Therapeutic communication in nursing students

A Walker & Avant concept analysis

Authors

  • Shahrzad Ghiyasvandian Associate Professor, Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran

Keywords:

Communication, Nursing, Students, Patients

Abstract

Background and aim: Therapeutic communication, the fundamental component of nursing, is a complex concept. Furthermore, the poor encounters between nursing student and patient demonstrate the necessity of instruction regarding therapeutic communication. The aim of this study was to define and clarify this important concept for including this subject in the nursing curriculum with more emphasis. 

Methods: A literature search was conducted using keywords such as “nursing student”, “patient” and “therapeutic communication” and Persian-equivalent words in Persian databases (including Magiran and Medlib) and English databases (including PubMed, ScienceDirect, Scopus and ProQuest) without time limitation. After extracting concept definitions and determining characteristic features, therapeutic communication in nursing students was defined.  Then, sample cases, antecedents, consequences and empirical referents of concept were determined.

Results: After assessing 30 articles, therapeutic communication defining attributes were as follows: “an important means in building interpersonal relationships”, “a process of information transmission”, “an important clinical competency”, “a structure with two different sections” and “a significant tool in patient centered care”. Furthermore, theoretical and clinical education and receiving educators’ feedback regarding therapeutic communication were considered as antecedents of the concept. Improving physical and psychological health status of patient as well as professional development of nursing students were identified as consequences of the concept. 

Conclusion: Nursing instructors can use these results in order to teach and evaluate therapeutic communication in nursing students and train qualified nurses. Also, nursing students may apply the results to improve the quality of their interactions with patients, perform their various duties and meet patients’ diverse needs.

References

Faden RR, Kass NE, Goodman SN, Pronovost P, Tunis S, Beauchamp TL. An ethics framework for a

learning health care system: A departure from traditional research ethics and clinical ethics. Hastings Cent

Rep. 2013; Spec No: S16-27. doi: 10.1002/hast.134. PMID: 23315888.

Purtilo RB, Haddad AM, Doherty RF. Health professional and patient interaction. 8 th ed. St. Louis:

Elsevier; 2014.

Lin YH, Li J, Shieh SI, Kao CC, Lee I, Hung SL. Comparison of professional values between nursing

students in Taiwan and China. Nurs Ethics. 2016; 23)2): 223-30. doi: 10.1177/0969733014561912. PMID:

School of Nursing and Midwifery, Tehran Uinversity of Medical Sciences. Notification codes and ethics of

nursing schools. 2016. Available From: http://fnm.tums.ac.ir/post/detail/Fa/2-120-4- 123640/ethicalcodesannouncment.aspx. Accessed Oct 12 2016.

Johnston J, Fidelia L, Robinson KW, Killion JB, Behrens P. An instrument for assessing communication

skills of healthcare and human services students. Internet J Allied Health Sci Pract. 2011; 10(4): 1-6.

Karolak H. Philosophy of communication ethics: Scholarship beyond the one and the other. Rev Comm.

; 15(4): 316-31. doi: 10.1080/15358593.2015.1114138.

Sherko E, Sotiri E, Lika E. Therapeutic communication. JAHR-European Journal of Bioethics. 2013; 4(7):

-66.

Kourkouta L, Papathanasiou IV. Communication in nursing practice. Mater Sociomed. 2014; 26(1): 65-7.

doi: 10.5455/msm.2014.26.65-67. PMID: 24757408, PMCID: PMC3990376.

Berman A, Snyder S, Frandsen G. Kozier & Erb’s fundamentals of nursing: Concepts, practice, and

process. 10th ed. Boston: Pearson; 2015.

Henry-Newton SG, Einstein GP, Tulp OL. The formulation of a patient-centered quality care improvement

tool for nursing home patients. FASEB J. 2016; 30(1 Supplement): 674-42.

Parsapoor AR, Salari P, Larijani B. Implementation of patient’s rights charter: A report from Ministry of

Health and Medical Education, Iran. Iran J Public Health. 2013; 42(Supple1): 9-12. PMID: 23865009,

PMCID: PMC3712606.

Birks M, Chapman Y, Davis J. Professional and therapeutic communication. South Melbourne, Vic:

Oxford University Press; 2015.

Aled J. Putting practice into teaching: An exploratory study of nursing undergraduates’ interpersonal skills

and the effects of using empirical data as a teaching and learning resource. J Clin Nurs. 2007; 16(12): 2297- 307. doi: 10.1111/j.1365-2702.2007.01948.x. PMID: 18036120.

