Nurse-patient communication in cancer care: does responding to patient's cues predict patient satisfaction with communication.

OBJECTIVE: The aim is to investigate the relationship between nurses' cue-responding behaviour and patient satisfaction. METHODS: One hundred patient-nurse conversations about present concerns were videotaped and patients' expression of emotional cues and nurses' cue responses were coded using the Medical Interview Aural Rating Scale. Nurses (N=34) and patients (N=100) were recruited from seven oncology inpatient clinics from a University Medical Centre. RESULTS: A mixed-model analysis was conducted to examine whether cue responding was related with patient satisfaction with the conversation, after adjusting for confounding variables and correlation due to repeated measure of each nurse. Nurses' cue responding was independently related to patient satisfaction. Controlling for the level of cue responding, palliatively treated patients were more satisfied with the communication than curatively treated patients. CONCLUSIONS: This study provides evidence that nurses' cue-responding behaviour is appreciated by the patients. Future studies might focus on the effect of improved cue-responding skill on more distal outcome measures, such as identification of concerns, mood and coping behaviour.

Cue-responding behaviours of oncology nurses in video-simulated interviews.

AIM: This paper is a report of a study to describe nurse-patient interactions, i.e. nurses' cue-responding behaviour in encounters with actors playing the role of patients. BACKGROUND: Patients with cancer seldom express their concerns directly but express cues instead. Few studies empirically investigated nurses' cue-responding behaviour and the subsequent influence of disclosure of cues and concerns. METHODS: In this descriptive observational study, conducted from April to June 2004, five oncology nurses interviewed an actor playing the role of a patient with cancer. Each nurse performed seven different interviews (n = 35); these were videotaped and subsequently rated for cue-responding using the Medical Interview Aural Rating Scale. Mixed model analysis was used to investigate the relation between cues and cue-responding. FINDINGS: Half of the patients' cues were responded to with distancing behaviours. The other half of the cues were either explored (33%) or acknowledged (17%). In 16% of these responses, nurses used open directive questions. One out of four open directive questions were used as a distancing response, suggesting that open directive questions are not used to explore or acknowledge cues of patients. Cue-responding influenced subsequent expression of concerns and emotions, i.e. disclosure of a concern is two times higher after exploration or acknowledging of a preceding cue than after a distancing response. CONCLUSION: Cue-responding is a valuable concept which can contribute to our understanding of optimal ways of communicating. Cue-responding behaviour facilitates the disclosure of worries and concerns of patients. Further research is needed to assess the clinical relevancy of cue-responding.