Improving Nurses Knowledge regarding to therapeutic Communication by implementing an Educational Program in Al Rashad Psychiatric Teaching Hospital at Baghdad City

 

 

Ihsan W. Yas¹, Saja H. Mohammed²

¹Academic Nurse, College of Nursing, University of Baghdad

²Prof. Dr. PHD in Psychiatric Nursing, Babylon University, College of Nursing, Psychiatric Nursing Department

 

ABSTRACT:

Background: The nurse communicates with the patient in several ways and the most important one is the therapeutic communication and the nurse must learn to do it well. Therapeutic communication in many aspects of nursing used to giving information's, obtaining information from the patient; it’s the important part of the nursing care in the psychiatric hospitals.

Objectives: Assess the nurses’ knowledge in therapeutic communication and evaluate the improving of program.

Methodology: Descriptive study was carried out from 1-5 to 30-11- 2016, the study was conducted in psychiatric teaching hospital (Al-Rashad) in Baghdad city. The sample of the study consisted of 34 nurses working in psychiatric hospital selected according to the criteria of the study sample. A questionnaire was constricted by the researcher. It consist of (64) items. The content validity of the questionnaire was established through penal of 15 experts. Reliability of the study was 83% percentage data was analyzed by Cronbach's alpha.

Result: the highest percent 52.9% for educational level was graduated from secondary nursing school; 44.1% are working for five years, there is a significant result between the pre-test and the posttest.

Conclusion: the study concluded that there is highly significant degree between the pre-test and the posttest lead for a positive improving and developing of nurse’s knowledge about therapeutic communication.

Recommendation: The study is recommended to insert the educational programming the yearly continues learning program.

 

 

 

 

INTRODUCTION:

Nurses provide nursing care services for patients and deal with them for 24 hours, seven days a week, so that they are very precious part in health care system^(1). Nurses in psychiatric hospitals have many kinds of care and role such as actions attempt to prevent illness and promote health ⁽²⁾. The nurse patient relationship is different from other relationships and especially in psychiatric patients ⁽³⁾.

 

The nurse communicates with the patient in several ways and the most important one is the therapeutic communication ⁽⁴⁾. Therapeutic communication in many aspects of nursing used to giving information's, obtaining information from the patient, it’s the biggest part of the nursing care in the psychiatric hospitals, the nurse must be characterized by tactful and the ability to conversation in Psychiatric departments because of unique characteristics of the psychiatric clients or patients those who have a lack of thinking and mental processes, and also reactions ⁽⁵⁾. The communication between the nurse and the client, lead to elevate the relationship and trust between them, according on this basis of principle, the nurse should have a continuous training program to raise the level of knowledge and communication techniques to develop the nursing care and elevate the health levels for patients and society ^{(6, 7)}.

 

OBJECTIVE OF THE STUDY:

The study aims to:

1.      Assess the nurses’ knowledge in therapeutic communication and demographical data.

2.      Evaluate the improving of nurses’ knowledge.

3.      Find out the relationship between some of demographical data and post-test of nurses.

 

METHODOLOGY:

Descriptive design is correlation study used to assess the nurses knowledge about therapeutic communication used with psychiatric patients. The sample of the study consisted of (34) nurses who works in psychiatric hospital in Baghdad city, the main hospital at Al Rusaffa sector is Al-Rashad Psychiatric Teaching Hospitals, during the period of 1^st   of may to 30^ty November2015.

 

A questionnaire was constructed by the researcher for the purpose of the study it consist of three parts: Part 1. Socio-demographic Data sheet: The first part contains information regarding; Gender, age, level of education, total time working in the psychiatric hospitals. Part 2. Nonverbal communication components: This part consisted of 21 items that measure the level of knowledge of nonverbal therapeutic communication among nurses as yes or no for answer. Part III: verbal communication components: This part consisted of 43 items or questions that measure the level of knowledge of verbal therapeutic communication among nurses as yes or no for answer. The total items were (64).

