providers' self-efficacy of communication skills used during their interaction with older patients. A sample of 230 healthcare providers working with older adults participated in the study. The scale showed good psychometric properties (S-CVI=.97, Cronbach a = .95, ICC = .81). A medium to high correlation was found with the generalized self-efficacy questionnaire. Exploratory Factor Analysis (EFA) yielded two factors ("Self-efficacy in communication skills and strategies" and "Self-efficacy of successful interaction") with good psychometric properties. The SE-12-GR is a brief, valid, and reliable tool for assessing self-efficacy of communication skills and it could be integrated as part of the health literacy tools for healthcare providers working with older people in Greece.

Interprofessional Differences in Multidimensional Self-Efficacy Associated With Professional Performance in Nephrology During Case-Based Learning

Introduction

Postgraduate medical education assumes rising importance in the rapidly advancing field of medicine. Case-based learning (CBL), a learner-centered pedagogy employing clinical cases to improve decision-making, is widely embraced in postgraduate medical education, including nephrology. Studies suggest that learning self-efficacy (SE) was closely associated with learning motivation and academic performance; however, very few studies examined this association in postgraduate nephrology education. None evaluated whether there were interprofessional differences concerning such association.

Methods

In 2022, we prospectively enrolled physicians and nurses participating in chronic kidney disease (CKD) care from institutions around Taiwan. They completed the Professional Medical Learning Self-efficacy (PMLS) questionnaire after attending >1 CBL session involving CKD care. We undertook confirmatory factor analysis (CFA), followed by structural equation modeling (SEM) to evaluate associations between 5 dimensions of learning SE (conceptual understanding [CU], higher-order cognitive skills [HC], practical work [PW], everyday application [EA], and medical science communication [MSC]) and their professional SE in nephrology according to participants' medical professions.

Results

A total of 513 healthcare providers were surveyed. The convergent and construct validity of our questionnaire were satisfied after analyses. We found that better perceived professional performance in the form of higher professional SE in nephrology was significantly associated with all 5 dimensions of learning SE among physicians and nurses. Only CU and PW were significantly associated with physicians' professional performance; whereas among nurses, only HC and MSC were significantly associated.

Conclusion

We showed that learning SE was an important determinant of nephrology professional performance. Different medical professions posed influences on major SE dimensions.

Caring Self-Efficacy of Personal Care Attendants From English-Speaking and Non-English-Speaking Countries Working in Australian Residential Aged Care Settings

Objectives: This study compared the caring self-efficacy between personal care attendants (PCAs) from English-speaking and non-English-speaking countries, controlling for potential sociodemographic and work-related covariates. PCAs' perceptions of their caring self-efficacy were further explored. Methods: An independent samples t-test was used to determine the mean difference in the caring self-efficacy score between the two groups. A multivariate analysis was conducted to adjust for covariates. Thematic analysis was conducted on open-ended responses. Results: The results showed that caring self-efficacy was significantly influenced by whether participants primarily spoke English at home rather than where they were born. Younger age and everyday discrimination experiences were negatively associated with caring self-efficacy. Both groups perceived that inadequate resources and experiencing bullying and discrimination reduced their caring self-efficacy. Discussion: Access to organisational resources and training opportunities and addressing workplace bullying and discrimination against PCAs, particularly younger PCAs and those from non-English-speaking backgrounds, could improve their caring self-efficacy.

Evaluation of a patient-centered communication skills training for nurses (KOMPAT): study protocol of a randomized controlled trial

BACKGROUND

To ensure high quality of nurses' communication as part of patient-centered care, training of communication skills is essential. Previous studies indicate that communication skills trainings can improve communication skills of nurses and have a positive effect on emotional and psychological burden. However, most show methodological limitations, are not specifically developed for nurses or were developed for oncological setting only.

METHODS

This study aims to evaluate the effectiveness of a needs-based communication skills training for nursing professionals and to derive indications for future implementation. A two-armed randomized controlled trial including components from both effectiveness and implementation research will be applied. Additionally, a comprehensive process evaluation will be carried out to derive indications for future implementation. Nurses (n=180) of a university medical center in Germany will be randomized to intervention or waitlist-control group. The intervention was developed based on the wishes and needs of nurses, previously assessed via interviews and focus groups. Outcomes to measure effectiveness were selected based on Kirkpatrick's four levels of training evaluation and will be assessed at baseline, post-training and at 4-weeks follow-up. Primary outcome will be nurses' self-reported self-efficacy regarding communication skills. Secondary outcomes include nurses' communication skills assessed via standardized patient assessment, knowledge about patient-centered communication, mental and work-related burden, and participants' satisfaction with training.

