Communication in health care from the experiences of Nursing students and teachers: contributions to health literacy

Soares, Adelia Karla Falcão; Sá, Caio Heinrich Correia de; Lima, Rayanne da Silva; Barros, Mirelly da Silva; Coriolano-Marinus, Maria Wanderleya de Lavor

doi:10.1590/1413-81232022275.21462021EN

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ARTICLE • Ciênc. saúde coletiva 27 (05) • May 2022 • https://doi.org/10.1590/1413-81232022275.21462021EN copy

Communication in health care from the experiences of Nursing students and teachers: contributions to health literacy

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The object of this study is communication about health in the training processes of nurses and the aim is to analyze the conceptions of teachers and students of an undergraduate nursing course about communication in regard to health based on the construct of health literacy. This is a descriptive, exploratory research, with a qualitative approach. Data were collected through individual narratives of students and semi-structured interviews with teachers at a public university. Data were analysed through inductive coding, supported by the Atlas T.I software, version 8.0 and using the theoretical framework of Health Literacy. The results identified two categories supported by the testimonies of students and teachers: 1) Communication in nursing care and health literacy; 2) Practice in communication skills during graduation. Students and teachers recognized the importance of communication and the relational process with patients in the classroom context. The need for practical and reflective tools is identified so that communication is experienced in a more dialogic and participatory manner, both with patients and in teaching-learning contexts, with the integration of affective, motivational and supportive elements.

Key words:
Communication; Nursing students; Teachers; University professor; Health literacy

Dimensions of health literacy	Subtheme	Students	Teaching staff
Access understanding	Horizontal relationship without distinctions	E5: Good communication is something necessary to understand the other’s opinions and needs [...] in an egalitarian way, without demeaning or humiliating someone, due to social class or knowledge E15: Respect for opposing opinions	D5: I think you should always take into account that you have knowledge and that you have wisdom. We have to take into account that my client has knowledge and I have to take it into consideration
Access understanding	Multiple forms Clarity and objectivity	R14: Clarity, objectivity and attention are essential factors for communication, because they guarantee a good flow of information R16: Speech, images, sounds, having a reciprocity between people	D10: I think it’s important for us to leave the classroom environment, I think it’s very important that whoever gives that class looks at the practical so you make this connection, so you don’t train a nurse who doesn’t know how to express themself, who doesn’t know how to talk to the client […] So I think this is important, it is our responsibility to awaken this in the student
Access understanding	Empathy	R44: Theoretical knowledge; empathy; put yourself in the other’s shoes R9: we can understand the other, what someone wants to share, let off steam and through communication we can establish relationships R10: Communication is extremely important […] which will help the patient, the family and the work environment
Access understanding	Knowledge of patient’s needs Team work	E22: Knowing what is happening with the patient, to understand their social context, to discover the causes of an illness, for example. And to have a unified team	D9: […] when we are at the basic unit, we ask them to do a have a discussion with patients, with caregivers, that they can also do training with community health agents, with other professionals, that they participate in trainings
Access understanding	Involve patients in decision making	E59: Engage with patients, so they know what will be done	D7: […] if you are not understood by the patient, they do not understand the therapeutic process, so for you to take care of someone, they need to understand what you are proposing as care. This enters into therapeutic communication as well
Access understanding	Patient autonomy educational processes	R16: Through communication, we can keep the patient informed of everything we are going to do, in addition to being able to maintain a dialogue with them and even promote health education for both the patient and the family R85: […] Vulnerable people need this communication to initiate treatments, follow recommendations, listen and practice health education and general instructions	D1: Understanding that we have to understand the limitations of communication in relation to others, such as in regard to the elderly, those who have hearing problems, who have decreased hearing acuity, and visual limitations
Access understanding	Professional response to patient’s needs and feelings	E23: With communication, it is possible to better understand what the patient feels, their anguish and problems in order to help them in the best way possible 113: Because care does not only involve technical procedures, it also involves words of comfort. Therefore, communication in the act of caring is of great importance
Access understanding evaluation	Patient satisfaction	E53: Care skills are optimized, the client is satisfied and the professional also feels fulfilled in the care process
Evaluation Application	Better patient adherence	E 65: Improvement in the patient-professional relationship, greater possibility of success in the treatment, increase in the patient-professional bond. Greater therapeutic adherence

Subtema	Discentes	Docentes
Learning in the relationship with patients	E24: [...] through learning, we are always putting our knowledge into practice and learn to communicate with both patients and professionals E70 [...] we are able to apply questionnaires (interviews) with patients, establishing oral communication, and enabling us to provide collective assistance with other professionals	D3: Lá na consulta com a criança, lá no atendimento da criança que tá doente, você demonstra como docente como é a comunicação, e fala por. Então, a comunicação, o aluno eu acho que ele aprende olhando como o docente se comunica, e o professor tem o papel fundamental para dizer ao aluno: “Esse tipo de abordagem não é adequado.”
Continuous classroom learning	E 27: Yes. In that we are constantly dealing with seminars, the internships, even without realizing it, we deal with communication	D4: [...] I have been trying to work in this sense [...] even those students who for some reason have a somewhat apathetic behavior, I try to get closer [...] if there is something outside of the context that is interfering in this relationship of learning D8: Knowledge, practical mastery, because as a nurse you need to exemplify what he sees in theory with what he will develop in his practice, so mastery, my practical skills, my experience within health services are also interesting, the report of cases with the patient, I add a lot of video tools, that’s not to say, that it’s interesting, combined with the theme, I think this is very important, and I also really like to open it up to the student, right, this exchange [...] because he thinks it is another way and from this we can build something
Limitations of the health professional to communicate and need for support		D3: So, communication limits will always exist, and the undergraduate should learn from us that they have limitations, and that they have the right to say “I can’t communicate, therefore I can’t care”

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[1] Collaborations

AKF Soares was responsible for the design, planning, data collection, analysis and writing of the text, CHC Sá was responsible for the analysis and writing of the text, R Lima was responsible for the analysis and writing of the text, MS Barros was responsible for the analysis and writing of the text, MWL Coriolano-Marinus was responsible for the guidance of the research process, conception, planning, data collection, analysis and writing of the text.