Journal of Nursing Science Research
Volume 1 Nomor 2 Desember 2024
Hal : 104-114
E-ISSN : 3062-8865
ENHANCING NURSE-PATIENT COMMUNICATION: A COMPREHENSIVE
SYSTEMATIC REVIEW OF EFFECTIVE STRATEGIES
Citra Suraya1 .
Tukimin bin Sansuwito2 .
Regidor i Poblete Dioso3 .
Aris Citra Wisuda4
1,2,3
Faculty of Nursing.
Lincoln University College.
Selangor Darul Ehsan.
Malaysia.
Faculty of Nursing.
Sekolah Tinggi Ilmu Kesehatan Bina Husada.
Palembang.
Indonesia Email: citrasuraya.
edu@gmail.
ABSTRACT
Background: Practical communication skills are imperative in nursing to ensure patient safety and Studies reveal that nurses often fail to implement therapeutic communication fully, resulting in dissatisfaction from beginning to end patient care.
Objective: This study seeks to pinpoint strategies to enhance nurses' communication proficiency with patients.
Method: Employing a systematic review approach, this research delved into journals archived in the EBSCO E.
Journal.
Elsevier Science Direct.
Pubmed.
CINAHL Complete, and Google Scholar databases, alongside nursing management and leadership literature.
The operational definition encapsulates the endeavors undertaken by nurses to refine communication strategies with their patients.
The study was conducted across diverse clinics and hospitals, encompassing all nurses within these settings, with the research sample comprising those lacking robust communication strategies.
Data was gathered through the administration of questionnaires and the utilization of observation sheets.
Results: Findings underscored that training initiatives bolstered nurses' confidence in delivering comprehensive patient care.
Furthermore, culturally sensitive communication skill guides proved instrumental in augmenting nurse-patient communication and patient satisfaction.
Moreover, tailored therapeutic communication programs designed for pediatric nurses yielded favorable outcomes, fostering secure and healthy interactions, nurturing trust, and expediting recovery.
Short workshops emerged as another effective avenue for refining nurses' communication skills.
Consequently, implementing training sessions, comprehensive guides, specialized programs, and brief workshops is pivotal in elevating communication between nurses and patients.
Keywords: Effective Communication.
Nurses.
Patients INTRODUCTION Communication is a dynamic and information exchange.
it is a transactional, symbolic exchange wherein individuals shape their environment by fostering relationships, influencing attitudes, and altering behaviors (Potter and Perry, 2.
Effective communication is paramount in professional nursing as the foundation for building rapport with clients and collaborating with healthcare colleagues to address patient needs and overcome challenges (Berman et al.
, 2.
Through effective communication, nurses can establish trust, provide emotional support, and empower patients to actively participate in their care actively, ultimately Moreover, professionals ensures seamless care coordination and the delivery of holistic treatment approaches, reinforcing its critical role in providing high-quality, patient-centered care (Craven, 2.
Therapeutic communication serves as a vital tool in helping clients navigate and articulate their emotional burdens, thereby alleviating anxiety and fostering a sense of However, communication training becomes essential to employ therapeutic communication Page | 104 Journal of Nursing Science Research Vol.
1 No.
2 Desember 2024 Through structured training programs, nurses can develop and hone their communication skills, enabling them to engage in purposeful and empathetic interactions that promote patient recovery (Yusuf, 2.
Beyond its impact on professionals facilitates collaborative efforts, leading to improved client and (Bello.
Moreover, as emphasized by (Suresh, 2.
, communication is pivotal in elevating the overall quality of nursing Nurses who possess adept communication abilities, as highlighted by (Noviyanti et al.
, 2.
, are adept at building meaningful connections with patients and their families, enhancing the contributing to positive health outcomes.
Around 72% of communication issues within healthcare settings are attributed to errors made by healthcare workers, as highlighted by (Hickey & Giardino, 2.
This statistic underscores a significant communication within healthcare teams.