DISCUSSION

To our knowledge, this is the first study systematically evaluating the effectiveness of a patient-centered communication skills training for nursing professionals in Germany. Results will yield insight whether a needs-based intervention can improve nurses' self-efficacy regarding communication skills and other secondary outcomes.

TRIAL REGISTRATION

Clinical trial registration number: NCT05700929, trial register: ClinicalTrials.gov (date of registration: 16 November 2022).

The Chinese version of the Health Professional Communication Skills Scale: Psychometric evaluation

Objective

This study aims to translate the Health Professional Communication Skills Scale (HP-CSS) into Chinese and assess its psychometric properties.

Methods

A total of 836 healthcare professionals were recruited. The demographic characteristics form and HP-CSS were used for data collection. The psychometric properties of HP-CSS were evaluated by examining item analysis, construct validity, known-group discriminant validity, internal consistency, and split-half reliability.

Results

In terms of item analysis, the critical ratio (CR) of 18 items was both >3 (CR ranging from 9.937 to 28.816), and the score of each item was positively correlated with the total score (r ranging from 0.357 to 0.778, P < 0.001). The fit indices showed that the original correlated four-factor model of HP-CSS was adequate: χ2 =722.801; df = 126; χ2/df = 5.737; RMSEA = 0.075; CFI = 0.923; NNFI = 0.908; TLI = 0.906; IFI = 0.923. In terms of known-group discriminant validity, the HP-CSS total score was related to gender, occupation, work years, and communication skill training. Cronbach's α coefficient was 0.922, and the split-half reliability was 0.865 for the total scale.

Conclusion

The Chinese version of the HP-CSS is a reliable and valid instrument to evaluate communication skills among healthcare professionals in China.

Nurses' practices and their influencing factors in palliative care

Background

In 2017, the Chinese government launched a pilot project in palliative care, in which Shanghai was a pioneer. Nurses play a key role in palliative care services as they are the main providers improving the quality of services for patients and their families. However, little is known about practices and influencing factors in the field of palliative care from a nursing perspective in China. This is an original empirical study that has meticulously analyzed the interrelationship and intensity between practices and other factors among nurses in the initial stage of palliative care in primary healthcare institutions in Shanghai, China.

Methods

A descriptive-correlational study design was used to sample 2,829 eligible palliative care nurses by purposive sampling survey in 225 healthcare institutions in Shanghai, China. Descriptive analyses were performed using IBM SPSS 24.0 software. Structural equation modeling was applied to analyze the data by AMOS 20.0. Data were collected using the well-designed Knowledge, Attitudes, and Practices of Hospice Care (KAPHC) scale.

Results

The final model showed a good model fit. Self-efficacy directly influenced practices (β = 0.506, P < 0.01) and indirectly influenced practices (β = 0.028, P < 0.01) through intention. Subjective norm directly influenced practices (β = 0.082, P < 0.01) and indirectly influenced practices (β = 0.030, P < 0.01) through intention. Intention (β = 0.152, P < 0.01) and knowledge (β = 0.068, P < 0.01) directly influenced practices. Perceived susceptibility (β = -0.027, P < 0.01), perceived benefits (β = -0.017, P < 0.01), and perceived barriers (β = -0.014, P < 0.01) indirectly influenced practices through intention.

Conclusion

This study provided evidence of the associations of knowledge, perceived susceptibility, benefits, barriers, subjective norm, self-efficacy, intention, and practices among nurses concerning palliative care and interventions improving their actual work practices. Our findings revealed that self-efficacy, intention, and subjective norms greatly influenced practices. It is imperative to take interventions that focus precisely on self-efficacy, intention, and subjective norms to improve nurses' practices.

Assessing emergency department nurses' ability to communicate with angry patients and the factors that influence it

Aims

To assess emergency department (ED) nurses' ability to communicate with angry patients and to explore the factors that influence nurses' communication skills.

Design

A cross-sectional survey design.

