The development and evaluation of a communication skills training program for registered nurses in cancer care in Beijing, China

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The development and evaluation of a communication skills training program for registered nurses in cancer care in Beijing, China


Author: Liu, Jun-E
Title: The development and evaluation of a communication skills training program for registered nurses in cancer care in Beijing, China
Degree: Ph.D.
Year: 2005
Subject: Hong Kong Polytechnic University -- Dissertations
Communication in nursing -- China
Nurse and patient -- China
Nursing -- Social aspects -- China
Department: School of Nursing
Pages: xv, 359 leaves : ill. ; 30 cm
Language: English
InnoPac Record:
Abstract: Background. Studies have shown that deficiencies in communication between health professionals and cancer patients have a direct effect on the psychosocial well-being of patients, as well as the psychological stress of health professionals. The results of training workshops developed to address the deficiencies in nurses' communication with patients have been identified with only limited success. Aims. The purposes of this study are to explore effective nurse-patient communication skills in cancer care in the context of Chinese culture, then integrate these findings and those from international literature into the development and evaluation of a communication skills training program for nurses in China. Methods. The research design is a two-phase study, which employed qualitative and quantitative approaches, respectively. Phase one involves exploration of effective communication skills from the perspectives of cancer patients and experienced nurses. Data collection was conduced with 27 experienced nurses and 20 cancer patients using semi-structured interview guides in two oncology special hospitals and two general hospitals in Beijing, China in 2002. Phase two is a quasi-experimental research design to implement the communication skills training for 129 nurses who were working in 5-pair matched wards in a specialist oncology hospital. The matched wards were randomly allocated into either training or control group. Measures including nurses' basic communication skills, self-efficacy in oncology specified communication skills, communication outcome expectancies, and self-perceived support for communication, as well as patient satisfaction with nurses' communication skills, were administered at pre-training evaluation, formative evaluation (one month after training) and summative evaluation (six months after training). Findings of the qualitative study. The findings show that cancer patients have a substantial need for informational and emotional support during their hospitalization. They employ active information seeking behavior to communicate with health professionals and fellow patients, but they mainly ventilated their emotional needs with their close family members. However, they appreciate nurses who showed empathy and caring attitudes. Furthermore, cancer patients are sensitive to the nonverbal expressions of nurses during nursing actions. Nurses prefer to use indirect questioning techniques to elicit patients' psychological concerns, especially under the context of a nurse-patient trusting relationship. Nurses use various communication skills to deal with patients with different psychological reactions. Nurses also express considerable needs for communication skills training. Based on the qualitative findings, an effective nurse-patient communication model was formulated, and a communication skills training program was developed, which integrated communication knowledge, attitudes, skills, and managerial support. Findings of the quantitative study. The communication skills training program was implemented with a systematic multi-dimensional evaluation. The formative evaluation shows that the training significantly improves nurses' overall basic communication skills (u=-2.049, p=.040), whereas no significant difference is found for the overall self-efficacy (u=-1.917, p=.055), outcome expectancy (u=-.172, p=.863), and perceived support (u=-1.920, p=.055), but their mean scores shows positive improvement compared with pre-training. The summative evaluation shows that there is significant improvement in the mean scores of all overall nurses' basic communication skills (u=-2.981, p=.003), self-efficacy (u=-4.429, p=.000) in oncology specific communication tasks, communication outcome expectancy (u=-2.370, p=.018), and perceived support (u=-5.752, p=.000), as well as patient satisfaction toward nurses' communication skills (u=-2.566, p=.010) compared with pre-training in the training group. In contrast, no significant improvement is found on all nurses' outcome variables and patient satisfaction in the control group over the same period. Conclusions: The developed communication skills training program is effective in improving nurses' communication skills in cancer care. The positive findings provide evidence and direction for future communication skills training programs in China.

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