Baghcheghi N, Koohestani HR, Rezaei K. A comparison of the cooperative learning and traditional

learning methods in theory classes on nursing students’ communication skill with patients at clinical

settings. Nurse Educ Today. 2011; 31(8): 877-82. doi: 10.1016/j.nedt.2011.01.006. PMID: 21288608.

Xie J, Ding S, Wang C, Liu A. An evaluation of nursing students’ communication ability during practical

clinical training. Nurse Educ Today. 2013; 33(8): 823-7. doi:10.1016/j.nedt.2012.02.011. PMID:

Waters A, Whyte A. 'Nurses have a duty to be kind, friendly and polite'. Nurs Stand. 2012; 26(23): 16-8.

doi: 10.7748/ns2012.02.26.23.16.p7488. PMID: 22413680.

Klakovich MD, Dela Cruz FA. Validating the interpersonal communication assessment scale. J Prof Nurs.

; 22(1): 60-7.doi: 10.1016/j.profnurs.2005.12.005. PMID: 16459290.

Jouzi M, Vanaki Z, Mohammadi E. Factors affecting the communication competence in Iranian nursing

students: A qualitative study. Iran Red Crescent Med J. 2015; 17(3): e19660. doi: 10.5812/ircmj.19660.

eCollection 2015. PMID: 26019902, PMCID: PMC4441787.

Shafakhah M, Zarshenas L, Sharif F, Sabet Sarvestani R. Evaluation of nursing students’ communication

abilities in clinical courses in hospitals. Glob J Health Sci. 2015; 7(4): 323-8. doi: 10.5539/gjhs.v7n4p323.

PMID: 25946924, PMCID: PMC4802203.

Wloszczak-Subzda A, Jarosz MJ. Professional communication competences of nurses. Ann Agric Environ

Med. 2012; 19(3): 601-7. PMID: 23020064.

Heidari H, Mardani Hamooleh M. Improving communication skills in clinical education of nursing

students. Client-Centered Nursing Care. 2015; 1(2): 77-82.

Sheldon LK, Hilaire DM. Development of communication skills in healthcare: Perspectives of new

graduates of undergraduate nursing education. J Nurs Educ Pract. 2015; 5(7): 30-7. doi:

5430/jnep.v5n7p30.

Zamanzadeh V, Rassouli M, Abbaszadeh A, Nikanfar A, Alavi-Majd H, Ghahramanian A. Factors

influencing communication between the patients with cancer and their nurses in oncology wards. Indian J

Palliat Care. 2014; 20(1): 12-20. doi: 10.4103/0973-1075.125549. PMID: 24600177, PMCID:

PMC3931236.

Cowen KJ, Hubbard LJ, Hancock DC. Concerns of nursing students beginning clinical courses: A

descriptive study. Nurse Educ Today. 2016; 43: 64-8. doi: 10.1016/j.nedt.2016.05.001. PMID: 27286947.

Ma F, Li J, Liang H, Bai Y, Song J. Baccalaureate nursing students’ perspectives on learning about caring

in China: A qualitative descriptive study. BMC Med Educ. 2014; 14: 42. doi: 10.1186/1472-6920-14-42.

PMID: 24589087, PMCID: PMC3944811.

Mullan BA, Kothe EJ. Evaluating a nursing communication skills training course: The relationships

between self-rated ability, satisfaction, and actual performance. Nurse Educ Pract. 2010; 10(6): 374-8. doi:

1016/j.nepr.2010.05.007. PMID: 20541974.

Jirwe M, Gerrish K, Emami A. Student nurses’ experiences of communication in cross‐cultural care

encounters. Scand J Caring Sci. 2010; 24(3): 436-44. doi: 10.1111/j.1471-6712.2009.00733.x. PMID:

McMillan LR, Shannon DM. Psychometric analysis of the JSPE nursing student version R: Comparison of

senior BSN students and medical students attitudes toward empathy in patient care. ISRN Nurs. 2011;

: 726063. doi: 10.5402/2011/726063. PMID: 21994895, PMCID: PMC3169335.

Rosenberg S, Gallo-Silver L. Therapeutic communication skills and student nurses in the clinical setting.

Teaching and Learning in Nursing. 2011; 6(1): 2-8. doi: 10.1016/j.teln.2010.05.003.

MacDonald-Wicks L, Levett-Jones T. Effective teaching of communication to health professional

undergraduate and postgraduate students: A Systematic Review. JBI Libr Syst Rev. 2012; 10(28 Suppl): 1- 12. doi: 10.11124/jbisrir-2012-327. PMID: 27820404.

Jvaher AA, Khaghanizadeh M, Ebadi A. Study of communication skills in nursing students and its

association with demographic characteristics. Iranian Journal of Medical Education. 2014; 14(1): 23-31.