Methods

This study was conducted in November and December 2020. Stratified sampling was adopted to recruit ED nurses from 18 tertiary hospitals in western, eastern, and central China to complete an online questionnaire. The Nurses' Communication Ability with Angry Patients Scale (NCAAPS) and the General Self-Efficacy Scale were used to assess ED nurses' communication ability and self-efficacy, respectively. Descriptive statistics, the Mann-Whitney U-test, the Kruskal-Wallis H test, Spearman's correlation analysis, and the generalized linear model were used for data analysis.

Results

A total of 679 valid questionnaires were collected. The mean total score for the NCAAPS was (3.79 ± 0.47), while the scores for its four dimensions were (3.87 ± 0.59) for communication skills, (3.82 ± 0.59) for anger perception, (3.79 ± 0.53) for self-preparation, (3.73 ± 0.54) for exploring the cause of anger. The generalized linear regression analysis result showed that a longer employment duration, previous communication ability training, and higher self-efficacy were significantly and independently associated with higher NCAAPS scores (p < 0.05).

Conclusions

The mean total score and the four dimensions score for the NCAAPS were moderate. But there is still room for improvement in ED nurses' ability to communicate with angry patients. "Exploring the cause of anger" was the lowest score among the four dimensions. To improve ED nurses' ability to communicate with angry patients, future studies should focus on constructing specific communication training, improving nurses' ability to explore the cause of anger and self-efficacy.

Impact

The findings of this study provide important insights into ED nurses' ability to communicate with angry patients and can thus guide the future development of intervention programmes to improve this ability among ED nurses.

Factors associated with attitudes toward advance directives in nurses and comparisons of the levels between emergency nurses and palliative care nurses

AIM

Little is known about attitudes toward advance directives and factors associated with them among emergency and palliative care nurses who often or daily face end-of-life circumstances. Thus, we aimed to compare the levels of attitudes toward advance directives, communication skills, knowledge about end-of-life care (knowledge), and awareness of the concept of a good death (good death awareness) between emergency and palliative care nurses, and to examine factors associated with attitudes toward advance directives in the total sample.

METHODS

In this cross-sectional, correlational study, data were collected from 153 nurses (59 emergency and 94 palliative care nurses) at three tertiary hospitals using online or offline surveys and were analyzed using t-tests and multiple linear regression analysis.

RESULTS

The levels of attitudes, communication skills, knowledge, and good death awareness were moderate in both groups. Attitudes in emergency compared to palliative care nurses were less positive (46.78 vs. 48.38; p = .044), and knowledge was significantly lower (13.64 vs. 15.00; p = .004). Communication skills and good death awareness between the two groups were similar. In the total sample, emergency practice (B = -1.59, p = .024), and lower levels of good death awareness (B = 0.30, p < .001), communication skills (B = 0.18, p = .001), and education (B = -2.84, p = .015) were associated with less positive attitudes (F = 9.52, p < .001; R²  = 0.35).

CONCLUSIONS

The findings demonstrate the need for improvements in attitudes, knowledge, communication skills, and good death awareness in both groups, especially emergency nurses. Two modifiable targets of interventions to improve nurses' attitudes were also noted.

How Did the Pandemic Affect Communication in Clinical Settings? A Qualitative Study with Critical and Emergency Care Nurses

The objective of the present study was to determine the subjective impact of the pandemic due to COVID-19 on communication, as perceived by nurses working at emergency services and Intensive Care Units at various hospitals in the Region of Murcia (Spain). A qualitative study was conducted based on the content analysis of 12 semi-structured individual interviews. The participant recruitment process was performed through a snowball sampling technique. Four main dimensions, eleven categories, and two sub-categories were obtained: (1) communication (communicative expressions, both verbal and non-verbal-, and limitations); (2) emotional aspects (positive, negative); (3) overload (first wave, second wave, and third wave); and (4) relationships (health professionals-patients, healthcare professionals, patients-family, and family-health professionals). The main findings of the study show that communication was slightly affected during the pandemic, especially the non-verbal kind, with verbal communication maintained and, in some occasions, strengthened. The lack of training in communication skills and its influence on the management of difficult periods was another important finding. Communication in general deteriorated during the pandemic, especially during the initial waves. Non-verbal communication was more affected due to the use of Personal Protective Equipment and the initial fear of infection, with this finding strongly observed in departments such as emergencies or critical care. The nurses who were interviewed underlined negative emotional aspects associated with a deficit in communication. The positive aspects described were associated with the creation of mutual support spaces and the group cohesion of the work teams during the pandemic. As an implication for current and future clinical practice, we recommend a coordinated institutional response to mitigate the potential emotional effects on workers by designing appropriate communication and emotional expression protocols.

