Nurse-patient communication strategies: A proposal of an educational video for Nursing students

Pereira, Jéssica França; Silva, Natália Chantal Magalhães da; Sampaio, Rodrigo Soares; Ribeiro, Vanessa dos Santos; Carvalho, Emília Campos de

doi:10.1590/1518-8345.6177.3858

Jéssica França Pereira

Study concept and design

Obtaining data

Data analysis and interpretation

Statistical analysis

Drafting the manuscript

Universidade Federal do Estado do Rio de Janeiro, Escola de Enfermagem Alfredo Pinto, Rio de Janeiro, RJ, Brazil.

https://orcid.org/0000-0002-3889-5378

Natália Chantal Magalhães da Silva

Study concept and design

Obtaining data

Statistical analysis

Drafting the manuscript

Critical review of the manuscript as to its relevant intellectual content

Universidade Federal do Estado do Rio de Janeiro, Escola de Enfermagem Alfredo Pinto, Rio de Janeiro, RJ, Brazil.

https://orcid.org/0000-0003-1883-4313

Rodrigo Soares Sampaio

Study concept and design

Data analysis and interpretation

Drafting the manuscript

Critical review of the manuscript as to its relevant intellectual content

Universidade Federal do Estado do Rio de Janeiro, Escola de Enfermagem Alfredo Pinto, Rio de Janeiro, RJ, Brazil.

Universidade do Estado do Rio de Janeiro, Hospital Universitário Pedro Ernesto, Rio de Janeiro, RJ, Brazil.

https://orcid.org/0000-0001-7171-5888

Vanessa dos Santos Ribeiro

Study concept and design

Data analysis and interpretation

Drafting the manuscript

Critical review of the manuscript as to its relevant intellectual content

Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador de la OPS/OMS para el Desarrollo de la Investigación en Enfermería, Ribeirão Preto, SP, Brazil.

Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil.

https://orcid.org/0000-0002-0686-4307

Emília Campos de Carvalho

Study concept and design

Data analysis and interpretation

Drafting the manuscript

Critical review of the manuscript as to its relevant intellectual content

Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador de la OPS/OMS para el Desarrollo de la Investigación en Enfermería, Ribeirão Preto, SP, Brazil.

https://orcid.org/0000-0003-0738-0539

Corresponding author:
Jéssica França Pereira E-mail: jessica.france.p@gmail.com https://orcid.org/0000-0002-3889-5378

Conflict of interest:

the authors have declared that there is no conflict of interest.

Associate Editor:

Sueli Aparecida Frari Galera

Nurse-patient communication strategies

General communication aspects(²⁸28. Milic MM, Puntillo K, Turner K, Joseph D, Peters N, Ryan R, et al. Communicating with patients’ families and physicians about prognosis and goals of care. Am J Crit Care [Internet]. 2015;24(4):e56-e64. Available from: https://doi.org/10.4037/ajcc2015855
https://doi.org/10.4037/ajcc2015855... ,³²32. Hermann RM, Long E, Trotta RL. Improving patients’ experiences communicating with nurses and providers in the emergency department. J Emerg Nurs [Internet]. 2019 [cited 2022 Mar 16];45(5):523-30. Available from: https://bit.ly/3JyHCsR
https://bit.ly/3JyHCsR...

33. Alves KYA, Bezerril MS, Salvador PTCO, Feijão AR, Santos VEP. Effective communication in nursing in the light of Jürgen Habermas. REME Rev Min Enferm [Internet]. 2018 [cited 2022 Mar 16];22:e-1147. Available from: https://bit.ly/3ibHt2e
https://bit.ly/3ibHt2e...

34. Borges JWP, Moreira TMM, Silva DB, Loureiro AMO, Menezes AVB. Adult nursing-patient relationship: integrative review oriented by the king interpersonal system. Rev Enferm UFPE Online [Internet]. 2017 [cited 2022 Mar 16];11(4):1769-78. Available from: https://bit.ly/3ibAUNl
https://bit.ly/3ibAUNl...

