An Interprofessional Communication Training Program to Improve Nurses' Ability to Communicate With Stroke Patients With Communication Disorders.

PURPOSE: The aim of the study was to evaluate change in nurses' knowledge, attitudes, and behaviors after an Interprofessional (IP) Communication Training Program designed to improve nurses' ability to communicate with stroke rehabilitation inpatients with communication disorders. DESIGN/METHODS: A quasi-experimental longitudinal study was conducted to evaluate an IP Communication Training Program consisting of a full-day and booster workshop and speech language pathologist support for nurses. The Communication Impairment Questionnaire and the Providers Interactional Comfort Survey were collected prior to and 3 months and 1 year postintervention. Focus groups assessing program acceptability were conducted. RESULTS: Forty-six nurses participated. The Communication Impairment Questionnaire significantly improved postintervention (p = .001), but not at 1 year follow-up (3.76, p = .123). The Providers Interactional Comfort Survey significantly improved postintervention (p = .001) and remained significant 1 year later (8.84, p = .03). Focus groups indicated high acceptability and reported that the education increased their confidence and reduced their frustration. CONCLUSION: Nurses' attitudes toward and knowledge about communication strategies improved, which enhances their ability to care for stroke patients with communication disorders. CLINICAL RELEVANCE: Interdisciplinary workshops and speech language pathologist support appear beneficial to nurses working with patients with communication disorders.

The effects of an interprofessional patient-centered communication intervention for patients with communication disorders.

PURPOSE OF THE STUDY: This small scale study examined the influence of an interprofessional (IP) evidence based patient-centered communication intervention (PCCI), delivered by trained nurses in collaboration with Speech Language Pathologists, on patient outcomes in an active stroke rehabilitation setting. DESIGN AND METHODS: The setting constraints imposed the use of a single-group pretest and post-test design to determine the influence of the intervention on patient outcomes. Validated tools measured patient quality of life (QOL), depressive symptoms and satisfaction with care. RESULTS: Patients (n=34) showed improvement in all outcomes from pretest to post-test, including quality of life, geriatric depressive symptoms, and satisfaction with care. IMPLICATIONS: The findings indicate that a comprehensive person-centered communication intervention has the potential to enhance patient outcomes at discharge. Challenges to implementing and evaluating evidence-based interventions in practice are highlighted.

Patient-centred communication intervention study to evaluate nurse-patient interactions in complex continuing care.

BACKGROUND: Communication impairment is a frequent consequence of stroke. Patients who cannot articulate their needs respond with frustration and agitation, resulting in poor optimization of post-stroke functions. A key component of patient-centred care is the ability of staff to communicate in a way that allows them to understand the patient's needs. We developed a patient-centred communication intervention targeting registered and unregulated nursing staff caring for complex continuing care patients with communication impairments post stroke. Research objectives include 1) examining the effects of the intervention on patients' quality of life, depression, satisfaction with care, and agitation; and (2) examining the extent to which the intervention improves staff's attitudes and knowledge in caring for patients with communication impairments. The intervention builds on a previous pilot study. METHODS/DESIGN: A quasi-experimental repeated measures non-equivalent control group design in a complex continuing care facility is being used. Patients with a communication impairment post-stroke admitted to the facility are eligible to participate. All staff nurses are eligible. Baseline data are collected from staff and patients. Follow-up will occur at 1 and 3 months post-intervention. Subject recruitment and data collection from 60 patients and 30 staff will take approximately 36 months. The Patient-Centred Communication Intervention consists of three components: (1) development of an individualized patient communication care plan; (2) a one-day workshop focused on communication and behavioural management strategies for nursing staff; and (3) a staff support system. The intervention takes comprehensive patient assessments into account to inform the development of communication and behavioural strategies specifically tailored to each patient. DISCUSSION: The Patient-Centred Communication Intervention will provide staff with strategies to facilitate interactions with patients and to minimize agitation associated with considerable stress. The improvement of these interactions will lead to a reduction of agitation, which has the additional significance of increasing patients' well-being, quality of life, and satisfaction with care. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT01654029.

Focus on communication: increasing the opportunity for successful staff-patient interactions.

OBJECTIVES: This study reports on a pilot study examining the feasibility of a Patient-Centred Communication Intervention. Aims of this study include: assessing the implementation of the communication care plans; identifying staff perceptions of the intervention; exploring changes in patients' perceptions of care and psychosocial functioning; and exploring changes in nurses' knowledge of and attitude towards communication with patients. BACKGROUND: More than 50% of stroke survivors have speech and language impairments. Many nurses lack the specialized skills to effectively communicate with patients and therefore have difficulties understanding the patients' needs. DESIGN: A one-group pre- post-test design supplemented with a focus group session with nursing staff was used. The intervention consisted of developing individualized communication plans; attending at a workshop; and implementing a system to support nurses when using the plans. The plans were used over a 2-month period. Focus groups were held with seven nurses. RESULTS: The pilot study demonstrated feasibility. There was an excellent response rate and nurses adhered to the intervention. CONCLUSION: The Patient-Centred Communication Intervention is feasible and has demonstrated potential for a larger-scale study. RELEVANCE TO CLINICAL PRACTICE: Providing tailored approaches to communication-enhancement education may be necessary for changes in practice to occur.

A systematic review of the effectiveness of communication interventions for health care providers caring for patients in residential care settings.

OBJECTIVES: This systematic review will describe the theoretical grounding, components, duration, mode of delivery, and outcomes of communication interventions for health care providers delivering care in residential care settings and will evaluate the effectiveness of these interventions. METHODS: We conducted a comprehensive literature search of multiple databases published from January 1985 to the first week of December 2007, supplemented by a hand search of the references in all relevant articles, to find studies that met the inclusion criteria. Intervention details were extracted, and the studies' validity was evaluated independently by two researchers using a standardized data collection form based on Cooper and Hedges' (1994) approach to quality assessment. RESULTS: Of the six studies that met the inclusion criteria (three randomized controlled trials, three quasi-experimental designs), three used a theoretical framework to guide intervention design. Across the six studies, the most commonly used components were (1) cognitive (to teach staff about communication), (2) behavioral (including practice at the bedside), and (3) psychological (involving individualized feedback). Despite the studies' variability in methodological quality, their results indicated that communication interventions have a positive effect on staffs' knowledge and communication skills and on residents' agitation and challenging behaviors. However, none of the studies provided sufficient information on the duration of the intervention and on determining which interventions were most effective. This made it difficult to draw conclusions about the effectiveness of the interventions' different components. CONCLUSION: Although communication training has been shown to have positive effects on staffs' communication knowledge and skills as well as on resident outcomes, future controlled intervention research is needed to assess the effectiveness of individual intervention components.