McGilton Katherine, Irwin-Robinson Heather, Boscart Veronique, Spanjevic Lily
Department of Research, Toronto Rehabilitation Institute, Toronto, Ontario, Canada.
J Adv Nurs. 2006 Apr;54(1):35-44. doi: 10.1111/j.1365-2648.2006.03787.x.
This paper presents an evaluation of a communication enhancement intervention on staff and patients in a complex continuing care facility.
The importance of effective communication as a fundamental element of nursing has been emphasized and is regarded as integral to the provision of quality patient care. For people residing in complex continuing care (similar to long-term care facilities), opportunities for socialization occur primarily during interactions or communication with staff, and these interactions have been found to be limited. One way to improve nursing staff communication is through a communication enhancement intervention.
Twenty-one nursing staff members (Registered Nurses, Registered Practical Nurses and healthcare aides) working in a complex continuing care environment and 16 patients participated in this study, conducted in the summer of 2003. A repeated measures design was used to evaluate the effects of the communication enhancement intervention on outcomes. Data were collected from patients and nurses at baseline, 5 weeks into the intervention and at 10 weeks after the intervention. Nurse outcome variables included nurses' job satisfaction and their relationships with patients; patient outcome variables included two measures of patient satisfaction with care.
Nursing staff felt closer to their patients (F(2,40) = 3.0, P = 0.045) following the intervention and reported higher levels of job satisfaction (F(2,40) = 4.1, P = 0.02). No changes were found in the level of patient satisfaction with care.
Our results suggest that nursing staff can feel better about their job and about their patients as they enhance their communication skills. Understanding the barriers to finding time to talk with patients for a few minutes a day, outside of direct hands-on caregiving, requires further exploration.
本文介绍了一项针对一家复杂的持续护理机构中工作人员和患者的沟通强化干预措施的评估。
有效沟通作为护理的基本要素的重要性已得到强调，并被视为提供优质患者护理不可或缺的一部分。对于居住在复杂持续护理机构（类似于长期护理机构）的人来说，社交机会主要出现在与工作人员的互动或交流过程中，而这些互动被发现是有限的。改善护理人员沟通的一种方法是通过沟通强化干预。
2003年夏天，在一个复杂的持续护理环境中工作的21名护理人员（注册护士、注册实用护士和医疗护理员）以及16名患者参与了这项研究。采用重复测量设计来评估沟通强化干预对结果的影响。在基线、干预进行5周时以及干预后10周从患者和护士那里收集数据。护士的结果变量包括护士的工作满意度及其与患者的关系；患者的结果变量包括两项患者对护理满意度的测量指标。
干预后，护理人员感觉与患者的关系更亲密了（F(2,40) = 3.0，P = 0.045），并且报告的工作满意度更高（F(2,40) = 4.1，P = 0.02）。患者对护理的满意度水平没有变化。
我们的结果表明，护理人员在提高沟通技巧时，对自己的工作和患者会有更好的感受。在直接的实际护理之外，每天抽出时间与患者交谈几分钟的障碍需要进一步探索。
