Barriers of Communication

Between
Nurses and Children
Ralise by: Supervisor:
Hassan Safsafi
Mr Timothy Palmer
Abdelghani Oukammou
Omar Khayi
Fatima Belqasmi
Yousra Adzaouia
Plan
Introduction
Definition
Nurse-related communication barriers
Children-related communication barriers
Family-related communication barriers
Solutions
Conclusion
References
INTRODUCTION

Communication is so important that it can be considered the primary

medium of care delivery (Wallace 2001). Healthcare professionals can
provide an appropriate setting for optimal communication to support
patients . This setting includes an appropriate environment , allocation of
enough time to process information and emotions, and inclusion of the
patients identified support system (Von Gunten et al. 2000).

However many barriers can affect communication between nurse and

child patient. Those barriers are related to nurse; patients and their family.
DEFINITION
Effective communication:

Communication is the application of words and conduct for making,

transmitting and interpreting messages (Dewolf Bosek 2002).
Communication, in addition to a positive contact, ranks among the
basic social needs of human beings (Kolegarov & Zitkov 2006).

Barriers of communication:

Obstacle in a workplace that prevent effective exchange of ideas or

thoughts such as language, culture and environment.
Shared communication barriers:

A. Cultural:

Cultural diversity is a challenge faced by the nurses; Witch noted that

patients can come from a variety of ethnic backgrounds and religious beliefs
which influences their acceptance of death.
Afraid that they might offend patients unknowingly, the nurses found
themselves limiting communication with patients from a different cultural
background.

B. Environment:

Noise
lack of privacy
lighting
C. Language:

In regard of language differences nurses are not able to reach their

patients at all because of the language barrier.

Nurse-related communication barriers:

A. Heavy workload:

The heavy workload of hospital nurses is a major problem for the

health care system. Nurses are experiencing higher workloads than
ever before due to many reasons :increased demand for nurses,
inadequate supply of nurses, reduced staffing and increased overtime,
and reduction in patient length of stay.
B. Ineffective interpersonal communication:

Inappropriate communication ranged from a general lack of

communication and coordination, indifference and paternalism :

Some physicians show a disrespectful behavior towards nurses

without any attention to their difficulties and exhaustion during
a shift.

lack of support from managers demotivate the nurses, adversely

affecting their desire to communicate effectively with patients.
The lack of collaborative between nurses and physicians led
to conflicting advice given to patients.

Exerces of paternalism by physician and nurse managers.

Conflict between team care workers.

C. Use of medical jargon:

Use of medical jargon by all members of the health-care

team which is unfamiliar to patients constituted another
aspect of communication difficulties.
D. Lack of empathy:

Referring to instances of cold, mechanical,

indifferent or other negative non verbal
communication behaviours are perceived as
angry or impatient behaviour towards the patient.

E. Fear of the family reaction:

Particularly when they are unable to answer

patients questions or when they have to deliver
unfavorable information.
Children-related communication barriers

A. Cognitive Problems:

Children with cognitive problems may have

insufficient thinking skills, which can lead to
problems in such areas as imagination, intellect,
judgment, memory, perception and reasoning.

Brain or head injuries, neurological conditions

and premature birth Causes of poor cognitive
functioning include.
B. Fluency Problems:

Fluency refers to child's ability to talk with

normal, uninterrupted speech flow. The speech
of children with fluency problems often contains
a large amount of hesitations, prolonged sounds
or repetitions.

Stuttering is a common example of a fluency

disorder, which is also called dysfluency.
C. Language Problems:

Language disorders affect the ability to understand

speech or use spoken or written language
effectively. Examples of language disorders:

expressive language disorder, which makes it difficult

for a child to use the correct words to state what
she means to others.

receptive language disorder, which makes it difficult

for a child to understand the words that others use.
D. Speech Problems:

Also called articulation disorders, speech

disorders prevent a child from pronouncing
sounds correctly,. As a result, his speech may
include a lot of mistakes and sound poorly
articulated.

Speech problems often occur because of

physical issues, such as cleft palate, hearing loss
and teeth problems.
E. Voice Problems:

Voice problems arise when certain aspects of

your child's voice affects its quality. The disorder
may then lead to issues, including nasality,
hoarseness and inappropriate volume, such as
being too soft or too loud.

Voice disorders are usually related to phonation,

which concerns how air from the lungs make
the vocal cords vibrate, or resonance, which
involves the way air travels through mouth, nose
and throat.
Family-related communication barriers

A. lack of respect for the nurses:

They devalue nurses, believing that doctors are the only ones
with knowledge.

They fail to recognize that nurses are also knowledgeable

professionals and can work as patient advocates.

They forget that the nurse is always there and the nurse also
understand all the treatment plans.
B. Unreasonable demands:

patients treat nurses similarly to domestic

workers rather than professionals.

there are some family who were seen to use

complaints inappropriately to obtain the care or
service they desired.

This was believed to be due to the patients lack

of understanding of the nurses high workload.
SOLUTIONS

Nurses should take patients cultural background into

consideration when approaching sensitive topics .
Provide targeted funding for quality nursing workplace initiatives
directed at improving nursing workload and patient outcomes.

Involve nurses at all levels in health care solutions.

 Clarify nursing scopes of practice and the role of unregulated
workers in the system, and ensure replacement of nurses with
nurses.

nurses need to improve their understanding of communication

processes and receive proper education and training.

Health professionals need to adopt a more collaborative

approach to care and should share their expertise with parents
and others involved in the childs care.
CONCLUSION
Communication is essential in order to provide quality
health care, promote patient satisfaction and patients
adherence with treatment recommendations, nurses
should therefore understand perception differences
between patients and nurses and practice strategies to
reduce the associated communication barriers.
Accordingly, health planners and workers should first try
to remove these barriers, and then emphasize those
specific factors expressed as most important barriers for
nurses.
REFERENCES
Dewolf Bosek 2002
Kolegarov & Zitkov 2006

Association for Childrens Palliative Care, 2009

states the American Speech-Language-Hearing Association
Li Hui Tay, Emily Ang and Desley Hegney . Nurses perceptions of
the barriers in effective communication within patient cancer
adults in Singapore. Journal of Clinical Nursing, 21, 26472658.
ANOOSHEH M., ZARKHAH S., FAGHIHZADEH S. &
VAISMORADI M. (2009) Nursepatient communication barriers
in Iranian nursing. International Nursing Review 56, 243249.
Jane Coad, Reena Patel, and Sarah Murray. Disclosing Terminal
Diagnosis to Children and Their Families: Palliative Professionals
Communication Barriers 302307, 2014