Spanish linguistic validation of the Self-efficacy questionnaire in communication skills

Background Self-efficacy is a critical element of social cognitive theory and refers to a person's estimation of their ability to complete a specific task. Self-efficacy scales evaluate the effectiveness of communication skills training programs. There were not validated scales in Spanish. Aims: to cross-culturally adapt the Self-efficacy questionnaire-12 scale in communication skills in Spanish, evaluate its psychometric properties, and analyse the sample's descriptive characteristics. Design: we conducted an instrumental study to develop evaluation scales. Methods: nursing students were invited to participate (N = 387). The inclusion criteria were: (1) enrolment in first or fourth academic course year; (2) not having received specific training in communication skills; and (3) understanding written and spoken Spanish fluently. A total of 334 undergraduates participated (86.3% response rate); their mean age was 21.9 years (SD = 5.8), 83.2% were female. Results: data showed high internal consistency (0.94) and a good fit to the model. The overall instrument score correlated with the attitude towards communication skills (r = 0.20; p < 0.001). Moderate communication self-efficacy scores were observed in these nursing students. Impact statement: Evaluating communication skills through self-efficacy scales allows teachers to know each student's perceived proficiency to handle communication with users safely and to understand users' needs, giving information about aspects to improve and to establish effective institutional strategies as one of the inherent characteristics of the concept of skills-based evaluation. Conclusions: The Spanish version of the Self-efficacy questionnaire-12 in communication skills was a valid and reliable instrument, essential for evaluating the perceived self-efficacy towards communication in nursing.

Pediatric Ward Nurses' Caring Self-Efficacy Scale: Development and Validation

BACKGROUND

No instrument specifically designed to investigate the caring self-efficacy of nurses in pediatric wards was found. The aim of the present study was therefore to develop a scale to evaluate pediatric wards nurse's caring self-efficacy.

MATERIALS AND METHODS

In this study, an exploratory, sequential, mixed method was used in 2015 in Iran. Data collected from 27 semi-structured interviews with nurses in pediatric wards were analyzed using conventional content analysis. The initial version of the scale was obtained with 65 items. Face validity was determined using impact score and content validity using the Content Validity Index (CVI) and Content Validity Ratio (CVR). The construct validity of the scale was investigated using exploratory factor analysis with 305 nurses in pediatric wards. The concurrent validity of the scale was acquired using the General Self-Efficacy Scale. Internal consistency and test-retest reliability were also examined.

RESULTS

The scale-CVI (S-CVI) (average) was 0.85. The 14 items with a CVR and CVI of less than 0.51 and 0.70, respectively, were deleted and the final 51-item scale was approved. All 51 items had good impact score (>1.50). In the final scale, four subscales were extracted using construct validity. The concurrent validity of the scale was also obtained (r = 0.77, p < 0.001). The total Cronbach's α correlation coefficient of the scale was 0.96 and test-retest reliability was 0.98.

CONCLUSIONS

The Pediatric Ward Nurses' Caring Self-Efficacy (PWNCSE) scale developed in this study is a practical, reliable, and valid scale to evaluate pediatric ward nurses' caring self-efficacy.

Anxiety Effect on Communication Skills in Nursing Supervisors: An Observational Study

Communication represents an essential skill in nurse managers’ performance of everyday activities to ensure a good coordination of the team, since it focuses on the transmission of information in an understandable way. At the same time, anxiety is an emotion that can be caused by demanding and stressful work environments, such as those of nurse managers. The aim of the present study was to analyze the impact of anxiety management on nurse managers’ communication skills. The sample comprised 90 nursing supervisors from hospitals in Madrid, Spain; 77.8% were women, and 22.2% were men, with an average of 10.9 years of experience as nursing supervisors. The instruments used for analysis were the Sixteen Personality Factor Questionnaire: version five (16PF5) and State Trait Anxiety Inventory (STAI) questionnaires, validated for the Spanish population. The results showed that emotional stability was negatively affected by anxiety (r = −0.43; p = 0.001), while apprehension was positively affected (r = 0.382; p = 0.000). Nursing supervisors, as managers, were found to possess a series of personality factors and skills to manage stress and communication situations that prevent them from being influenced by social pressure and the opinion of others.