 

The Educational program: The program consist of ten subjects implemented in ten working days from Sunday to Wednesday and one day before two weeks for pre-test and one day after two weeks for post-test, all in all the full program take six weeks to complete.  The educator used different types of teaching style such as role play, brain storming, individual working, and group working. Reliability: The Reliability of the study was determined through the use of Cronbach's Alpha by Alpha correlation coefficient. The result revealed that the reliability was 0.83.

 

Data analysis: Data were analysed through the application of a descriptive statistic is used descriptively by frequency, percentage, summation, and standard deviation. And for differentiate within group the researcher used ANOVA test for data analytic^.

RESULTS:

Table: 1 Demographical data

age	20 or less	11	32.4
	41 and more	11	32.4
Level of education	Secondary or less	18	52.9
Total time working in psychiatric hospitals	5 years or less	15	44.1
Gander	Male	18	52.9

 

Table (1) shows that the highest percent are male in 52.9 % and the same results for educational level whom graduated from secondary nursing school; the total period of nurses working in the psychiatric hospital at 44.1% are worked for five years or less in F (15); the highest number for age are 11 at 32.4% they are in age between 41-50 and same results in age between 20 or less from the participants.

 

Table: 2. Nursing therapeutic communication knowledge for pretest

type	mean	Std. deviation	Mini-mum	Maxi-mum
Verbal communication	12.88	1.950	8	17
Nonverbal communication	26.29	4.261	18	35
Total number of score	39.29	5.173	30	49
Total participant	34	34	34	34

 

Table (2) shows that the pretest for nurses in therapeutic communication knowledge, the result shows in verbal therapeutic communication test the mean is 12.88 and in nonverbal is 26.29 and more in the total score is 39.29. The minimum and maximum score for verbal therapeutic communication are 8 to 17 scores and in nonverbal are 18 to 35 scores, and in the total score are 30 to 49 scores. Standard deviation in seriatim is1.95 in verbal, 4.261 in nonverbal, and in total score for the pretest is 5.173.

 

Table: 3. Nursing therapeutic communication knowledge for post-test

type	mean	Std. deviation	Mini-mum	Maxi-mum
Verbal communication	17.15	2.488	11	21
Nonverbal communication	33.00	5.543	25	58
Total number of score	49.29	5.469	38	61
Total participant	34	34	34	34

 

Table (3) shows that the post test for nurses in therapeutic communication knowledge, the result shows that in verbal therapeutic communication test the mean is 17.15 and in nonverbal is 33 and more in the total score is 49.29. The minimum and maximum score for verbal therapeutic communication are 11 to 21 and in nonverbal are 25 to 58, and in the total score are 38 to 61. Standard deviation is 2.488 in verbal, 5.543 in nonverbal, and in total score is 5.469.

 

Table: 4. Evaluation of nursing therapeutic communication knowledge in pre-posttest:

 

Table (4) shows that the comparison between pre and post test results in therapeutic communication for nurses working in psychiatric hospital. The results show that the mean is 39.29 in the pre-test and in the post-test is 49.29. The minimum score in the pre-test is 30 score but in post-test is 38 score. In the same way the maximum score is 49 score but in the post-test is 61 score. Standard deviation in the pre-test is 5.173 and in the post-test is 5.469.

 

Table: 5. Comparison of mean for pre-posttest ( ANOVA)

Type	Sum of Squares	df	Mean Square	Sig.
Between Groups	360.225	15	24.015	0.764
Within Groups	626.833	18	34.824
Total	987.059	33

 

Table (5) explain the relation between the pre-post-test by ANOVA statistical method to find out the improvement in the nurses knowledge in this study. The summation of squares in between groups is 360.225 and in within groups is 626.833. And the mean of square in between groups was 24.015 and in within groups was 34.824.the significant at 0.764.