Notably, studies such as that by (Haugen, 2.
reveal a concerning trend in nurses' interpersonal communication skills, with 80% of respondents indicating subpar Despite this, patient satisfaction levels remain relatively high, surpassing However, as elucidated by (Alzahrani, 2.
, a substantial portion of patients still experience moderate stress levels, suggesting potential gaps in the communication provided by nurses.
Moreover, (Singh et al.
, 2.
shed further light on this issue, with 76.
2% of patients expressing dissatisfaction due to perceived shortcomings in therapeutic communication skills.
These findings underscore the critical importance of addressing communication deficiencies particularly nurses, to enhance patient satisfaction and overall quality of care.
The data highlights a concerning deficiency in nurse therapeutic communication, with 4% of cases showing lapses, notably during the termination stage, where the rate reaches 42.
Additionally, the failure to implement therapeutic communication during the orientation stage correlates significantly with patient dissatisfaction, reaching a rate 9% (Alasad, 2.
These findings underscore the critical need to improve communication practices within healthcare According to the World Health Organization (WHO) cited in (Hamendra, 2.
, a staggering 70-80% of errors in communication and understanding among team members.
Effective teamwork is indispensable in addressing such issues and mitigating patient safety concerns.
These insights emphasize the urgent necessity for healthcare professionals to strategies to enhance patient care outcomes and overall quality of service delivery (Hewison, 2.
Achieving an effective communication process encompasses various factors crucial for successful interaction, as elucidated by (Bakhtiar & Duma, 2.
These factors include sensitivity to the recipient's needs, an understanding of communication, timing ensuring messages are delivered at the most opportune moments, and establishing feedback understanding and clarity.
Moreover, prioritizing face-to-face interaction fosters deeper connections and ensures nuanced Communication is a pivotal catalyst for driving change, as .
, establishing a transparent, concise, and continuous communication system.
Such a system enables effective dissemination of among team members, and enhances organizational responsiveness to evolving needs and challenges.
In essence.
Page | 105 Journal of Nursing Science Research Vol.
1 No.
2 Desember 2024 principles is essential for fostering change, and promoting organizational Based on this background, the Improving Nurse-Patient Communication:
Comprehensive Systematic Review of Effective Strategies is especially important because it consolidates evidence-based strategies to address the nuanced factors of effective Conducting this study through a systematic review allows for a rigorous and comprehensive synthesis of existing research, ensuring that the proposed strategies are robust, applicable, and relevant to diverse healthcare settings.
This research is essential in providing healthcare professionals with a validated framework to enhance nurse-patient interactions, ultimately contributing to improved patient satisfaction, quality of care, and organizational success.
METHOD
This systematic review methodology involved a thorough evaluation of research designs, encompassing a wide range of scientific journals featuring qualitative studies, case studies, and descriptive These studies were based on foundational evidence from primary data.
The inclusion criteria for this review covered all research focused on improving nurse-patient The literature search targeted publications within a specified timeframe and populations consisting of nurses and patients, utilizing databases such as PubMed.
EBSCOhost, and ScienceDirect, which yielded 218, 161, and 283 journals.
Additional searches on Google Scholar.
Wiley, and Garuda were also conducted, filtered by publication dates from 2019 to 2024, resulting in 214, 29, and 116 journals, respectively, using keywords like "effective communication," "improvement efforts," and "patient-nurse Articles meeting the inclusion criteria were evaluated using the Critical Appraisal Skills Programme (CASP) to assess methodological rigor and relevance.
Data extraction involved a thorough reading of research findings to capture essential details, including the study title, author names, publication year, journal publisher, research objectives, methodologies, and critical results.
These details were systematically documented in a structured tabular format to facilitate clear understanding and analysis.
This rigorous, systematic approach ensured that relevant data were accurately captured and organized for subsequent analysis and Page | 106 Journal of Nursing Science Research Vol.
1 No.
2 Desember 2024 Figure.
The inclusion process overview is depicted in the PRISMA Flow Diagram below:
Pubmed Articles identified .
