Running head:

LITERATURE REVIEW

Literature Review

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Literature Review

If not addressed properly, challenging behaviors can destroy therapeutic interactions.

While medicine, environmental design, and human resources are all necessary for the
management of deviant behavior, communication skills is also critical. The patient becomes a
more enthusiastic participant in the process when there is improved relation in communication.
Both patients and healthcare personnel might benefit from employee training that concentrates
on effective communication. The purpose of this work is to examine the empirical findings from
available communication development and coaching programs that are solely or partially focused
on reducing patient hostility.

Obstacles to Patient-based Care and Communication

Large components of the health sector are nurses, and their activities can have a
significant impact on patient outcomes (both positive and negative). Nurses devote a significant
amount of time to patients and their relatives. As a consequence, positive relationships between
nurses and patients and caregivers are beneficial and an essential part of care (Lijun Kang et al.,
2020). In conjunction to their core care responsibilities, nurses frequently act as interpreters or
advocacy for patients. Regardless of the fact that good nurse-patient relations promote nurse-
patient interaction and understanding, evidence has revealed that some variables suffocate these
ties, with major repercussions for care results and satisfaction. As a consequence, these
roadblocks make it difficult for healthcare practitioners to provide treatment that fulfills the
needs of patients and doctors. There are two types of impediments to patient-based care and
communication: organizational and nursing system-related, and communication-related. Despite
the fact that these limitations are mentioned in distinct subheadings, they are intricately
interrelated in clinical practice.

Barriers in the Healthcare System and in the Institutions

Many of the obstacles to delivering patient-based care and communicating when nurse-
patient encounters are caused by institutional procedures or the healthcare system itself. A few of
these elements are linked to healthcare reform, as well as managerial methods and techniques.
One important organizational and healthcare system-level impediments to efficient healthcare
provision are shortage of nursing personnel, excessive workload, fatigue, and restricted time.
“Nurses in an Iranian critical care unit were unable to spend enough time with patients and their
caretakers due to a staffing deficit. Nurse staffing shortages combined with a heavy workload
resulted in fewer contact among nurses, patients, and attendants. Likewise, in Iran, a tremendous
nursing workload is cited as the most significant barrier to therapeutic communication in nurse-
patient encounters” (Abukari Kwame et al., 2021).

Obstacles to Communication
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Delivering patient-based care necessitates effective relation in communicating. Lack of

communication between caregivers and patients and their caregivers has been proven to impair
quality care results and impressions of quality of care in studies. Communication breakdown is a
common communication obstacle in nurse-patient interactions, leading to misconceptions among
nurses, patients, and their relatives. “Language obstacles between patients and healthcare
professionals, ineffective communication, and patients' incapacity to communicate owing to their
health status, particularly in ICU, dementia, or end-of-life care settings, are all examples of
communication hurdles” (Gillian Rayner etal., 2018). Conversations among nurses/midwives and
pregnant moms is substantially hampered by communication difficulties. Despite the fact that
several nurses are courteous and speak well, certain caregivers have difficulty talking with
patients in a manner that they comprehend, which limits their capacity to connect successfully
with patients.

Patient-based care and communication enablers

Building strong nurse-patient connections is one method to make patient-based care and
communication easier. “Addressing suitable communication hurdles in the nurse-patient
interaction is an important enabler of patient-centered communication in healthcare. Clinicians,
patients, caregivers, nursing supervisors, and hospital administration must make sure that
successful therapeutic interaction is achieved in the process of care and becomes part of the
treatment itself, given the significance of effective interaction in healthcare provision. Attentive
listening among care professionals has been proven in studies to be critical in overcoming
significant obstacles to patient-centered therapeutic communication” (Elicia L.Kunst et al.,
2017). Even if it is vital to complete medical chores as quickly as possible during the treatment
plan, the potential of attentive learning is equally important, significant, and healing. Nurses can
detect patients' care requirements and desires, as well as their worries and disappointments, by
listening attentively to their concerns.

Acknowledging patients and their individual needs, demonstrating compassion and

attentive perspectives, exhibiting love and tolerance, and addressing patients and caregivers with
humility and care as people are all facilitators of patient-centered treatment. Attendance is a
patient-centered care approach that requires nurses to show that they are available and willing to
hear to patients. Given the huge pressure, it is essential for nursing professionals to demonstrate
authenticity and empathy (Maria Baby et al., 2018). Compassion, attentive listening, respect, and
addressing patients with dignity are all important aspects of healthcare and treatment, as stated in
the “Code of Ethics for Nurses” and stressed even more in the ongoing reform of the “Code of
Ethics for Nurses.”

Another enabler of patient-centered management and treatment is including patients and

healthcare professionals in the treatment process by sharing details, soliciting their opinions, and
working with them. Disagreement and prejudices are reduced when patients and nurses are
involved in the treatment plan. Patients and caregivers have a better understanding of their health
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issues and the treatment they require when details are shared. To improve patient-centered care,
honest dialogue between care professionals and patients and their relatives is critical. Whenever
patients or their relatives are refused information or participation in the treatment process,
disputes happen.
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References

Abukari Kwame et al. (2021). A literature-based study of patient-centered care and

communication in nurse-patient interactions: barriers, facilitators, and the way forward.
BMC Nursing. Retrieved from:
https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-021-00684-2

Elicia L.Kunst et al. (2017). Using simulation to improve the capability of undergraduate nursing
students in mental health care. Science Direct, 29-35. Retrieved from:
https://www.sciencedirect.com/science/article/abs/pii/S0260691716303082

Gillian Rayner etal. (2018). Emergency department nurse's attitudes towards patients who self-
harm: A meta-analysis. International Journal of Mental Health Nursing. Retrieved from:
https://onlinelibrary.wiley.com/doi/abs/10.1111/inm.12550

Lijun Kang et al. (2020). Impact on mental health and perceptions of psychological care among
medical and nursing staff in Wuhan during the 2019 novel coronavirus disease outbreak:
A cross-sectional study. Science Direct, 11-17. Retrieved from:
https://www.sciencedirect.com/science/article/pii/S0889159120303482

Maria Baby et al. (2018). Communication skills training in the management of patient aggression
and violence in healthcare. Science Direct. Retrieved from:
https://www.sciencedirect.com/science/article/abs/pii/S1359178916301288