Szpak JL, Kameg KM. Simulation decreases nursing student anxiety prior to communication with mentally

ill patients. Clin Simul Nurs. 2013; 9(1): e13-9. doi:10.1016/j.ecns.2011.07.003.

Emmanuel E, Collins D, Carey M. My face, a window to communication: Using creative design in

learning. Nurse Educ Today. 2010; 30(8): 720-5. doi:10.1016/j.nedt.2010.01.011. PMID: 20149503.

Miles LW, Mabey L, Leggett S, Stansfield K. Teaching communication and therapeutic relationship skills

to baccalaureate nursing students: A peer mentorship simulation approach. J Psychosoc Nurs Ment Health

Serv. 2014; 52(10): 34-41. doi: 10.3928/02793695-20140829-01. PMID: 25207556.

Norouzinia R, Aghabarari M, Shiri M, Karimi M, Samami E. Communication barriers perceived by nurses

and patients. Glob J Health Sci. 2015; 8(6): 65-74. doi: 10.5539/gjhs.v8n6p65. PMID: 26755475, PMCID:

PMC4954910.

Campbell SH, Pagano MP, O’Shea ER, Connery C, Caron C. Development of the health communication

assessment tool: Enhancing relationships, empowerment, and power-sharing skills. Clin Simul Nurs. 2013;

(11): e543-e50. doi:10.1016/j.ecns.2013.04.016.

Figueiredo SV, Gomes ILV, Pennafort VPdS, Monteiro ARM, Figueiredo JV. Therapeutic communication

between health professionals and mothers accompanying children during inpatient treatment. Esc Anna

Nery. 2013; 17(4): 690-7. doi: 10.5935/1414-8145.20130013.

McDonald M. The nurse educator’s guide to assessing learning outcomes. 3ed. Burlington, MA: Jones &

Bartlett Learning; 2014.

Grant MS, Jenkins LS. Communication education for pre-licensure nursing students: Literature review

–2013. Nurs Educ Today. 2014; 34(11): 1375-81. doi: 10.1016/j.nedt.2014.07.009. PMID: 25151020.

Walker LO, Avant KC. Strategies for theory construction in nursing. 5th ed. Boston: Prentice Hall; 2011.

Jones T, Shaban RZ, Creedy DK. Practice standards for emergency nursing: An international review.

Australas Emerg Nurs J. 2015; 18(4): 190-203. doi: 10.1016/j.aenj.2015.08.002. PMID: 26440608.

Hess EP, Grudzen CR, Thomson R, Raja AS, Carpenter CR. Shared decision-making in the emergency

department: Respecting patient autonomy when seconds count. Acad Emerg Med. 2015; 22(7): 856-64.

doi: 10.1111/acem.12703. PMID: 26112797.

Gifu D, Dima IC, Teodorescu M. New communication approaches vs. traditional communication.

International Letters of Social and Humanistic Sciences. 2014; (31): 46-55. doi:

18052/www.scipress.com/ILSHS.31.46.

Walker D, Ross JM. Therapeutic computing: Teaching therapeutic communications utilizing a videodisc.

Comput Nurs. 1995; 13(3): 103-8. PMID: 7796366.

Hayes A. A mental health nursing clinical experience with hospice patients. Nurse Educ. 2005; 30(2): 85-8.

PMID: 15785347.

Sadat Manzari Z, Memarian R, Vanaki Z. The effect of implementing therapeutic communication plan on

burned patients’ pain. ZUMS. 2006; 14(54): 10-16.

Becker KL, Rose LE, Berg JB, Park H, Shatzer JH. The teaching effectiveness of standardized patients. J

Nurs Educ. 2006; 45(4): 103-11. PMID: 16629278.

McNeill C, Shattell M, Rossen E, Bartlett R. Relationship skills building with older adults. J Nurs Educ.

; 47(6): 269-71. doi: 10.3928/01484834-20080601-07. PMID: 18557314.

Weissman GV. Evaluating associate degree nursing students’ self-efficacy in communication skills and

attitudes in caring for the dying patient. Teaching and Learning in Nursing. 2011; 6(2): 64-72. doi:

1016/j.teln.2010.10.004.

Suplee PD, Solecki SM. Creating and implementing pediatric simulation experiences for licensed practical

nursing students. Clin Simul Nurs. 2011; 7(4): e127-32. doi: 10.1016/j.ecns.2010.01.001.

Damasceno MM, Zanetti ML, de Carvalho EC, Teixeira CR, de Araújo MF, Alencar AM. Therapeutic

communication between health workers and patients concerning diabetes mellitus care. Rev Lat Am

Enfermagem. 2012; 20(4): 685-92. doi: 10.1590/S0104-11692012000400008. PMID: 22990153.