= 1.
Results are filtered .
Included Eligibility Identification Identification ScienceDirect Screening EBSCO Google Scholar Wiley Garuda SecondarySource Exclusion > Last 5 Years .
Not English & Indonesian .
The title and abstract do not match the research question = .
Exclusion There is no full text .
= .
Different study design .
= .
Decent fulltext article .
Duplicate .
Articles Included .
Not in accordance with research results .
Exclusion
RESULTS
Based on the analysis of the article, several efforts were found to improve effective communication among patient nurses, namely:
Training Research conducted by Santosa & Ariyani .
highlights the consistently positive impact of training on nurses' communication skills.
The evaluation results indicate that most participants, comprising 384 out of 401 .
7%),
strongly agreed that communication training enhanced their confidence in engaging with individuals experiencing Furthermore, 366 out of 401 participants .
2%) expressed willingness to converse with and address the emotional needs of patients.
Moreover, 376 out of 401 participants .
7%) strongly agreed that the training would positively influence The questionnaire also revealed high ratings for safety standards during training sessions, with 92% of participants rating them as very good.
Additionally, 94% of participants strongly affirmed that the training bolstered their confidence in providing intensive patient care, and a similar percentage expressed readiness to engage with individuals facing emotional Overall, underscore the substantial impact of communication training on nurses' abilities and attitudes, suggesting significant improvements in patient care and nursing In a study conducted by Murdiany .
, 325 United States cancer center nurses participated in a Communication Skills Training (CST) module to enhance empathetic responses to patients.
Pre- and post-training standardized patient assessments (SPA) revealed notable improvements in various Page | 107 aspects.
Results indicated high satisfaction among nurses with the module, with agreement or strong agreement reported for 5%-99.
75% of satisfaction items.
Moreover, nurses exhibited a significant increase in self-efficacy in responding empathetically post-training, alongside demonstrated improvements in empathy skills as assessed by SPA.
Furthermore, a substantial proportion of nurses .
reported feeling confident in applying the acquired skills post-training, with a notable increase in the utilization of specific empathic skills observed .
64%).
Overall, the study findings underscore the feasibility, acceptability, and effectiveness of the CST module in enhancing nursepatient communication and fostering patient-centered care.
Highlights the potential of targeted interventions, such as CST communication challenges and promote empathetic interactions within healthcare A Guide to Culturally Sensitive Communication Skills In the (Aronowitz et al.
, 2.
study, an equal number of male and female nurses were inadvertently included in both groups, inadvertently balancing the gender The intervention group communication skills, as evidenced by a pvalue of 0.
00 and an alpha of 0.
%).
These results were delineated across various phases outlined in communication In the "Ready" phase, nurses emphasizing awareness of Southeast Asian cultural values, such as gender-specific norms, to enhance client comfort and understanding of the client's family intentions in clinical decision-making.
Secondly, during the "Greeting" phase, nurses focused on building trust and demonstrating respect within the Southeast Asian cultural context, where clients may be hesitant to express concerns directly, relying instead on subtle non-verbal cues.
The "Invite" phase encouraged nurses to explore clients' feelings and physical complaints while acknowledging that affirmative responses may not always reflect actual agreement within the cultural Lastly, in the "Discuss" phase, nurses completed tasks while respecting client expectations and promoting two-way communication, especially in the context of complementary alternative medicine (CAM), prevalent in Southeast Asian It was emphasized that CAM overshadow modern medicine, with nurses remaining aware of the influence of the client's family in clinical decision-making, ensuring that client autonomy is respected.
The simulation results revealed distinct differences between the untrained and intervention groups.
In the untrained group, eight red bands indicated very dissatisfied responses, five yellow bands denoted dissatisfaction, four green bands represented satisfaction, and three blue bands indicated delighted responses.
Conversely, the intervention group outcomes, with 14 green and six blue bands signifying satisfaction and delighted responses, respectively.
