Journal List > J Korean Acad Nurs > v.40(1) > 1002685

TOOLS
Kim: Nurse-Patient Interaction Patterns and Patient Satisfaction in the Emergency Department
Original Article
Journal of Korean Academy of Nursing

Journal of Korean Academy of Nursing 2010; 40(1): 99-109.

Published online: 28 February 2010

DOI: https://doi.org/10.4040/jkan.2010.40.1.99

Nurse-Patient Interaction Patterns and Patient Satisfaction in the Emergency Department

Eun Jung Kim

Full-time Lecturer, College of Nursing, Eulji University, Seongnam, Korea.

Address reprint requests to: Kim, Eun Jung. College of Nursing, Eulji University, 212 Yangji-dong, Sujeong-gu, Seongnam 461-713, Korea. Tel: 82-31-740-7398, Fax: 82-31-740-7359, nicemuse@hanmail.net

Received 18 August 2009       Accepted 4 February 2010

Copyright © 2010 Korean Society of Nursing Science

Abstract

Purpose

The purpose of this study was to identify effective nurse interaction patterns with patients in the emergency department.

Methods

For this study, video technology was used to record complete conversations between the nurse and patient. The participants were 28 nurses and 63 patients in the emergency department at one university hospital located in Seoul. The data were collected from November, 2002 to April, 2003. The video recordings were observed for 4 hr for each case and coded using an adapted version of Roter's Interaction Analysis System (RIAS). The data were analyzed using cluster analysis to identify the patterns of nurse-patient interaction.

Results

Cluster analysis revealed 4 distinct nurse interaction patterns; 1) "closed" characterized by orientation and negative talk, 2) "positive" characterized by positive affective talk, 3) "informative and directing" characterized by task-focused behavior including data gathering, and giving information about medical condition and treatment, 4) "facilitative" characterized by balance of psychosocial and biomedical topics. Patient satisfaction was highest in the facilitative interaction pattern.

Conclusion

The patient centered interaction pattern, balancing information exchange and psychosocial exchange are the most effective interactions in the emergency department, suggesting that effective interaction skill is a core clinical nursing intervention in acute care.

Keywords: Emergency nursing, Interaction, Patient satisfaction, Cluster analysis

Figures and Tables

Table 1
Emergency Nurse-Patient Interaction Analysis System
jkan-40-99-i001
Table 2
Percentage of Nurse Interaction Behavior Categories according to the Interaction Pattern of Nurses (N=2,315)
jkan-40-99-i002

*Scheffe's test.

Table 3
Percentage of Patient Interaction Behavior Categories according to the Interaction Pattern of Nurses (N=1,297)
jkan-40-99-i003

*Scheffe's test.

Table 4
Patient Satisfaction with Interaction (N=63)
jkan-40-99-i004

*Scheffe's test; †the inverse value.

Notes

This article is based on a part of the author's doctoral dissertation from Yonsei University and the secondary analysis of previous study.

