Health Care Communication Health care communication is fundamental to nursing practice, establishing the groundwork for relationships with patients, families, and health care colleagues. Effective communication is essential not only for teaching and caring but also for ensuring patient safety and improving health outcomes. According to Caris Verhallen, Kerkstra, and Bensing (1997), verbal communication encompasses all behaviors that convey messages using language, while nonverbal communication includes behaviors that impart information without verbal language, such as body language, appearance, timing, tone of voice, personal space, and touch (Oliver & Redfern, 1991).
Despite its importance, sustained research programs focused on health care communication are limited. A review by S. Brown (1999) found that only 15 nursing journal references were cited out of 69 total references in a review of patient-centered communication, highlighting the need for further investigation into nursing communication practices.
Communication Expertise
The development of communication expertise among nurses is crucial for effective patient interactions. Research has examined how nurses enhance their communication skills through clinical practice and educational interventions. For instance, Kotechi (2002) conducted a grounded theory study of baccalaureate nursing students, revealing a four-stage process that students went through to develop their “personal communication repertoire.”
- Affirming the Self: This initial stage involves self-talk to boost confidence and evaluate one’s communication skills.
- Engaging the Patient: Students learn to establish boundaries and build rapport with patients. They utilize various types of conversation, including social talk, professional talk, and personal talk.
- Experiencing Communication Breakdowns: Students encounter challenges when interacting with difficult patients, prompting them to adapt their strategies based on observations of experienced nurses.
- Refining the Repertoire: With experience, students become more adept at selecting effective communication strategies, allowing them to navigate complex patient interactions with greater confidence.
This progression underscores the importance of both experience and education in developing communication skills in nursing.
Communication as a Research Concern
Research in nursing communication primarily focuses on describing how nurses interact with patients across various clinical settings. Many studies differentiate between affective communication (providing emotional support) and instrumental communication (performing necessary tasks). For example, Caris Verhallen et al. (1997) investigated communication patterns between nurses and older adults in community and extended care settings, finding that a significant portion of communication (44% to 72%) was socioemotional. This suggests that relational aspects of communication are vital, especially in long-term care contexts where established relationships facilitate interaction.
Conversely, an experimental study found that nurses admitted simulated cancer patients with a predominantly instrumental focus (62% of verbal communication) and limited encouragement for patient input (Kruijver et al., 2001). This discrepancy raises questions about the impact of simulated conditions on nursing communication.
Difference to Verbal Communication
The distinction between verbal and nonverbal communication is crucial in nursing practice. Verbal communication encompasses spoken and written language, while nonverbal communication includes body language, facial expressions, and other cues that can significantly impact patient interactions. For instance, research shows that home care nurses initiate conversations about compliance with medical regimens approximately 60% of the time (Vivian & Wilcox, 2000), indicating a predominance of instrumental communication. Understanding the balance between these forms of communication is essential for effective nursing care.
Context of Communication
The context in which communication occurs plays a significant role in its effectiveness. However, this aspect has not been extensively examined in nursing research. Caris Verhallen et al. (1998) found that while nurses initiated health topics with parents during well-child visits, they also invited questions, reflecting a more collaborative communication style. This contrasts with findings from Kruijver et al. (2001), emphasizing the need for further investigation into how context influences communication dynamics.
Use of Communication
The therapeutic use of communication is another essential area of nursing research. It shifts the focus to the interaction between nurses and patients. For example, in cancer care, nurses and patients often encourage optimism by highlighting positive aspects of their situation, ultimately leading to more constructive interactions (Jarrett & Payne, 2000). Listening skills are critical in this process, as they allow nurses to understand patients’ experiences and support them in finding their own interpretations of their health conditions (Fredriksson, 1999).
Nursing research has also explored how to support patients in communicating effectively. This focus has shifted from simply testing communication tools to understanding the broader implications of effective communication strategies. For instance, augmentative and alternative communication (AAC) devices, which assist individuals with speech impairments, have been studied to uncover their impact on patients’ sense of humanness and emotional expression (Dickerson et al., 2002).
Nursing Communication and Research
Nursing communication is an evolving field that requires ongoing research to enhance patient-provider interactions. Supporting patients in effective communication has garnered renewed attention, particularly regarding the use of AAC devices and their role in improving health outcomes. Studies have indicated that training older adults in pain communication skills can lead to better pain management after surgery (McDonald & Molony, in press).
These findings highlight the need for a more nuanced understanding of communication strategies and their impact on patient care. Future research should focus on identifying specific strategies that promote effective communication and contribute to positive patient outcomes.
Health Communication
The body of research on health communication within nursing remains diverse and somewhat fragmented. While some studies have provided detailed analyses of communication segments, they often fail to capture the broader context or motivations behind these interactions. Naturalistic studies, like those conducted by Jarrett and Payne (2000) and Kotechi (2002), offer valuable insights but underscore the need for comprehensive investigations that explore communication dynamics in real-world settings.
Moving Forward
To advance the field of nursing communication, it is essential to focus on the contributions of patients in communication processes. Research should aim to empower patients to communicate effectively with healthcare providers, ultimately enhancing self-care and overall health outcomes. Additionally, identifying ways to improve patient communication within the constraints of existing healthcare systems will be critical.
Conclusion
Effective health communication is integral to nursing practice, serving as the foundation for patient relationships and the delivery of quality care. Despite the challenges in studying and defining communication in nursing, significant progress has been made in understanding the complexities of patient-provider interactions. As the field continues to evolve, ongoing research will be essential in developing effective communication strategies that improve patient outcomes and enhance the overall quality of care.
By prioritizing communication as a critical component of nursing practice, healthcare professionals can better meet the needs of patients and foster a more supportive and collaborative healthcare environment.mini