Pytel Constance, Fielden Nina M, Meyer Kate H, Albert Nancy
Emergency Institute, Cleveland Clinic, OH, USA.
J Emerg Nurs. 2009 Sep;35(5):406-11. doi: 10.1016/j.jen.2008.09.002. Epub 2008 Nov 17.
Patients and visitors need to be encouraged to express their needs and be provided with enough relevant information so that treatment and recovery from illness are optimized. In the emergency department, it is important for nurses to create an environment of trust, respect, and acceptance. Using a survey design, a convenience sample of nurses and patients/visitors described patient/visitor communication needs and determined if needs were met during the ED encounter. Data were analyzed using descriptive statistics. Mantel Haenszel chi(2) tests were used to determine associations between patient-rated importance of nurse communication needs and nursing communication performance. Sixty-four nurses and 123 patients/visitors completed a communication needs survey. More than 80% of patients answered "excellent" or "very good" to 6 of the top 10 important communication needs. Patient and nurse importance differed significantly on only 2 communication needs: calm voice and social status (nurses rated these needs of higher importance than patients; P = .01, P = .006). Patient-ranked importance was positively associated with patient opinion of how well needs were met in 6 of 19 patient/visitor communication needs; that is, not making assumptions about social status (P = .0006), offering reassurance to calm fears (P = .004), and teaching about primary medical concerns/conditions (P = .01). Nurse and patient/visitor perceptions of important communication are similar. Educating nurses about patient/visitor communication needs is the first step in enhancing how well nurses meet those needs.
需要鼓励患者和访客表达他们的需求,并为他们提供足够的相关信息,以便优化疾病的治疗和康复。在急诊科,护士营造一个信任、尊重和接纳的环境非常重要。采用调查设计,选取护士以及患者/访客的便利样本,描述患者/访客的沟通需求,并确定在急诊科就诊期间这些需求是否得到满足。使用描述性统计分析数据。采用Mantel Haenszel卡方检验来确定患者对护士沟通需求重要性的评分与护理沟通表现之间的关联。64名护士和123名患者/访客完成了沟通需求调查。超过80%的患者对前10项重要沟通需求中的6项给出了“优秀”或“非常好”的评价。患者和护士认为的重要性仅在2项沟通需求上存在显著差异:平静的声音和社会地位(护士认为这些需求比患者认为的更重要;P = 0.01,P = 0.006)。在19项患者/访客沟通需求中的6项中,患者排名的重要性与患者对需求满足程度的看法呈正相关;也就是说,不假设社会地位(P = 0.0006)、给予安慰以缓解恐惧(P = 0.004)以及讲解主要医疗问题/病症(P = 0.01)。护士与患者/访客对重要沟通的认知相似。对护士进行患者/访客沟通需求的教育是提高护士满足这些需求能力的第一步。