Iran Journal of Nursing

fa ارتباط اضطراب اعضای خانواده بیماران مراجعه کننده به بخش‌های اورژانس با دیدگاه آنان در مورد مهارت‌های ارتباطی پرستاران 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 پرستاری nursing پژوهشي Research <div style="text-align: justify;">زمینه و هدف: بستری شدن یکی از اعضای خانواده در بیمارستان به ویژه در بخش اورژانس باعث ایجاد اضطراب و مشکلات روحی و روانی در دیگر اعضای خانوده می‌شود. نحوه تعامل پرستاران با بیمار و همراهان ایشان می‌تواند نقش مهمی در کنترل و مدیریت اضطراب آنان داشته باشد. این مطالعه با هدف تعیین ارتباط اضطراب عضو خانواده بیماران مراجعه کننده به بخش‌های اورژانس با دیدگاه آنان در مورد مهارت‌های ارتباطی پرستاران انجام شد. روش بررسی: پژوهش حاضر یک مطالعه مقطعی از نوع توصیفی- همبستگی بود که بر روی 263 نفر از اعضای خانواده بیماران مراجعه کننده به بخش اورژانس دو مرکز آموزشی درمانی منتخب وابسته به دانشگاه علوم پزشکی ایران انجام شد. نمونه‌ها به روش مستمر در سال 1398 بر اساس معیارهای ورود به مطالعه انتخاب شدند. اطلاعات با استفاده از پرسشنامه ارتباطات سلامت (HCCQ) و پرسشنامه اضطراب Beck (BAI) جمع آوری شد. برای تجزیه و تحلیل داده‌ها از ضریب همبستگی پیرسون، آزمون‌های تی مستقل، آنالیز واریانس و کروسکال والیس در سطح معنی‌داری 05/0 استفاده شد. داده‌ها با استفاده از نرم افزار آماری  SPSSنسخه 22 تجزیه و تحلیل شد. یافته‌ها: میانگین نمره مهارت ارتباطی پرستاران بخش اورژانس از دیدگاه همراهان بیمار در سطح پایین (74/36 با انحراف معیار 3/7) بود. 3/75 درصد از همراهان بیمار اضطراب در سطح خفیف داشتند. بین مهارت ارتباطی پرستاران و حیطه‌های آن با اضطراب همراهان بیمار همبستگی معنی‌دار آماری وجود نداشت. اضطراب همراهان بیمار با سطح تحصیلی (039/0P=) ، وضعیت اقتصادی (033/0P =) و نسبت خانوادگی آنان با بیمار (001/0P =) ارتباط معنی‌دار آماری داشت. همچنین میانگین نمره اضطراب در فرزندان به طور معنی‌داری بالاتر از همسران بیماران بود (008/0P =). سطح تریاژ بیمار نیز با اضطراب همراهان بیمار ارتباط معنی‌دار آماری داشت (001/0P <). نتیجه‌گیری کلی: اغلب اعضای خانواده بیماران مراجعه کننده به اورژانس، اضطراب خفیفی را تجربه کردند. همچنین از دیدگاه آن‌ها مهارت ارتباطی پرستاران اورژانس در سطح ضعیف بود. با وجود آن که ارتباط معنی‌دار آماری بین اضطراب عضو خانواده بیمار و دیدگاه آنان درباره مهارت ارتباطی پرستاران در این مطالعه یافت نشد، به نظر می‌رسد ضعیف بودن مهارت ارتباطی پرستاران از دیدگاه عضو خانواده بیمار نیاز به توجه ویژه دارد. نتایج پژوهش حاضر می‌تواند زمینه‌های لازم را جهت برنامه ریزی برای بهبود مهارت‌های ارتباطی پرستاران و همچنین کنترل اضطراب مراقبین بیمار از طریق آموزش‌های ضمن خدمت و یا سایر مکانیسم‌های تشویقی فراهم کند.</div> <div style="text-align: justify;">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.  </div> اضطراب, خانواده, بخش اورژانس, مهارت ارتباطی, پرستار Anxiety, Family, Emergency Department, Communication Skills, Nurses 87 98 http://ijn.iums.ac.ir/browse.php?a_code=A-10-2284-2&slc_lang=fa&sid=1 M Seyedoshohadaee مهناز سیدالشهدایی 10800319475328460025075 10800319475328460025075 No Instructor, Nursing Care Research Center, Department in Internal-Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran مربی، مرکز تحقیقات مراقبت‌های پرستاری، گروه داخلی جراحی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ایران، تهران، ایران M Ahmadi مینا احمدی 10800319475328460025076 10800319475328460025076 Yes MS in Emergency Department Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran (*Corresponding author) Tel: 09224501760 Email: mina.ahmadi3388@gmail.com‏ کارشناسی ارشد پرستاری اورژانس، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ایران، تهران، ایران (نویسنده مسئول) شماره تماس: 09224501760 Email: mina.ahmadi3388@gmail.com‌ H Haghani حمید حقانی 10800319475328460025077 10800319475328460025077 No Instructor, Department of Biostatistics, School of Health, Iran University of Medical Sciences, Tehran, Iran مربی، گروه آمار زیستی، دانشکده بهداشت، دانشگاه علوم پزشکی ایران، تهران، ایران