The findings revealed the influence of the socio-demographic characteristics of nurses and patients in the caring and curing relationship. No significant. Good communication skills make the difference between average and excel- lent nursing care. The therapeutic relationship between the patient and the nurse. Communication is integral to the nurse-patient relationship and is one of the six fundamental values of nursing identified in the government's strategy to deliver.
A nurse quoted her patient family as saying: Often nurses reported confrontations with patients' family members. Non-observance of visiting hours by patients' relatives resulted in negative interactions between nurses and family members of patients. Nurses complained that visitation by family members outside the stipulated visiting hours disrupted their work, disturbed other patients and threatened their privacy.
Failure by family members to observe visiting hours elicited negative responses from the nurses. We told them to leave as we were in the process of ward rounds but they refused to leave the ward.
Miscommunication Negative interactions between nurses and patients family occurred when information given by nurses was not properly understood. Patients misunderstood what the nurses said and this resulted in adverse health outcomes. For example, the nurses reported that a patient did not receive the right information from the nurse about his treatment needs. Nurses were perceived as powerful and patients as powerless. This unequal relationship was seen as a barrier to effective nurse-family interactions.
Forced dependence Forced dependence is defined as the use of force by a nurse to condition the patient. In situations where nurses have perceived patients to be difficult, the nurses applied forced dependence measures to compel their clients to obey orders.
Staffing shortages were such that nurses did not have adequate time for their patients. Few numbers of nurses coupled with high workloads led to inadequate interactions with patients.
Nurses attributed the nursing shortage to the migration of nurses to other countries such as the United Kingdom and the United States. Reflecting on the nursing shortage, one nurse participant stated: That is happening and during the night, a nurse will attend to about 30 children with one ward. You can well imagine the workload and the frustration that happens under such circumstances. Professional nursing problems Task orientation and organization made it difficult for nurses to give holistic care to their patients.
All nurses mentioned that they had to combine tasks in order to complete them which dissatisfied their efforts to render holistic care to patients. The nurses were busy and unable to communicate effectively with their patients.
Nurses have become so adapted to this situation that they forget to teach and communicate with patients even when they are less busy. Nurse Problems Nurses who stay in rented premises outside the hospital cannot effectively respond to emergency calls. Stress, tiredness, frustration and long working hours without a break affect nursing attitudes, which has serious negative implications for patients and their family members.
The nurses noted that stress and overwork led to frustration and anger in the work place. In some cases, nurses identified personal issues as justification for how they interacted with patients and their families.
According to one nurse: Negligence by nurses or failure to take proper care of patients by nurses has emerged strongly in this research which was acknowledged by all participants. As one nurse stated: Lack of concern about staff by managers interfered with nurse-family member communication.
Many nurses who left the hospital sought employment elsewhere in Kerman.
Difficulties with patients B. In some instances patients refused to be admitted even when it was strongly advised.
Such professional advice was resisted by the patients because of financial reasons. One nurse quoted her patient as saying: Of nurses, mentioned that patients found fault with everything the nurses did for them.
In a study by O'Malley et al.
According to Irurita 20an effective nurse- family relationship was considered to be central to quality nursing and emotional support. The nurses in mentioned study described the essential structure of caring as the establishment of a human care relationship and provision of patients' family needs. Based on the results of the study, it can be said that the main responsibility is continuation of this communication with the patient as the responsibility of the nurse and the patient family had low power in this communication.
Spiritual care were one of the most important issues being emphasized by the families and nurses and the nurses considered this issue more despite all their problems and by giving hope to the families, referring them to prayer and asking for his help and doing the religious actions tried to approach the families and reduce their anxieties.
Allah remembrance gives us comfort and they will be calm in this way. But giving unreal hope to the families is not good and God will is observed in all their words. The families ask for the health of their patients from God and they try to get close to God by religious actions. Generally, religious principles are powerful source for the patients leading into the improved health of the patients. The anxiety of being separated from religious acts and neglect in this regard will have negative effect on disease improvement and increased the hospitalization period and increased costs.
According to cultural and religious beliefs in Iran, touching and gazing are inconsistent with the principles of the society Anoosheh et al. Similar to many Asian cultures, speaking about sexual problems is also considered impolite Im et al. Given the aforementioned principles, the number of male nursing students should increase considering the shortage of male nurses in hospital wards.
In another study, differences in age and social class were included as communication barriers Anoosheh et al.
Communication Barriers Perceived by Nurses and Patients
However, according to a study by Baraz, age differences had no negative impact on nurse-patient relationship Baraz et al. Generally, communicating with different age groups has its own challenges and complexities. Evaluation of the viewpoints of nurses and patients showed that among nurse-related barriers, being overworked, shortage of nurses, and lack of time were the most important barriers for the nurse group.
Nurse is considered the direct care provider and the smallest delay in care provision will be considered as medical negligence. Thus, given the direct relationship between nurses and patients, the image created by nurses affects their being accepted as professional staff, and their role will be highlighted in establishing an effective communication Aghabarari et al. In terms of environmental barriers, the presence of critically ill patients in the ward, the hectic environment of the hospital, and unsuitable environmental conditions are considered the main barriers in both groups.
The findings of previous studies confirm the aforementioned results.
Communication Barriers Perceived by Nurses and Patients
The shortage of nurses and the presence of critically ill patients in the ward cause a lot of stress for the patient and lead to decreased ability and motivation to communicate with other patients; on the other hand, medical environment conditions have great effects on the quantity and quality of communication Bartlett et al.
Factors disturbing the communication process can be improper temperature, excessive noise, poor ventilation, and lack of respect for the privacy of the two sides of the relationship Mendes et al.
Thus, providing a safe and comfortable environment leads to psychological and physical comfort of the nurse and patient, and facilitates using communication skills and establishing an effective communication. One of the limitations of this study was the low number of male nurses. Another limitation was lack of evaluation of cultural forces operating between patients and nurses, regardless of the country of origin or background in the hospitals active, passive, or power relationships.
It is recommended that future studies pay more attention to communication facilitators and divide the participants to male and female groups. It is also suggested that religious and cultural beliefs as well as language barriers be more thoroughly evaluated in patients and nurses.
Conclusion The purpose of any system is to provide services with optimal quality and quantity, and health care systems are no exception. Thus, according to the results of this study and previous studies, the following measures will be considerably helpful in establishing an effective nurse-patient communication: The authors wish to express their sincere gratitude to the study participants without whom this study could not have been conducted.
This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https: By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. This article has been cited by other articles in PMC. Abstract Therapeutic interpersonal relationships are the primary component of all health care interactions that facilitate the development of positive clinician—patient experiences.
Consequently, with an increasing necessity to focus on patient-centered care, it is imperative for health care professionals to therapeutically engage with patients to improve health-related outcomes. Studies were identified through an electronic search, using the PubMed, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO databases of peer-reviewed research, limited to the English language with search terms developed to reflect therapeutic interpersonal relationships between health care professionals and patients in the acute care setting.