There is abundant evidence verifying that patients benefit when nurses communicate better; therefore improving team dynamics will positively impact patient care and improve nurse engagement resulting in many positive outcomes for teams. This applied action research study assessed the research question: “What is the experience of team work and team dynamics among members of a multidisciplinary nursing team from a Licensed Practical Nurse perspective?” The experiences of licensed practical nurses (LPNs) and key external leaders (KELs) are explored and analyzed drawing from current literature in the field of teams in health, organizational culture in health, and transformative learning in health. Historical and leading communication, organizational culture, and leadership theories guide this study. During focus groups and interviews, the researcher and participants were influenced to generate new knowledge and insight on team dynamics, through appreciative inquiry. Manifest and latent content analysis identified key themes within each of the subtopic themes, generating a number of recommendations for future action. Through the identification of similar and unique perspectives between the literature and participants in this study, the action research goals of empowerment and emancipation of team members was dynamically met for research participants. Keywords: nursing; team dynamics; communication; collaboration; culture; leadership

Thesis (M.Info.Tech.-Res.)--University of Wollongong, 2007. / Typescript. Includes bibliographical references.

I was inspired to choose this diploma thesis by reading an article written by an anxious family member of a person suffering from a mental illness. The stigma of a mentally ill patient does not affect only the patient themselves, it also extends to psychiatrists and nursing staff who work with these people, but it also affects their families and close relatives. For them mental illness is a burden from the psychological as well as social perspective; there are changes in family roles, the emotional climate is influenced too. The theoretical part focuses on the cooperation of nurses, families and a multidisciplinary team. It also deals with the personality of the nurse in psychiatric care, psychiatric rehabilitation limitations, communication and education in psychiatry. It also deals with the family of a mentally ill person and forms of support provided to families. The objective of this thesis was to determine whether psychiatric nurses involve families of the mentally ill in nursing care. The secondary objective was to determine whether the families of the mentally ill are aware of all the possibilities of psychiatric treatment in all areas of care. These objectives have been met. A quantitative research, the techniques of a questionnaire and a standardized interview were chosen for this work. The first research set consisted of 212 nurses working in psychiatric care; the second research set consisted of 33 families. Based on the results, it was found that nurses do not have time to educate families during their shifts. The nurses encourage families to participate actively in caring for their relatives and they have no problems in communicating with the families. Furthermore, the results indicate that families do have access to information and they are satisfied with the information from healthcare professionals; families use the information provided in the care of their relatives. Six hypotheses were set to obtain the research objectives, of which 5 hypotheses have been confirmed and a hypothesis has been refuted. This work also included an educational lesson that can help non-medical professionals to orientate in education. An educational lesson on ``Appropriate behaviour of family members of the mentally ill{\crqq}, which can be used in educating families, was prepared for family members.