35. Moreira MDS, Gaíva MAM. Communication of the nurse with the mother/family in the nursing appointment to the child. Ciênc Cuid Saúde [Internet]. 2016 [cited 2022 Mar 16];15(4):677-84. Available from: https://bit.ly/3tgRXDS
https://bit.ly/3tgRXDS...

36. Söderlund M, Cronqvist A, Norberg A, Ternestedt BM, Hansebo G. Conversations between persons with dementia disease living in nursing homes and nurses – qualitative evaluation of an intervention with the validation method. Scand J Caring Sci [Internet]. 2016 [cited 2022 Mar 16];30(1):37-47. Available from: https://bit.ly/3IikNIb
https://bit.ly/3IikNIb... -³⁷37. Pulkkinen M, Junttila K, Lindwall L. The perioperative dialogue – a model of caring for the patient undergoing a hip or a knee replacement surgery under spinal anaesthesia. Scand J Caring Sci [Internet]. 2016 [cited 2022 Mar 16];30(1):145-53. Available from: https://bit.ly/3q8uJ0U
https://bit.ly/3q8uJ0U... ):

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Search for visual contact and entire focus on the patient;
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Clarity and objectivity;
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Adaptable to the receiver’s knowledge level and to their needs;
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Appreciation of doubts and respect towards the receiver, showing interest and free from judgments;
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Guaranteeing a space for the receiver to speak, without interruptions;
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Provision of explicit instructions, keeping the patient informed and repeating what was said;
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Use of techniques aimed at improving efficiency of the communication process, such as: open questions, reflection statements, and hope and concern statements.

Intercultural Communication(²⁷27. Yakar HK, Alpar SE. Intercultural communication competence of nurses providing care for patients from different cultures. Int J Caring Sci [Internet]. 2018;11(3):1743- 55. Available from: https://bit.ly/3IggIV6
https://bit.ly/3IggIV6... ):

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Collection of the maximum information possible about individuals with different cultural characteristics and understanding the essence of
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Translation of the content provided to the language spoken by the patient.

NURSE^* * NURSE = Acronym for Naming, Understanding, Respecting, Supporting and Exploring; (²⁸28. Milic MM, Puntillo K, Turner K, Joseph D, Peters N, Ryan R, et al. Communicating with patients’ families and physicians about prognosis and goals of care. Am J Crit Care [Internet]. 2015;24(4):e56-e64. Available from: https://doi.org/10.4037/ajcc2015855
https://doi.org/10.4037/ajcc2015855... ):

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Show empathy as a response to the expression of emotions;
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Name, understand, respect, offer support and explore the patient’s emotions.

Tell me more(²⁸28. Milic MM, Puntillo K, Turner K, Joseph D, Peters N, Ryan R, et al. Communicating with patients’ families and physicians about prognosis and goals of care. Am J Crit Care [Internet]. 2015;24(4):e56-e64. Available from: https://doi.org/10.4037/ajcc2015855
https://doi.org/10.4037/ajcc2015855... ):

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Learning about another person’s perspectives.

Ask-Tell-Ask(²⁸28. Milic MM, Puntillo K, Turner K, Joseph D, Peters N, Ryan R, et al. Communicating with patients’ families and physicians about prognosis and goals of care. Am J Crit Care [Internet]. 2015;24(4):e56-e64. Available from: https://doi.org/10.4037/ajcc2015855
https://doi.org/10.4037/ajcc2015855... ):

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Obtain due permission to present information;
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Present information clearly;
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Verify understanding or agreement.

Therapeutic Communication(²⁹29. Andrade KCS, Ferraz FF, Marques DKA, Lucena ALR, Costa KNFM. Therapeutic communication basicinstrument in hospitalized children. Rev Enferm UFPE Online [Internet]. 2015 [cited 2022 Mar 16];9(11):9784-92. Available from: https://bit.ly/34SUvPi
https://bit.ly/34SUvPi... ):

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Help the patient discover and solve their problems and conflicts, recognize own limitations, adapt to what cannot be changed and face the challenges.