These findings underscore the efficacy of the research intervention, which focused on enhancing nurse communication skills with clients.
Notably, the intervention improved nurses' communication proficiency, personal satisfaction, and self-confidence posttraining.
Overall, the intervention group, which received culturally sensitive communication skills training, attained higher scores than the control group, highlighting the significance of tailored training programs in enhancing nurseclient interactions and overall satisfaction.
Page | 108 C.
Planned Therapeutic Communication Program The research conducted by (Ryrtveit et al.
, 2.
revealed a statistically significant positive correlation between nurses' total knowledge scores and total practice scores concerning therapeutic communication skills at each measurement time, both pre-and post-training .
re: r = 54, p <.
post: r = 0.
56, p < .
Additionally, a substantial increase in pediatric nurses' knowledge, practice, and skills related to therapeutic communication was observed .
The study concluded that implementing a planned significantly enhanced pediatric nurses' knowledge and skills in communicating with hospitalized pediatric patients.
Introducing communication programs tailored for pediatric nurses aims to foster safe and healthy interactions, cultivate trust, and enhance the recovery process for hospitalized children, ultimately yielding therapeutic benefits for the patients under their care.
Mini Workshops (Al-Hussami, 2.
research in 2017 communication training for new nurses through a mini workshop.
The study aimed to assess the workshop's effectiveness in communication skills.
The results indicated a notable improvement in nurses' communication abilities post-training, with 36 out of 50 respondents .
%) demonstrating proficiency in therapeutic Conversely, respondents .
%) exhibited inadequate therapeutic communication skills.
These findings underscore the positive impact of workshops in equipping new nurses with the necessary skills to communicate with patients effectively.
By improving nurses' experiences and overall healthcare DISCUSSION
Training The SAGE
THYME
communication training models have proven highly effective, providing invaluable guidance and training to nurses in patient-centered care.
These models emphasize the importance of respecting patients and addressing their concerns and Through the implementation of the SAGE & THYME communication model training, nurses have gained confidence in experiencing depression, anxiety, and various other challenges.
This training enhances nurses' basic communication skills and aids in end-of-life discussions and life care planning for patients.
The quality of the training is consistently evaluated, and positive feedback from nurses has been garnered, indicating its communication skills.
By fostering better communication between nurses and patients, particularly in therapeutic contexts, these models play a crucial role psychological well-being and facilitating Research conducted by (Murdiany, 2.
showcased the success of implementing a communication skills training program for nurses at a prominent cancer center.
The program received favorable evaluations from most nurse participants (>85%) across various modules, indicating strong support for its Notable improvements were self-efficacy concerning communication with patients in diverse contexts, alongside significant enhancements in empathy and clarification Particularly noteworthy were the Page | 109 communication skills as evidenced by standardized patient assessments (SPA) conducted before training.
A logical progression of this research would involve extending the communication skills training to outpatient oncology nurses and comparing their skill utilization.
The study revealed that empathy skills were underscoring the significance of such communication between nurses and patients/families within oncology settings.
Highlights the potential of communication skills training programs for oncology nurses and other healthcare providers in fostering effective communication and patient-centered care.
Previous research unequivocally demonstrates the myriad benefits of effective communication in healthcare settings, spanning improved patient recovery rates, enhanced pain control, greater adherence to treatment regimens, enhanced psychological functioning, and overall quality of life.
Conversely, ineffective communication can harm nurses, leading to heightened stress levels, diminished job satisfaction, and emotional Recognizing the pivotal role of communication in nursing practice, providing communication skills training emerges as a valuable investment for Such training equips nurses with essential skills and fosters their enthusiasm to fulfill their duties and responsibilities By prioritizing communication skills development, hospitals can enhance patient care outcomes and the well-being of their nursing staff.
A Guide to Culturally Sensitive Communication Skills Research conducted by (Aronowitz et al.