References

1. Bottorff JL, Morse JM. Identifying types of attending: Patterns of nurses' work. Journal of Nursing Scholarship. 1994. 26:53–60.
2. Bowles N, Mackintosh C, Torn A. Nurses' communication skills: An evaluation of the impact of solution-focused communication training. Journal of Advanced Nursing. 2001. 36:347–354.
3. Caris-Verhallen WM, Gruijter IM, Kerkstra A, Bensing JM. Factors related to nurse communication with elderly people. Journal of Advanced Nursing. 1999. 30:1106–1117.
4. Caris-Verhallen WM, Kerkstra A, Heijden PG, Bensing JM. Nurse-elderly patient communication in home care and institutional care: An explorative study. International Journal of Nursing Studies. 1998. 35:95–108.
5. Chang SO, Park J. The study on the communication barrier for nurses in clinical settings. Journal of Korean Academy of Fundamentals Nursing. 1999. 6:130–140.
6. Eleanor H, Cheung YK, Cheung SW, Luk FS, Wong WW. A Chinese cultural perspective of nursing care behaviors in an acute setting. Journal of Advanced Nursing. 1998. 28:1289–1294.
7. Hall JA, Irish JT, Roter DL, Ehrlish CM, Miller LH. Satisfaction, gender, and communication in medical visit. Medical Care. 1994. 32:1216–1231.
8. Hawley MP. Nurse comforting strategies: Perceptions of emergency department patients. Clinical Nursing Research. 2000. 9:441–459.
9. Hewison A. Nurses' power in interactions with patients. Journal of Advanced Nursing. 1995. 21:75–82.
10. Jarrett N, Payne S. A selective review of the literature on nurse-patient communication: Has the patient's contribution been neglected? Journal of Advanced Nursing. 1995. 22:72–78.
11. Kang BS, Kim KS. Social science statistical analysis. 2001. Seoul: SPSS Academy.
12. Kasch CR, Lisnek PM. Role of strategic communication in nursing theory and research. Advances in Nursing Science. 1984. 7:56–71.
13. Kim DH. Understanding experience of nurses dealing with difficult patients. Journal of Korean Academy of Psychiatric and Mental Health Nursing. 2002. 11:62–77.
14. Kim EJ. The nurse-patient interaction behavior. Journal of Korean Academy of Nursing. 2005. 35:1004–1013.
15. Kim YM, Kols A, Thuo M, Mucheke S, Odallo D. Client-provider communication in family planning: Assessing audiotaped consultations from Kenya, Working Paper Number 5. 1997. Baltimore, MD: Johns Hopkins University, School of Public Health Center for Communication Programs.
16. Kishi KI. Communication patterns of health teaching and information recall. Nursing Research. 1983. 32:230–235.
17. Kruijver IP, Kerkstra A, Bensing JM, Van de Wiel HB. Communication skills of nurses during interactions with simulated cancer patients. Journal of Advanced Nursing. 2001. 34:772–779.
18. Leathart AJ. Communication and socialization (1): An exploratory study and explanation for nurse-patient communication in an ICU. Intensive & Critical Care Nursing. 1994. 10:93–104.
19. Lee DW. A conversational analysis of doctor-patient communication. Korean Journal of Journalism & Communication studies. 2000. 45:232–265.
20. Lee JY, Song MS. The types and perceptions of touch in nurse-elderly patient interactions. Journal of Korean Academy of Adult Nursing. 1998. 10:61–75.
21. Lim SL. Marital communication and marital satisfaction: The effect of gender, demanding status difference, and personality. 1998. Seoul: Korea University;Unpublished master's thesis.
22. Morse JM, Havens GA, Wilson S. The comforting interaction: Developing a model of nurse-patient relationship. Scholarly Inquiry for Nursing Practice. 1997. 11:321–340.
23. Park JW. The experiences of psychiatric patients about nurses' nonverbal communication behaviors in interpersonal relationship. Journal of Korean Academy of Psychiatric and Mental Health Nursing. 2000. 9:35–43.
24. Roter D. The Roter method of interaction process analysis. 1997. Baltimore, MD: The Johns Hopkins University, School of Hygiene and Public Health, Department of Health Policy and Management.
25. Roter D, Hall J. Physician's interviewing styles and medical information obtained from patients. Journal of General Internal Medicine. 1987. 2:325–329.
26. Roter D, Hall J, Merisca R, Bordstrom B, Cretin D, Svarstad B. Effectiveness of interventions to improve patient compliance: A meta-analysis. Medical Care. 1998. 36:1138–1161.
27. Roter D, Larson S. The Roter interaction analysis system (RIAS): Utility and flexibility for analysis of medical interactions. Patient Education and Counseling. 2002. 46:243–251.
28. Roter D, Stewart M, Putnam SM, Lipkin M, Stile W, Inui TS. Communication patterns of primary care physicians. Journal of the American Medical Association. 1997. 277:350–356.
29. Sandvik M, Eide H, Graugaard PK, Torper J, Finset A. Analyzing medical dialogues: Strength and weakness of Roter's interaction analysis system (RIAS). Patient Education Counseling. 2002. 46:235–241.
30. Shin HS. Analysis of metacommunicative behaviors between nurses and patients in a pediatric unit. 2002. Seoul: Yonsei University;Unpublished doctoral dissertation.
31. Sitzia J, Wood N. Patient satisfaction: A review of issues and concepts. Social Science Medicine. 1997. 45:1829–1843.
32. Sondell K, Soderfeldt B, Palmqvist S. Dentist-patient communication and patient satisfaction in prosthetic dentistry. The International Journal of Prosthodontics. 2002. 15:28–37.
33. Wilkinson S. Factors which influence how nurses communicate with cancer patients. Journal of Advanced Nursing. 1991. 16:677–688.
34. Wilkinson S, Gambles M, Roberts A. The essence of cancer care: The impact of training on nurses' ability to communicate effectively. Journal of Advanced Nursing. 2002. 40:731–738.
TOOLS
Similar articles