Webster D, Seldomridge L, Rockelli L. Making it real: Using standardized patients to bring case studies to

life. J Psychosoc Nurs Ment Health Serv. 2012; 50(5): 36-41. doi: 10.3928/02793695-20120410-06. PMID:

Leef BL, Hallas D. The sensitivity training clown workshop: Enhancing therapeutic communication skills

in nursing students. Nurs Educ Perspect. 2013; 34(4): 260-4. doi: 10.5480/1536-5026-34.4.260. PMID:

Grossman S. Development of the palliative care of dying critically ill patients algorithm: Implications for

critical care nurses. J Hosp Palliat Nurs. 2013; 15(6): 355-9. doi: 10.1097/NJH.0b013e3182987b1c.

McAllister M, Levett-Jones T, Downer T, Harrison P, Harvey T, Reid-Searl K, et al. Snapshots of

simulation: Creative strategies used by Australian educators to enhance simulation learning experiences for

nursing students. Nurse Educ Pract. 2013; 13(6): 567-72. doi: 10.1016/j.nepr.2013.04.010. PMID:

Taylor EJ, Mamier I. Nurse responses to patient expressions of spiritual distress. Holist Nurs Pract. 2013;

(4): 217-24. doi: 10.1097/HNP.0b013e318294e50a. PMID: 23774721.

Spinner-Gelfars AH. Using simulation to promote effective communication with a diverse student

population. Teaching and Learning in Nursing. 2013; 8(3): 96-101. doi:10.1016/j.teln.2013.01.004.

Webster D. Using standardized patients to teach therapeutic communication in psychiatric nursing. Clin

Simul Nurs. 2014; 10(2): e81-6. doi: 10.1016/j.ecns.2013.08.005.

Mawson K. Use of media technology to enhance the learning of student nurses in regards to auditory

hallucinations. Int J Ment Health Nurs. 2014; 23(2): 135-44. doi: 10.1111/inm.12031. PMID: 23755742.

Sadat Manzari Z, Memarian R, Vanaki Z. Effectiveness of therapeutic communication program based on

Hilgard Peplau theory on burned patient’s participation in caring and curing plans. Journal of Ethics and

Culture in Nursing and Midwifery. 2014; 1(1): 35-46.

Rossetti J, Musker K, Smyth S, Byrne E, Maney C, Selig K, et al. Creating a simulated mental health ward:

Lessons learned. J Psychosoc Nurs Ment Health serv. 2014; 52(10): 52-8. doi: 10.3928/02793695- 20140903-02. PMID:25207558.

Martin CT, Chanda N. Mental health clinical simulation: Therapeutic communication. Clin Simul Nurs.

; 12(6): 209-14. doi: 10.1016/j.ecns.2016.02.007.

Yas MI, Mohammed SH. Assessment of nurses knowledge about therapeutic communication in psychiatric

teaching hospitals at Baghdad City. Kufa Journal for Nursing Sciences. 2016; 6(2): 1-7.

Moghadami A, Jouybari L, Baradaran HR, Sanagoo A. The effect of narrative writing on communication

skills of nursing students. Iranian Journal of Medical Education. 2016; 16: 149-156.

Jacobs AC, van Jaarsveldt DE. 'The character rests heavily within me': Drama students as standardized

patients in mental health nursing education. J Psychiatr Ment Health Nurs. 2016; 23(3-4): 198-206. doi:

1111/jpm.12302. PMID: 27090349.

Vaghee S, Salarhaji A, Karimi Moonaghi H, Soadatjo SAR, Banezhad A. Effect of portfolio application on

satisfaction and educational achievement of nursing students in psychiatry clerkship. J Med Edu Dev. 2016;

(23): 112-21.

Liebrecht C, Montenery S. Use of simulated psychosocial role-playing to enhance nursing students’

development of soft skills. Creat Nurs. 2016; 22(3): 171-5. doi: 10.1891/1078-4535.22.3.171.

Ross JG, Bruderle E, Meakim CH, Willens JS, Holmwood JA. Development of formative capstone

simulations to prepare novice students for initial clinical practicum. J Nurs Educ. 2016; 55(10): 587-9. doi:

3928/01484834-20160914-09. PMID: 27668740.

Draper P. A critique of concept analysis. J Adv Nurs. 2014; 70(6): 1207-8. doi: 10.1111/jan.12280. PMID:

Knafl KA, Deatrick JA. Commentary on: Draper P. (2014) Editorial: a critique of concept analysis. Journal

of Advanced Nursing 70, 1207-1208. J Adv Nurs. 2014; 70(12): 2968. doi: 10.1111/jan.12465. PMID:

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2022-01-18

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