Patient-centred communication intervention study to evaluate nurse-patient interactions in complex continuing care.
BACKGROUND
Communication impairment is a frequent consequence of stroke. Patients who cannot articulate their needs respond with frustration and agitation, resulting in poor optimization of post-stroke functions. A key component of patient-centred care is the ability of staff to communicate in a way that allows them to understand the patient's needs. We developed a patient-centred communication intervention targeting registered and unregulated nursing staff caring for complex continuing care patients with communication impairments post stroke. Research objectives include 1) examining the effects of the intervention on patients' quality of life, depression, satisfaction with care, and agitation; and (2) examining the extent to which the intervention improves staff's attitudes and knowledge in caring for patients with communication impairments. The intervention builds on a previous pilot study.


METHODS
A quasi-experimental repeated measures non-equivalent control group design in a complex continuing care facility is being used. Patients with a communication impairment post-stroke admitted to the facility are eligible to participate. All staff nurses are eligible. Baseline data are collected from staff and patients. Follow-up will occur at 1 and 3 months post-intervention. Subject recruitment and data collection from 60 patients and 30 staff will take approximately 36 months. The Patient-Centred Communication Intervention consists of three components: (1) development of an individualized patient communication care plan; (2) a one-day workshop focused on communication and behavioural management strategies for nursing staff; and (3) a staff support system. The intervention takes comprehensive patient assessments into account to inform the development of communication and behavioural strategies specifically tailored to each patient.


CONCLUSIONS
The Patient-Centred Communication Intervention will provide staff with strategies to facilitate interactions with patients and to minimize agitation associated with considerable stress. The improvement of these interactions will lead to a reduction of agitation, which has the additional significance of increasing patients' well-being, quality of life, and satisfaction with care.


BACKGROUND
ClinicalTrials.gov Identifier NCT01654029.
Department of Research, Toronto Rehabilitation Institute-UHN, E.W. Bickle Centre for Complex Continuing Care, 130 Dunn Avenue, Toronto, Ontario M6K 2R7, Canada. kathy.mcgilton@uhn.ca
Katherine S
KS
McGilton
Riva
R
Sorin-Peters
Souraya
S
Sidani
Veronique
V
Boscart
Mary
M
Fox
Elizabeth
E
Rochon
D001291:Attitude of Health Personnel; D010054:Brief Psychiatric Rating Scale / Q000592:standards; D003142:Communication; D003266:Continuity of Patient Care / Q000592:standards*; D005069:Evaluation Studies as Topic; D005500:Follow-Up Studies; D006801:Humans; D009723:Nurse-Patient Relations; D018802:Patient-Centered Care / Q000379:methods / Q000592:standards*