A. Kerkstra

Nurse-patient communication in cancer care - A review of the literature

Patients with cancer seem to experience distress particularly in the first period after diagnosis, and are likely to develop an affective disorder in the first 2 to 3 months. Communicative behaviors of nurses seem to play an important role in meeting the cognitive and affective needs of patients with cancer. This review of the literature examines the communicative behaviors of nurses during care activities with patients who have cancer. The studies show that emphasis is placed on the affective side, in which facilitating behaviors such as empathy, touch, comforting, and supporting are considered essential in caring for patients with cancer. Unfortunately, further studies in this review demonstrate that communication in oncologic care is complicated by such emotionally laden issues as the consequences associated with the life-threatening character of the disease and the far-reaching consequences of the medical treatment. This results in barriers to effective communication between patients with cancer and nurses. It is important, therefore, that nurses working with patients who have cancer are provided both structurally and repeatedly with continuing education programs in communication. Finally, most of the studies covered in this review have an explorative character. Future research in this area should pay attention to the use of controlled studies, large sample sizes, and observational instruments.

The effects of job characteristics and individual characteristics on job satisfaction and burnout in community nursing.

The aim of this article is to describe job satisfaction and burnout among two categories of community-based nurses (N = 402) in the Netherlands taking account of job and individual characteristics. Results show that these nurses are moderately satisfied with their jobs and the effects of burnout are average. Further, community nurses are less satisfied and have experienced burnout to a greater extent than community nurse auxiliaries. Both job characteristics and individual characteristics are related to job satisfaction and burnout. However, job satisfaction is affected to a greater extent by job characteristics whereas burnout is more often a result of individual characteristics. As research in this area is scarce and home care is changing radically, these results may be valuable in coping with change without losing sight of nursings professional values.

Nurse-elderly patient communication in home care and institutional care: an explorative study

This study explores communication patterns between nurses and elderly patients in two different care settings. In a sample of 181 video-taped nursing encounters, involving 47 nurses and 109 patients, a study was made of nurse-patient communication. The video recordings were observed using an adapted version of Roters Interaction Analysis System, which yields frequencies of 23 types of verbal behaviours. These data were analyzed using correspondence analysis, to reduce them to a smaller number of verbal categories, in which two socio-emotional categories and three categories with task-related communication, could be distinguished. For each encounter five summary statistics corresponding to these categories were calculated. Using analysis of variance, it was shown that the amount of socio-emotional interaction in both settings appeared to be higher than was reported in previous studies into nurse-patient communication. Compared with the home for the elderly, communication was more task-related in home care.

Effects of the resident assessment instrument on the care process and health outcomes in nursing homes: a review of the literature.

The objective of the paper is to review the effects of the implementation of the Resident Assessment Instrument (RAI) on process measures (quality of care plans and staff satisfaction) and outcome measures (health problems and quality of life) in nursing homes. All available publications on the effects of the RAI were included in the review. The most positive effects of the RAI were found in improvements in the comprehensiveness and accuracy of the care plans. As regards outcome quality, the RAI method had most positive effects on the health condition of nursing home residents with diminished physical and mental functioning. In psychosocial areas of assessment, fewer positive effects were found. We concluded that positive effects have been found, based on pre-test-post-test noncontrolled designs. Control-group designs are needed in future evaluation studies to determine if these positive results will hold.

Palliative care services in The Netherlands: a descriptive study

In this paper several types of specialized palliative care services in The Netherlands are presented. These include palliative care units in homes for the elderly, in nursing homes, in a general hospital and in an oncology clinic. In addition, a description is given of private hospices and of a home specializing in the care of terminally ill children. Furthermore, a number of other services relevant to palliative care are presented, such as professional and volunteer services for patients dying at home. Although many different types of services can be distinguished, regional distribution is not always optimal. The policy of the Dutch government on palliative care is also discussed. This policy is characterized by a strong emphasis on the further integration of palliative care in the regular health care system.

Nurse-elderly patient communication in home care and institutional care

This study explores communication patterns between nurses and elderly patients in two different care settings. In a sample of 181 video-taped nursing encounters, involving 47 nurses and 109 patients, a study was made of nurse-patient communication. The video recordings were observed using an adapted version of Roters Interaction Analysis System, which yields frequencies of 23 types of verbal behaviours. These data were analyzed using correspondence analysis, to reduce them to a smaller number of verbal categories, in which two socio-emotional categories and three categories with task-related communication, could be distinguished. For each encounter five summary statistics corresponding to these categories were calculated. Using analysis of variance, it was shown that the amount of socio-emotional interaction in both settings appeared to be higher than was reported in previous studies into nurse-patient communication. Compared with the home for the elderly, communication was more task-related in home care.

Communication between simulated patients and nurses in an oncology setting

Introduction. From literature, it is well known that communication between health care providers and cancer patients is complicated by emotional issues. In this study, we investigated the communication skills of ward nurses during interactions with simulated cancer patients. This study is part of a large study in which the effect of a communication training for nurses is being evaluated by means of videotaped admission conversations of nurses with actual cancer patients as well as with simulated patients. Methods. In total, 55 ward nurses of different medical disciplines have been recruited for participation. The medical disciplines included: gynaecology, urology, surgery, internal medicine/ haematology and, the ear-nose-throat diseases. Each nurse had a videotaped admission conversation with an actor who played a recently diagnosed cancer patient who arrived on the ward for admission. The actor was instructed to play a cancer patient according to the script we developed specifically for this study. For each nurse, the script was standard, but small adaptions were made for each medical discipline. The participating nurses were instructed to have the admission conversation with the simulated patient as they were used to have on the ward with actual patients. The 55 videotaped admission conversations with simulated patients were observed using an adapted version of Roter’s Interaction Analysis System, in which a divisionis made between instrumental and affective categories. Results. The results show that nurses predominantly use technical behaviours and discuss biomedic topics reflected in the instrumental clusters of the RIAS, relative to facilitating behaviours, reflected in the affective clusters of the RIAS. Conclusions. We will present results and draw conclusions about nurses’ communication skills concerning interactions with simulated patients in general, as well as nurses skills hereabout within the different mentioned medical disciplines. (aut. ref.)