Este estudo teve como objetivo caracterizar referenciais de competências comunicativas interpessoais e propor bases teórico-metodológicas para o aprendizado da comunicação interpessoal no ensino da Enfermagem. Abordando questões norteadoras sobre competência em comunicação interpessoal, utilizou-se referencial teórico de comunicação e método de análise de conteúdo em 13 discursos de professores de Enfermagem, especialistas em comunicação. Os resultados obtidos representam que a competência em comunicação é um processo interpessoal que deve atingir o objetivo dos comunicadores, pressupor conhecimentos básicos de comunicação, ter consciência do verbal e do não-verbal nas interações, atuar com clareza e objetividade, promover o autoconhecimento e, conseqüentemente, ter a possibilidade de uma vida mais autêntica. Os sujeitos relatam que a expressão da competência comunicativa está, necessariamente, no vivenciar o cotidiano profissional e pessoal, ouvindo o outro, prestando atenção na comunicação não-verbal, validando a compreensão das mensagens, sendo capaz de eliminar as barreiras impostas à comunicação, demonstrando afetividade e investindo no autoconhecimento. O desenvolvimento da competência comunicativa verifica-se pelo estímulo recebido desde a graduação, pelas leituras de aprofundamento do tema, pela prática profissional e realização de pesquisas e publicações na área. O ganho alcançado com a competência em comunicação interpessoal resulta em relações profissionais e pessoais mais significativas, maior autoconsciência e aceitação das diferenças do outro, ampliação dos caminhos do ensino e da pesquisa e conquista de um bem-estar. Os teóricos mais citados como referenciais, pelos sujeitos do estudo, foram: Stefanelli MC., Silva MJP., Travelbee J., Littlejohn SW., Davis F., Rogers CR., Sullivan HS., Ruesch J., Peplau HE., Bales RF. e Moscovici F. As bases metodológicas propostas para o aprendizado e ensino da comunicação interpessoal em Enfermagem, são: assumir a comunicação como base para o cuidar, ensinar os fundamentos teóricos da comunicação no início da graduação, desenvolver a competência de todos os professores em comunicação, vincular a prática assistencial com o ensino da comunicação, acompanhar a progressão da competência comunicativa no aluno e vivenciar a comunicação efetiva com as pessoas na escola. Os resultados que emergiram deste estudo permitem considerar a competência em comunicação interpessoal, como uma habilidade fundamental a ser adquirida pelo enfermeiro, sabendo que esta lhe possibilitará um cuidar consciente, verdadeiro e transformador. / This study aimed at characterizing references of interpersonal communicative competence and proposing theoretical methodological bases for interpersonal communication learning on nursing teaching. Through guiding questions about competence on interpersonal communication, the theoretical reference of communication and the method of the content analysis in thirteen communication expert nursing teachers’ speeches were used. The results show that competence in communication is an interpersonal process which must reach the communicator’s objectives, require basic knowledge of communication, have verbal and non-verbal perception in the interactions, act clearly and objectively, develop self-knowledge and, therefore lead to the possibility of a more legitimate life. The subjects report that the communicative competence expression is necessarily, in the living of the professional and personal every day life, listening to the other, perceiving nonverbal communication, validating the message understanding, being able to break communication barriers, showing affection and developing self-knowledge. The development of a communicative competence has been reached by the stimulus received since the undergraduation course, by reading deeply the theme, by professional practice and by accomplishing research as well as publishing in the field. The benefits originated from competence in interpersonal communication lead to a more significant professional and personal relationship, a better self-knowledge and acceptance of the other’s differences, a widening on ways of teaching and researching as well as an achievement of welfare. The most cited theorists as reference by the study subjects were as follows: Stefanelli MC., Silva MJP., Travelbee J., Littlejohn SW., Davis F., Rogers CR., Sullivan HS., Ruesch J., Peplau HE., Bales RF. E Moscovici F. The target methodological bases for interpersonal communication learning and teaching in nursing are: assuming communication as the basis for caring, teaching the communication theoretical principles in the beginning of the undergraduation course, developing the communication competence of all teachers, linking assistance practice to communication teaching, following the student communicative competence progression and living the effective communication with people in the school. The results coming out from this study allow us to consider competence in interpersonal communication as a major ability to be acquired by the nurse, being aware that it will enable a conscious, true, and transforming care.

M.Cur. (Psychiatric Nursing) / The psychiatric nurse, as a member of the multiprofessional mental health team, utilises a goal directed approach to assist the psychiatric patient to mobilise resources to promote, restore and maintain his mental health as an integral part of his quest for wholeness. This goal directed approach is the nursing process which comprises assessment, planning, implementing and evaluation. All four steps of the nursing process and the nurse's interaction wi th the patient are dependent upon therapeutic communication between the nurse and the patient to elicit the necessary information so as to be able to formulate the nursing diagnosis, nursing actions and the patients' outcomes. Therapeutic communication remains important as the core of all nurse-patient interactions. Lack of therapeutic communication with the patient can cause conflict in the patient's internal and external environments since he will be unable to communicate his needs and problems and this will delay the mental health promotion, restoration and maintenance phases. Currently much attention is paid to the pharmacological treatment of the patient as more and more sophisticated psychotropic drugs are produced, and yet the other aspect of the patient's treatment which is equally important is neglected, namely his communication during hospitalisation, especially with the psychiatric nurse as she is the person in direct contact with him and should spend most of her time interacting with him.

M.Cur. / Please refer to full text to view abstract

No description available.