, 2.
underscores the efficacy of training programs utilizing culturally sensitive communication skills guides in enhancing nurses' communication skills and subsequently improving client Nurses who underwent training based on these guidelines demonstrated greater sensitivity and proficiency in communication with clients than their untrained counterparts, as assessed through objective structured clinical examinations (OSCE) involving observers and simulated clients.
The formation and introduction, followed by interactive sessions involving drama/roleplay scenarios simulating primary care clinic and home settings.
Feedback and reflection sessions encouraged participants to reflect on and apply communication skills within socio-cultural contexts, information about nurse-client guidelines provided in interactive lectures.
Posttraining role-play exercises aimed to consolidate learned skills, with a follow-up period of 4 days allowing for learning This approach ensured that training effects extended beyond shortterm memory, as emotional responses elicited during training sessions with simulated patients facilitated long-term Such enhance nurses' communication abilities and contribute to sustained improvements in client care practices.
In the context of the ideal objective and structured clinical examination (OSCE), typically comprising 6 to 12 stages, our study opted for a 7-stage OSCE The selection of seven stages was deliberate, considering factors such as the number of observers involved, the availability of trained simulation clients.
Observers, consisting of seven clinical instructors, rated the nurses without knowledge of their training status.
These observers had extensive experience conducting OSCEs spanning over three years at the research institution, ensuring familiarity with OSCE methodologies.
Before the OSCE sessions, the study Page | 110 authors conducted a 2-hour briefing for observers, equipping them with a checklist adapted from the Gadjah Mada nurses' Additionally, researchers meticulously prepared patient simulations for the seven scenarios designed to elicit "culturally sensitive communication skills" from the Each simulation patient was assigned colored bands indicative of their satisfaction level with the nurse's communication at each stage of the OSCE, ranging from red .
ery dissatisfie.
to blue .
ery satisfie.
Both intervention and control group nurses underwent assessment across all OSCE stages, interacting with all Informal discussions between nurses from the intervention and control groups were strictly prohibited before assessment time to prevent any potential Significant between the intervention and control groups were observed across all communication sessions.
The robustness of this study lies in the culturally sensitive communication skills plans and guidelines employed, which offer nuanced insights into addressing cultural aspects related to health issues.
These guidelines are adept at sensitively addressing cultural nuances within the context, particularly concerning potential unresolved health problems linked to non-personnel communication styles, effectively demonstrated during role-play exercises.
Grounded feedback sessions, nurses have the opportunity to recognize the imperative for culturally sensitive communication skills among healthcare providers, particularly Communication skills training, such as the one implemented in this study, which emphasizes cultural communication proficiency, holds significant potential for enhancing nursing care, especially for racial, ethnic, and minority populations, as communication serves as the conduit for transmitting and upholding culture.
Nurses who underwent training based on the Gadjah Mada nurse communication skills guidelines exhibited superior performance and demonstrated heightened cultural sensitivity in their communication with clients compared to their untrained counterparts, as evaluated by observers and simulated clients in an objective structured (OSCE).
incorporating nurse communication skills guidelines into nurses' preparation for caring for Southeast Asian patients, potentially enhancing client satisfaction and overall quality of care.
Planned Therapeutic Communication Program (Ryrtveit et al.
, 2.
Research highlights a notable increase in pediatric nurses' knowledge and skills concerning hospitalized children after participating in a structured therapeutic communication The study employed two Therapeutic Communication Structured Questionnaire and a Likert Scale Structured Performance Checklist.
The former consisted of a sociodemographic nurses' background information and a knowledge questionnaire comprising eight questions assessing their understanding of therapeutic communication skills.
The latter, the Likert scale checklist, aimed to evaluate nurses' practical improvement in observation, encompassing 42 items divided into three categories: nurses' communication skills, their communication skills during hospital admission, and their communication skills during nursing care The scoring system employed a 5-point Likert scale, ranging from "Always" to "Never".
The study advocates for the continued implementation of advanced therapeutic communication programs tailored for pediatric nurses to enhance safe and healthy interactions.
