Author Affiliation: University of Michigan School of Nursing, Ann Arbor.
Cancer Nurs. 2022;45(2):E338-E344. doi: 10.1097/NCC.0000000000000959.
Effective communication between physicians and nurses is crucial to the safety of patients, especially for those with cancer, which is a complex disease requiring multidisciplinary treatment. However, little is known about the factors that contribute to effective communication, which is defined as the development of shared understanding between two or more people.
This qualitative secondary analysis was conducted to identify factors that contribute to shared understanding between physicians and nurses from video-recorded conversations that occurred between them during inpatient rounds on oncology units.
We used inductive grounded theory to identify videos depicting moments of shared understanding. We then searched for preceding events to develop a preliminary conceptual model that described the factors contributing to shared understanding.
Four factors emerged as contributors to shared understanding: engagement, clarification, confirmation, and resolution. These factors occurred in sequence with engagement occurring first and resolution occurring last, as the closure of a communication exchange.
Existing interventions to improve communication include some of the factors identified as contributing to shared understanding (eg, closed-loop communications require clarification and confirmation). However, nurses may need to pay attention to all four factors to develop shared understanding that will promote effective communication with physicians and thereby enhance cancer care.
Nurses achieve effective communication when they are assertive and avoid indirect communication. A greater awareness of body language and positioning in relation to a physician at the start of a communication exchange may increase the effectiveness of nurse-physician communication.
医生和护士之间的有效沟通对于患者的安全至关重要，尤其是对于那些患有癌症的患者，因为癌症是一种需要多学科治疗的复杂疾病。然而，对于促成有效沟通的因素知之甚少，有效沟通被定义为两个人或更多人之间达成共识。
本定性二次分析旨在从肿瘤病房住院查房期间记录的医生和护士的视频对话中确定促成医生和护士之间达成共识的因素。
我们使用归纳扎根理论来识别描述达成共识时刻的视频。然后，我们寻找前置事件来开发一个初步的概念模型，描述促成共识的因素。
有四个因素被确定为促成共识的因素：参与、澄清、确认和解决。这些因素依次发生，参与首先发生，解决最后发生，作为沟通交流的结束。
现有的改善沟通的干预措施包括一些被认为有助于达成共识的因素（例如，闭环沟通需要澄清和确认）。然而，护士可能需要关注所有四个因素，以达成共识，促进与医生的有效沟通，从而提高癌症护理质量。
当护士表现出自信并避免间接沟通时，他们就能实现有效的沟通。在沟通交流开始时，更加关注与医生相关的身体语言和位置，可能会提高护士与医生之间沟通的有效性。
