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Int J Nurs Stud. 2008 Oct;45(10):1411-21. doi: 10.1016/j.ijnurstu.2008.01.002. Epub 2008 Mar 4.

Factors that enable nurse-patient communication in a family planning context: a positive deviance study.

Author information

1
Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs, Baltimore, MD 21202, USA. ykim@jhuccp.org

Abstract

BACKGROUND:

Family planning programmes in developing countries need a better understanding of nurse-patient communication in order to improve the quality of counselling.

OBJECTIVES:

To identify factors in the clinic and in the community that enable nurses and patients to communicate effectively with one another.

DESIGN:

The study explored the personal experiences of nurses and patients who communicate especially effectively during family planning consultations (so-called "positive deviants").

SETTING:

Sixty-four randomly selected public clinics located in East Java, Indonesia.

PARTICIPANTS:

Seven positive deviant nurses and 32 positive deviant patients were identified from among 64 nurses and 768 patients who participated in an earlier patient coaching study. Flooding prevented 5 patients from participating in the study, reducing their number to 27.

METHODS:

Investigators conducted: (1) a content analysis of qualitative data collected by structured in-depth interviews and focus-group discussions (FGDs) with positive deviant nurses and patients, and (2) analyses of variance (ANOVA) of quantitative data on clinic, nurse, and patient characteristics.

RESULTS:

Positive deviant nurses identified four factors, listed in rough order of importance, that helped them communicate effectively: independent study to strengthen their knowledge and skills; communication aids; feedback from colleagues; and motivation stemming from a desire to help people, patients' appreciation, husband's support, and increased income. Positive deviant patients identified five enabling factors: motivation due to their need for a service; confidence in their own communication skills; positive feedback from nurses; belief in patients' right and responsibility to communicate with nurses; and communication aids.

CONCLUSIONS:

Insights from positive deviant nurses and patients suggest that efforts to improve nurse-patient communication should go beyond conventional communication skills training. Managers should consider a mix of clinic-based interventions (such as peer feedback, communication aids, and better management of patient flow) and community-based interventions (such as patient education and mass media).

PMID:
18289545
DOI:
10.1016/j.ijnurstu.2008.01.002
[Indexed for MEDLINE]
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