Iran Journal of Nursing

Mendeley  

Zotero  

Seyedoshohadaee M, Ahmadi M, Haghani H. The Correlation between the Anxiety of the Family Members of the Patients Referring to the Emergency Department and Their Views on the Communication Skills of Nurses. IJN 2019; 32 (119) :87-98
URL: http://ijn.iums.ac.ir/article-1-2993-en.html

Background & Aims: Emergency departments (EDs) are the most challenging ward concerning patient care. The hospitalization of a family member in the hospital, especially in ED, increases anxiety and psychological problems in other members of the family. Given the emergency patients’ need for immediate and special care, understanding their problems in the ED is crucial to provide favorable services and increase satisfaction in these individuals. Effective communication and intrapersonal skills are the basic principles for the provision of high-quality care. Therefore, establishing effective communication between the healthcare team and family members of the patient is significantly vital to provide safe care and prevent damage to the patient. This is specifically important in stressful hospital wards (e.g., Eds). The way nurses interact with patients and their companions play an important role in the control and management of their anxiety levels. In addition, favorable nurses’ communication with patients and their families could contribute to gathering the required information and proper management of the treatment process. The present study aimed to determine the relationship between the anxiety of emergency patients’ family members with their views on nurses’ communication skills. 
Materials & Methods: This was a descriptive, correlational and cross-sectional study performed on 263 family members of patients referring to the Eds of two selected training healthcare centers affiliated with Iran University of Medical Sciences in 2019. The participants were selected by continuous sampling based on the inclusion criteria, which included age above 18 years, being literate, no history of psychological disorders or use of psychiatric medications (based on self-report), and being a first-degree relative (mother, father, sister, brother, child, spouse). The sample size was estimated at 263 to determine the sample size at 95% confidence level and 90% test power assuming that the correlation coefficient between the relationship between the nurse and anxiety in the patients' families was at least 0.2, so that this correlation is considered statistically significant. Data were collected using a demographic characteristics questionnaire (age, gender, level of education, marital status, economic status, occupational status, kinship, insurance status, and triage level), the health care climate questionnaire (HCCQ), and Beck anxiety inventory (BAI). Data analysis was performed in SPSS version 16 using Pearson’s correlation coefficient, analysis of variance, and the Kruskal-Wallis test. In addition, a P-value of 0.05 was considered statistically significant. 
Results: In this study, the mean age of the participants was 42.92 ± 11.64 years. In terms of gender, 56.3% of the participants were male and the rest were female. Regarding the level of education, the highest frequency was related to below diploma degrees (40.7%). In addition, poor (48.3%) and moderate (46.8%) economic states had the highest frequency, respectively. The majority of the participants were married (75.3%), and most of the companions were patients’ children (58.2%) and spouse (22.1%). Moreover, 89.4% of the patients had basic insurance coverage. Cardiovascular disease with 44.9% was the most common cause of referral, and the ratio of patients' triage level was almost equal. According to the results, the score of nurses’ communication skills in EDs was reported to be poor from the perspective of patients’ companions (36.74 ± 7.3). In addition, the results obtained from the BAI indicated that most family members (75.3%) had a mild anxiety level, whereas 18% and 6.8% of them had moderate and severe anxiety levels, respectively. Furthermore, the total anxiety score of the companions was estimated at 13.25 ± 14.16, which demonstrated their low anxiety level. Pearson’s correlation coefficient results were indicative of no significant relationship between nurses’ communication skills and their dimensions with anxiety levels in patients’ family members. In addition, the analysis of patients’ family members’ anxiety based on demographic characteristics showed a significant relationship between anxiety and level of education (P=0.039), economic status (P=0.033), and kinship (P=0.001). Moreover, the mean anxiety score was significantly higher in children of patients, compared to spouses (P=0.008). Furthermore, there was a significant relationship between the triage level of patients and the anxiety level of companions of patients (P<0.001). In addition, anxiety was significantly lower in family members of patients with a triage level of three and higher, compared to patients with a triage level of one (P=0.012) and two (P<0.001).
Conclusion: According to the results, nurses had unfavorable communication skills from the perspective of patients’ family members. In addition, a mild anxiety level was observed in most family members of emergency patients. Despite a lack of a significant relationship between the anxiety of family members and their views on nurses’ communication skills, it seems that the poor communication skills of nurses from the perspective of the patient's family member need special attention. As the first service providers that clients encounter, nurses are responsible for the perception of family members of patients about healthcare services. Therefore, it seems necessary to more focus on factors affecting the effective communication between nurses and companions of patients in hospitals. In addition, attempts should be made to remove or reduce communication issues through proper plans and measures. The results of the present study can be used to plan for improving nurses’ communication skills by designing and implementing in-service training or other incentive mechanisms to increase nurses' communication skills as well as managing the anxiety of patients and their companions.