Page | 111 foster trust, and expedite the recovery of hospitalized children.
Moreover, the research suggests that repeated testing, specifically test-retest reliability analysis, underscores the positive impact of communication training on nursing skills acquisition, ultimately leading to improved patient outcomes.
It aligns with other studies focusing on developing and evaluating communication skills training programs for cancer nurses, affirming the efficacy of such programs in enhancing nurses' communication abilities in patient care contexts.
Consequently, well-designed communication skills training programs prove instrumental in enhancing pediatric nurses' communication skills, reinforcing fundamental communication practices, facilitating the acquisition of new communication skills, and ensuring heightened patient satisfaction through improved communication practices.
Mini Workshops Research conducted by (Al-Hussami, 2.
focused on a mini workshop facilitated by the Head of the Department, aimed at guiding nurses on therapeutic communication strategies from the preinteraction phase to the termination phase.
Participants implementing action plans designed to enhance their communication skills after the workshop.
Subsequently, the researcher proficiency, rating their performance as satisfactory or unsatisfactory.
After implementation, nurses were interviewed to identify any obstacles or challenges during therapeutic communication.
Many nurses faced difficulties during the orientation phase, mainly when introducing themselves, while others struggled to The researcher delved deeper into these challenges, aiming to provide assistance and support where needed.
These findings underscore the hospital's commitment to delivering quality nursing services, exceeding patient expectations, and fostering trust in the facility.
Effective communication is crucial in nursing practice, potent for influencing human behavior and fostering trust and comfort in client interactions.
As primary healthcare providers, nurses play a vital role in patients' psychological well-being and overall satisfaction.
Possessing therapeutic communication skills facilitates trustbuilding with clients, mitigates legal issues, enhances professional satisfaction, and bolsters the profession's and hospital's Interpersonal training encompasses a series of programs designed to enhance nurses' interpersonal communication skills, focusing on fostering positive attitudes, behaviors, and knowledge related to communication.
Given the pivotal role of interpersonal communication in nursing practice, these training initiatives aim to bolster nurses' abilities in this area, recognizing its significance in shaping attitudes and improving service quality.
Effective communication forms the bedrock of nursing care, facilitating meaningful connections between nurses and patients and ultimately influencing the overall Competencies such as interpersonal non-verbal communication, professionalism, and counseling are essential for nurses when interacting with patients.
Through mini workshops and similar initiatives, nurses can receive guidance on fulfilling their duties and responsibilities while delivering communication, thereby contributing to the patient's recovery process and ensuring satisfaction with nursing services.
Page | 112
CONCLUSION AND SUGGESTIONS
The quality of communication among professional nurses is strongly linked to patient satisfaction, underscoring the importance of nurses possessing strategies, and skills.
This research underscores the necessity for nurses to acquire these competencies through formal professional channels, as they significantly impact the satisfaction levels of the patients under their care.
An evidencebased literature review highlights various avenues for enhancing nurse-patient communication, including communication training initiatives, developing culturally sensitive communication guides, planned therapeutic communication programs, and participating in mini-workshops.
These efforts are crucial for equipping nurses with the necessary tools to engage effectively with patients, fostering positive patient experiences and outcomes.
The findings of this research hold promise for informing policymakers in government settings, hospital leaders, and nursing education institutions about the importance communication strategies.
These strategies can be enhanced through various training initiatives, creating culturally sensitive therapeutic communication programs, and mini-workshops.
The anticipated outcomes of this research extend to providing valuable insights for future studies aimed at improving effective nurse-patient leadership management services in nursing, particularly in Indonesia.
These insights can serve as a reference point for further exploration and development of communication practices within healthcare settings, ultimately contributing to enhanced patient care and satisfaction.
ACKNOWLEDGEMENTS
Thank you to my supervisor and all those who have supported the researcher in writing this research.
CONFLICT OF INTEREST
The author declares no conflict of interest.
REFERENCES