Indiana University-Purdue University Indianapolis (IUPUI) / Parents have increasingly participated in their children’s bedside care. Parental participation has led to more provider-parent interactions and communication during such stressful events. Helping parents through such stressful events requires nurses to be skilled communicators. Brief methods of training emotion-focused communication with newly licensed nurses are needed, but as yet are rare. The purpose of this study was to evaluate the impact of a validated brief communication (Four Habits Model) training program for newly licensed pediatric nurses. The intervention focused on ways to improve nurses’ emotion-focused conversations with parents. Information processing and Benner’s novice to expert informed this study. The intervention is based on the four habits model, with “habits” providing a structure for nurses to organize their thinking and behavior during emotion-focused conversations with parents. Thirty-five pediatric nurses with 0–24 months of nursing experience at a large mid-western children’s hospital participated in the study. Mixed methods provided data for this experimental study, using a group-by-trials repeated measures ANOVA design. Participants randomized to the intervention group participated in a one-hour three-part training: adapted four habits model content, simulated nurse-parent communication activity, and debrief. Participants randomized to the control group observed a one-hour travel video. Key outcome variables were Preparation, Communication Skills, Relationships, Confidence, Anxiety, and Total Preparation. Compared with the controls, the intervention group improved significantly in the following areas: Preparation, F(1,33) = 28.833, p < .001; Communication Skills, F(1,33) = 9.726, p = .004; Relationships, F(1,33) = 8.337, p = .007; Confidence, F(1,33) = 36.097, p < .001; and Total Preparation, F(1,33) = 47.610, p < .001. Nurses’ experience level had no effect, with the exception of Anxiety. Nurses with more experience (≥ 12 m) showed a greater reduction in Anxiety, when compared to nurses with less experience (< 12 m), F(1,31) = 5.733, p = .023. Fifty-two percent of the nurses involved in the intervention later reported specific examples of implementing the four habits when working with parents in clinical settings. A one-hour four habits communication-training program is effective in improving newly licensed nurses’ preparation for emotion-focused conversations with parents.

Indiana University-Purdue University Indianapolis (IUPUI) / Technology dependent children such as those who require a feeding tube, tracheotomy or ventilator are a special group of chronically ill children who require complex care on a daily basis. When these children are hospitalized, the accompanying parent and the nurse caring for the child on the inpatient unit must communicate together about the care of the child. Care for the technology dependent child is optimized when parents and nurses both understand the plan of care for the child. To discover the process of parent-nurse communication that results in mutual understanding of the child’s plan of care, a grounded theory study to explore the perspectives of the parents of previously hospitalized technology dependent children was undertaken. The Theory of Shared Communication emerged from the data and illuminates the parent-nurse communication process. The antecedents of the process are respect for own and others expertise. The communication process consists of six communication behaviors; ask, listen, explain, advocate, verify understanding and negotiate roles. The behaviors are nested within each other and all are not necessarily required for the non-linear process to result in the relational outcome of mutual understanding of the child’s plan of care. An integrative review of the literature regarding the process of communication between parents of hospitalized chronically ill children and their nurses shed light on the components of the process, but no study was found that explicated the entire communication process. A subsequent grounded theory study added the perspectives of the nurses to the original theory. No new components of the process were uncovered, but the nurse’s narratives added significantly to our understanding of the communication process. Additionally, parents of currently hospitalized technology dependent children confirmed the propositions of the Theory of Shared Communication.

The purpose of this study was to develop and test a measuring instrument based on the Gibb’s Defensive Communication Climate Paradigm (1961) to assess the communication climate focus of professional nurses in selected public hospitals in the Gauteng province. This focus involves the communication behaviour orientation of the professional nurses and their perceptions of the communication behaviour orientation of their operational managers. The Gibb’s model comprises six bipolar conceptual continuums, namely Evaluation-Description, Control-Problem orientation, Strategy-Spontaneity, Neutrality-Empathy, Superiority-Equality and Certainty-Provisionalism Continuums. The study consisted of a non-experimental design, including a developmental phase and a testing phase. During the developmental phase the researcher developed a measuring instrument (a Semantic Differential Scale questionnaire); used a simple, random sample method to pre-test the instrument; analysed the data by applying Cronbach’s Alpha reliability analysis and refined the instrument. Further refinement of this new instrument by future researchers is recommended. During the testing phase the researcher also used a simple, random sample, consisting of professional nurses (N = 270) from three selected public hospitals in Gauteng; tested the items against the biographical data and the three research questions and analysed the obtained data by utilising both descriptive and inferential statistics. A Delphi panel of experts were involved in both phases of the study. The results of the study indicated that although the respondents had a predominantly supportive communication behaviour orientation, they were more focused on the communication behaviour of their operational managers than on their own. Furthermore, the results indicated no significant differences in the influencing factors: age, tenure (periods in hospital), gender, language and institution (public hospital), in terms of the six conceptual continuums. Significant differences were found only in the factor: unit/ward, indicating that the supportiveness of the communication behaviour of professional nurses could be dependent on their specific work environment. Guidelines aimed at the development of a supportive climate were drawn up for the National Department of Health, Gauteng Department of Health, public hospitals, operational managers and professional nurses. It is recommended that implementation of the newly developed guidelines be pivotal for public hospitals, to refocus their communication climates towards supportive communication. / Health Studies / D. Litt. et Phil. (Health Studies)