 

DISCUSSION:

The finding of the present study show that the majority of participants gander are male at (52.9%). and the educational level for nurses in the study are graduated from secondary nursing school at (52.9%), this findings are supported by Al Rusaffa directory monthly reports and statistic for nurses (unpublished reports) show that the high number of nurses are male and graduated from the secondary nursing school⁽¹⁰⁾. According to the total time spend or working in psychiatric hospital (44.1%) are working for five years or less ;( 32.4%) are in age between (20 years or less) and the same results for age (41-50) years. (Table 1)

 

Table 2 and 3 show that the results of verbal and nonverbal therapeutic communication for nurses in the pre-posttest reveal that the mean of verbal therapeutic communication is 12.88, the nonverbal communication 26.29 and in the total score is 39.29 in the pre-test. The Post-test reveals that the mean of verbal therapeutic communication is 17.15, the nonverbal communication is 33 and in the total score is 49.29.Supported by (1) the novice psychiatric nurses who had worked 19-24 months had stronger communication skills than those working less time with aggressive patients, and the change in the mean for ten scores is an indicating that the nurses got information and knowledge about therapeutic communication.

 

Table 4 and 5 are comparisons between two means to show the improvement in the nurses and that reveals there is a significant difference in the mean in a positive way at 0.764. This finding is supported by many studies such as (6) the study showed that the structured teaching module was effective in improving the knowledge on therapeutic communication among staff nurses and (5) study about the using of simulation way to teaching communication and the finding is used of simulation in teaching nurses and therapeutic communication is an emerging pedagogy with multidisciplinary potential. The impotent of therapeutic communication in nursing field especially in psychiatric hospitals become from improving and development of knowledge and skill so that when the nursing knowledge is improved, the communication level is elevated.

 

CONCLUSION:

The study conclude that:

1-       The majority of nurses are male and graduated from secondary nursing school. And their age are in to categories the first is between 20 years or less and 41-50 years for the second. The nurse’s majority in the study are working five years or less in the psychiatric hospital.

2-      The nurses from psychiatric hospital have an educational program as a workshop to develop and improve therapeutic communication knowledge.

3-      Therapeutic communication improved and knowledge developed for the nurses in the study whom working in psychiatric hospital.

 

RECOMMENDATION:

According to results of the study the researcher recommends the following:

1.      Insert the educational program in the yearly continues learning program in the psychiatric hospitals.

2.      Preparing specialists teachers or trainers to give such as subject.

3.      Farther study to improve the development of communication. 

 

REFERENCES:

1.       Rose Moss. Communication skills of novice psychiatric nurses with aggressive psychiatric patients, Walden University, doctoral study, (2013). 1-3.

2.       Rana A F Al-wamleh. Psychiatric mental health nursing, Almogamaa Alaraby for publish, 1^st edition, (2008).11-41.

3.       Maya George. Teaching and Learning in the Schools of Nursing, A.I.T.B.S. publishers, India, second edition, (2010).193-217.

4.       Palema S. Communication the key to the therapeutic relationship. Philadelphia: F. A. Davis, (2000). 22-42.

5.       Marjorie Hammer, Use of the communication simulation model in pre-licenser psychiatric mantel health nursing: enhancing strengths and transforming challenges. University of Oakland. Nursing and health 2 (1) 2014, 1-8.

6.       Cinar O, AK M, Sutcigil L, Congologlu ED, Canbaz H, Kilic E. et al. Communication skills training for emergency medicine residents. European Journal of Emergency Medicine 2011 no.2, 12-18

7.       Park, E. and Song, M. Communication barriers perceived by older patients and nurses. International Journal of Nursing Studies, 42, (2015). 159-166.

8.       Li Li. and Lambert V. A. Relationship among Nurses’ Communication Skills, Nurses’ Job University, Wuhan, China. Satisfaction and Inpatients’ Satisfaction with Nursing Care in Select Hospitals in Wuhan, China no.2 (2006). 28-31.

 

 

 

 

 

Accepted on 09.05.2017          © RJPT All right reserved