Running head: CRITIQUE NURSE-PATIENT COMMUNICATION 1

Critique of Nurse-Patient Communication: An Exploration of Patients Experiences

Allison Rogers

King University
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Critique of Nurse-Patient Communication: An Exploration of Patients Experiences

McCabe (2004) conducted a qualitative research study on effective nurse-patient

communication. This qualitative research study was accomplished by conducting unstructured

interviews with patients, allowing each patient to express their perspective and viewpoint based

on their experience during hospitalization. The article states that the researcher is a lecturer in

nursing at Trinity Centre for Health Sciences, Saint Johns Hospital in Dublin, Ireland. Based on

the documented educational credentials of the researcher contained in this article, the highest

degree held by the author Master of Science degree, making one wonder if the researcher was

qualified to solely perform this study. The title of the research article is appropriate, to the point,

and states the conducted research.

The article contains a section titled introduction. The introduction immediately grasps

ones attention by defining the main point in the title, communication, and then begins to explain

the proposed problem, perceptions of communication. This section does contain background

information through reviewing the history of communication, communication in healthcare, and

why this is significant to nursing. McCabe (2004) revels that previous research shows

communication is a fundamental part of building the nurse-patient relationship and delivering

quality care, however many nurses fail to properly communicate in order to build these

relationships. The significance to nursing is addressed through discussion of how

communication affects the nurse-patient relationship. The article relays how in that relationship,

communication is more than just relaying information through words, but also involves feelings.

Research Problem and Purpose

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As previously stated, McCabe (2004) explains that communication is a crucial part of

nursing, and the literature frequently proclaims nurses as poor-communicators, however few

studies have took into consideration patients thoughts on how nurses communicate. McCabe

(2004) states, in order to help improve nurse-patient communication, it is essential to get the

patients point of view on how nurses communicate. Therefore, the purpose of this study is to

obtain patients reflections on how nurses communicate with them (McCabe, 2004).

Hypothesis

The hypothesis for this research study is not clearly stated. The reference section

contains sixty-nine articles. In my opinion, I feel that this is an adequate number of references

because the author is able to adequately explain the background, defining characteristics, the

problem, previous literature review studies, and proposed solution to the problem. I feel that

most of the references are relevant to the topic being studied. A small number of references are

utilized to explain the background, but the majority of the references assist in defining the

findings of the research. The resources support and expand on the results of patients

conceptions found in the study. Twenty-two percent of the articles used for the study were

current, within five years of publication. Of the sixty-nine references, forty-one were dated

within ten years of publication of the article, and fifteen of those were within five years of

publication, leaving twenty-eight articles written more than ten years prior to the publication

date. According to McCabe (2004), the hospitals ethics committee granted ethical approval for

the study and each study participant gave written consent. Identification on documentation

related to the study was protected by a pseudonym chosen by the patient for means of

identification, and interviews were tape-recorded, using no personal information, and retained by

the researcher (McCabe, 2004).

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Theoretical or conceptual framework

McCabe (2004) identifies that Sandelowskis framework was used. According to

McCabe (2004), this framework was completed for this study using its four factors that include

credibility, fittingness, auditability, and confirmability in order to demonstrate trustworthiness.

Operational terms

No operational terms were identified or clearly stated.

Research design

The research design used for the study was Heideggarian/Gadamarian hermeneutic

phenomenological approach. According to McCabe (2004), this type of design was used in order

to reach a new understanding of nurse-patient communication as perceived by the study

participants. No randomization was used for the study, instead purposeful sampling was used in

order to obtain adequate data from participants who have experienced the phenomenon being

studied. No variables to the study were identified or clearly stated. No biases were clearly

stated. In my opinion, the implications after the study was performed have the potential for bias.

The researchers title is lecturer in nursing at the Trinity Centre for Health Sciences at Saint

Jamess Hospital. The researcher implicated that education regarding patient-centered

communication should be focused on at undergraduate and postgraduate levels. No conflicts of

interest were identified.

Population and sample

Patients in a general teaching hospital in the Republic of Ireland were studied for this

particular research project. Inclusion criteria for the study were individuals who had been
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inpatients for a minimum of four days, in order to have a sample who had regularly

communicated with nurses. The participants ages ranged from mid-twenties to early-seventies.

Three female and five male patients made up the participants for this study, making the exact

sample size eight patients (n=8). According to Grove, Burns, and Gray (2013), the adequacy in

a (qualitative research) sample size should be justified by the researchers (p. 371). Purposeful

sampling was used in this study. This type of sampling is often used in qualitative research in

order to provide data needed to gain insight and discover new meaning (Grove, Burns, & Gray,

2013). Grove, Burns, and Gray (2013) state, the higher the quality of data, the fewer research

participants are needed in order to saturate the data, believing that no additional samples would

provide new information. The researcher seemed to think that this sample size was possibly

limited due to the small number of participants, so I have to agree with the researcher that the

sample size was possibly inadequate.

The data collection was performed using phenomenological research, obtaining the

patients thoughts by using unstructured interviews with the researcher. According to McCabe

(2004), each interview began with an open-ended question, as not to guide patients perceptions.

According to Grove, Burns, and Gray (2013), qualitative studies are focused more on the sample

than the number of participants, making this type of study not statistically significant, therefore,

no p value or confidence interval will be available.

Assumptions and limitations

McCabe (2004) feels that the findings of the study are useful in order to educate nursing

students about the importance of nurse-patient communication and its impact on quality of care.

A possible limitation was identified as the small number of participants in the study.
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Conclusions

The findings of the study suggest that nurse-patient communication is enhanced when

using a patient centered approach and quality healthcare is achieved (McCabe, 2004). It is

believed that nurses use a task centered approach when providing care. Believed reasons behind

nurses using this type of approach are that nurses do not know what patients value during

interactions, and organizations not recognizing the importance of nurses using a patient-centered

approach. It is suggested, the quality of time spent with the patient, has more meaning that the

amount of time the nurse spends with the patient. It is believed that this behavior will continue

unless the importance of communication is recognized.

Implications for future research

McCabe (2004) believes there is a need for further research, using patient focused studies

having the potential to reveal nurse behaviors that patients value, allowing more patient-

centered skills to be developed by nurses.

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References

Grove, S. K., Burns, N., and Gray, J. R. (2013). The practice of nursing research: Appraisal,

synthesis, and generation of evidence, 7th (ed.). Saint Louis, MO: Elsevier Saunders.

McCabe, C. (2004). Nurse-patient communication: An exploration of patients experiences.

Journal of Clinical Nursing, 13, 41-49. Doi: 10.1111/j.1365-2702.2004.00817x