Nursing Trainees’ Health Communication Investigation after Curriculum Revision
Nursing Trainees’ Health Communication Investigation after Curriculum Revision
Mahbobeh Abdolrahimi,1,*
1. Nursing and Midwifery school, Shahid Beheshti University of Medical Sciences70- - 021
Introduction: Health communication (HC), the process of exchanging emotions and information between patients and healthcare workers, plays an influential role in providing positive physical and mental outcomes in patients and nurses’ professional success(1-2). However, results of various studies indicate the weakness of nurses in establishing HC with patients(3-4). According to healthcare reforms, since 2013, the “professional ethics and communication course” has been integrated into the nursing curriculum to train competent nurses(2). Therefore, it seems necessary to investigate the nursing trainees’ HC using psychometric tools.
Methods: In this descriptive, analytical research, the study population included all undergraduate nursing students (different grades) of Tehran University of Medical Sciences (TUMS), Tehran, Iran, in 2020. The minimum sample size was 234 (n=〖Z^2*S〗^2/d^2 ) at a 95% confidence interval and 10% attrition rate (d=0.67)(2).
Two instruments were used to gather data, including a demographic questionnaire and a nursing student health communication questionnaire (NSHCQ). The first questionnaire was used to collect the students’ background information, such as gender, age, and semester. The second tool was a valid and reliable questionnaire consisted of 35 items and five subscales: “cooperation attraction” (6 items), “maintaining dignity” (6 items), “preparedness” (9 items), “empathic understanding” (7 items), and “responsiveness” (7 items). The items were rated on a five-point Likert scale, ranging from one (“never”) to five (“always”). Cronbach’s alpha and intra-class correlation coefficient of NSHCQ were 0.75 and 0.85, respectively. The students’ HC was categorized based on their score (sum of item scores) into three categories of weak (<50%), moderate (50-75%), and desirable (>75%)(2).
The study was accepted by TUMS ethics committee (IR.TUMS.REC.1394.807). The second researcher attended selected TUMS hospitals for three months and distributed the questionnaires after explanations regarding the voluntary participation and data confidentiality. A convenience sample of 234 students passing at least one clinical rotation was recruited and asked to sign a consent form.
To analyze the data, SPSS Version 22 was used. After appraising the normal distribution of data using Kolmogorov-Smirnov test, descriptive statistics were measured to compare the frequency of nominal variables. Inferential statistics were also measured for evaluating the students’ demographic characteristics and semester distribution with regard to HC domains.
Results: The majority of nursing students in this study were female (59.17%) with mean age of 22.13±3.02. Also, most of the students (88.3%) were in the pre-internship period (semesters 2-6).
The results showed that the HC of students was moderate and desirable. The score of “cooperation attraction” was the lowest (24.55±2.92), this may be related to the fact that most students did not have enough knowledge to educate patients and give them feedback for modifying their health behaviors(3).
Results showed a significant difference between males and females in the domain of “empathic understanding” (P<0.005), based on the Chi-square test. It seems that intrinsically compassionate female students were more successful in HC because of their patience, flexibility, good listening skills, and understanding of the patient’s bad condition and problems both verbally and non-verbally(3).
Also, in the present study, there was no significant correlation between age and HC. This finding is in contrast to the results of Mirhaghjou et al. in which the majority of older students were experienced practical nurses, and therefore, obtained higher HC scores(4).
Moreover, the results demonstrated a significant correlation between all five domains of HC and the individual’s semester, based on the Chi-square test (P<0.01). Since senior students have more knowledge and experience in performing HC, they have higher interactional skills, compared to other students(4).
Conclusion: To conclude, the added course has been effective in promoting the HC of nursing trainees. However, applying simulation-based workshops can make students more successful in relating and educating patients.