Communicating Bad News(³3. Fontes CMB, Menezes DV, Borgato MH, Luiz MR. Communicating bad news: an integrative review of the nursing literature. Rev Bras Enferm [Internet]. 2017 [cited 2022 Mar 16];70(5):1089-95. Available from: https://doi.org/10.1590/0034-7167-2016-0143
https://doi.org/10.1590/0034-7167-2016-0... ,³⁰30. Santos BS, Macêdo TS, Araújo DV, Galindo NM Neto, Barros LM, Frota NM. Effectiveness of educational video on peripheral venous puncture for Portuguese-speaking student nurses. Rev Enferm UERJ [Internet]. 2021 [cited 2022 Mar 16];29:e53215. Available from: https://bit.ly/36utYIA
https://bit.ly/36utYIA... -³¹31. Rocha L, Melo C, Costa R, Anders JC. The communication of bad news by nurses in the context of obstetric care. REME Rev Min Enferm [Internet]. 2016 [cited 2022 Mar 16];20:e981. Available from: https://bit.ly/3JcIFhL
https://bit.ly/3JcIFhL... ):

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Provision of emotional support;
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Paying attention to the environment where the receiver is;
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Knowing when not to speak, knowing how to listen, resorting to an affectionate touch, establishing visual contact and expressing feelings;
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Bad news should be transmitted clearly, gradually and in a detailed manner, with truth and objectivity, without punishments or omissions and without resorting to technical terms, jargons or ambiguities;
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Use of protocols such as SPIKES^† † SPIKES = Acronym for Setting up, Perception, Invitation, Knowledge, Emotions and Strategy and Summary ;
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Stimulating hope based on reality;

Topics	Present (n = 5)	Desirable (n = 5)
Audiovisual technique
Initial identification of the content that is intended to be shown	5	5
Lighting required to adequately watch the scenes	5	5
Sound required to hear the narrator’s voice	5	5
When desired, it allows going back to any part of the scenes	5	5
Environment
The scenario reflects the Nursing care practice routine	5	5
The audiovisual material contemplates all the resources required to develop what was presented	5	5
Simplification of the images, animations and scenes does not interfere in the fidelity of what it is intended to be shown	5	5
Characters
The language used corresponds to the one employed in the Nursing practice	5	5
The presenter’s voice is clear	5	5
The tone of the presenter’s voice is adequate	5	5
Nurse-patient communication strategies
The concept of communication	5	5
Applicability of communication in Nursing	5	5
Importance of communication in Nursing care	5	5
General aspects of the nurse-patient communication	5	5
Nurse-patient communication strategies
Intercultural Communication	5	5
NURSE^* * NURSE = Acronym for Naming, Understanding, Respecting, Supporting and Exploring	5	5
Tell me more	5	5
Ask-Tell-Ask	5	5
Therapeutic Communication: Expression	5	5
Therapeutic Communication: Clarification	5	5
Therapeutic Communication: Validation	5	5
Communicating bad news	5	5

Topics	Understanding level (%)
The concept of communication	100
Applicability of communication in Nursing	100
Importance of communication in Nursing care	100
General aspects of the nurse-patient communication	100
Intercultural Communication strategy	97
NURSE^* * NURSE = Acronym for Naming, Understanding, Respecting, Supporting and Exploring strategy	98
Tell me more strategy	100
Ask-Tell-Ask strategy	100
Therapeutic Communication strategies: Expression	97
Therapeutic Communication strategies: Clarification	100
Therapeutic Communication strategies: Validation	98
Communicating Bad News strategy	98

[1] Corresponding author:
Jéssica França Pereira E-mail: jessica.france.p@gmail.com https://orcid.org/0000-0002-3889-5378

Brasil

Brasil

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