Improving Nursing Students' Therapeutic Communication Via Low-Cost Interventions

Therapeutic communication is considered fundamental to nursing, yet studies have shown that many nurses do not possess or utilize effective therapeutic nurse-patient communication skills (e.g., Archury et al., 2015; Arungwa, 2014; Stewart et al., 2015). Among the findings reported in the global research literature, nurses’ use of therapeutic communication has (a) helped circumvent dehumanizing treatment of patients with Alzheimer’s (Long & Slevin, 1999), (b) helped cancer patients cope with their illness (de Faria Velloso de Brito & de Souza, 2017), (c) facilitated establishment of an effective nurse-patient relationship that led to patients taking greater autonomy in their care (Santos et al., 2010), (d) influenced the therapeutic relationship and quality of patient care provided (Brownie et al., 2016), and (e) facilitated strong emotional support and reassurance during childbirth with women who had a history of miscarriage (Kinsey et al., 2013).

Researchers have concluded that nursing educators should strive to increase the therapeutic communication skills of nursing students (Bowles et al., 2001; Edwards et al., 2006). Leef and Hallas (2013) found that a workshop designed to enhance nursing students’ therapeutic communication skills was effective regardless of their area of nursing employment. Researchers also state that nurses should engage in continuing education to develop and/or further develop their therapeutic communication (e.g., Arungwa, 2014; Reinke et al., 2010), and that more research on nurse-client communication is needed to provide an evidence base for practice, education, and training (Callery & Milnes, 2012).

Increasing use of therapeutic communication holds the promise of improving patient care and patient outcomes. Strategies for increasing use of therapeutic communication include: (a) strengthening nursing students’ therapeutic communication skills, and (b) providing refresher training to nurses who provide direct patient care. Ideally, an educational intervention will lead to skill building and require a relatively low investment of time and money.

Purpose:

The purpose of this study is to compare the efficacy of two low-cost interventions designed to increase nursing students’ use of therapeutic communication: (1) a pocket-size therapeutic communication quick reference guide, and (2) weekly email reminders and examples pertaining to therapeutic communication.

Methods:

A randomized treatment and control group design was employed to compare two low- cost interventions: (1) a pocket-size therapeutic communication quick reference guide, and (2) weekly emails consisting of therapeutic communication reminders and examples. One-fourth of the participants were randomly assigned to one of four groups: (1) those who receive a pocket-size therapeutic communication quick reference guide, (2) those who receive weekly therapeutic communication emails throughout the semester, (3) those who receive both a therapeutic communication quick reference guide and weekly emails, and (4) a non-treatment control group.

Baccalaureate nursing students at a large public university in the southeastern US who took Mental Health Nursing in the Fall of 2016, Spring of 2017 or Fall of 2017 were invited to participate in the study.

An online version of the Staff-Patient Interaction Response Scale for Palliative Care Nurses (SPIRS-PCN) – developed by Yates et al. (1988) – was used to assess participants’ therapeutic communication skills (a) at the start of the semester (pre-test), (b) at the end of the semester (post-test), and (c) three months after the end of the semester (3-month follow-up). Adriaansen et al. (2008) found that reliability of the SPIRS-PCN was demonstrated in an educational setting and its validity was partially supported.

Each participant response to a patient’s statement is in the process of being independently rated by two doctoral-level nurses trained in the SPIRS-PCN. Ratings are being compared and agreement is being reached via discussion when ratings differ. To analyze differences between the two interventions over time, a 2x2x3 ANOVA will be used.

Results:

Pending completion of data analysis.

Conclusion:

Pending completion of data analysis.