RAJIVGANDHIUNIVERSITY OF HEALTH SCIENCES, KARNATAKA,BANGALORE
ANNEXURE-II
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATIONS
1 / Name of the candidate and address (in block letters) / Mr.SYED IMRAN1 YEAR M.Sc NURSING
FATHER MULLER COLLEGE OF NURSING
MANGALORE-575002
2 / Name of the Institution / FATHER MULLER COLLEGE OF NURSING
KANKANADY
MANGALORE – 575002.
3 / Course of study and subject / M.Sc. NURSING
PSYCHIATRIC NURSING
4 / Date of admission to course / 16th MAY 2008
5 / Title of the topic:
“EVALUATION OF COMMUNICATION SKILLS TRAINING PROGRAM FOR NURSING STUDENTS TO DEVELOP SUPPORTIVE WARD ATMOSPHERE DURING CARE OF PATIENTS WITH CANCER IN A SELECTED HOSPITAL AT MANGALORE”.
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8 / Brief Resume of the Intended Work
6.1 Need for the Study
The knowledge, Behaviors, and Attitudes that facilitate effective professional performance and mastery of tasks are collectively called professional skill. Effective communication skills are the most important tools with which health care professionals can transfer knowledge in to implementation. Communication skills are one of the fundamental elements in the daily performance of nurses and other health care professionals1.
A study conducted by the Department of Nursing and Health Sciences, The Hong Kong Polytechnic University,i.e.Assessing nursing student’s basic communication and interviewing skills: the development and testing of a rating scale. The instrument proved to be a reliable and valid means of assessing student Communication technique as well as a flexible educational tool2.
Communication is a major concern for individuals living with cancer. Cancer is a complicated illness, one that for many years has been incurable. Cancer meant death. It was hidden from the surrounding social environment, because when it was announced that a person hadCancer the patient was often unconsciously excluded from the life3.
A study shows many nurses acknowledge that their nursing practice is hampered by inadequate teaching about communication skills during their nursing education. Ineffective communication has negative effects on patient care and causes stress when nurses interact with each other, with medical colleagues, with patients and their relatives4.
Communication in oncology nursing is a complex and multifaceted process. Effective communication is important to patients with cancer, many of the nurses daily activities require communication skills to support patient’s feelings, emotions, anxieties and their relatives to deal with uncertainties and fear of death and dying. Nurses and nursing students should have good communication skills to support the patients with cancer when they will be admitted in the ward. So the effective communication skills will help the students to provide a good atmosphere in the ward which can be perceived by the patients.
Keeping in view of the above findings in literature the inadequate communication skills of the nurses can beConsidered as a communication problem, which directly affects the cancer patients.
After doing extensive review regardingcommunication skills training program for the nursing profession and by the personal experience of investigator in this field highlighted that communication skills must needed for the nursing students while caring for patients with specific problem like Cancer.
6.2 Review of literature
A quasi experimental study conducted by cancer hospital of Chinese academy of medical sciences,Beijing,China in 2002 on evaluation of communication skills training program for nurses in cancer care. A non equivalent group was used with sample size of 129. An integrated communication skills trainingmodel (ICSTM) developed by Parle et all-in 1997 was used to guide the development of the study. Inthis model, the ICSTP was developed as a learner-centered program, incorporating cognitive, affective, and behavioral components, as well as managerial support. It consists of two sections. One was intensive learning in a big group, which was a 3 day course over a 3-week period. The teaching methods include a lecture, a video demonstration, question and discussion, and a video review. Theresults show that there was continued significantImprovement in the overall basic communication skills, selfefficacy, outcome expectancy beliefs, andperceived support in the training group. No significant improvement was found in the control group over the same period5.
The qualitative study conducted by Scottishuniversity, Scotland on communication with terminally ill cancer patients and their families.33 student nurses was taken for the study. Eligible students were those in the 4th year of their undergraduate course. A semi-structured interview consisting of seven prompt questions was used to facilitate in depth exploration of the students perceptions of their experience of working with terminally ill cancer patients and their families. The findings revealed that communicating with terminally ill and dying cancer patients in the acute setting is difficult for student nurses and issue about death and dying tended to be ignored6.
A study conducted by department of psychiatry and behavioralsciences, royal free and UCL medical school, london, UK on the essence of cancer care: the impact of training on nurse’s ability to communicate effectively. The purpose of the study to evaluate a communication skills program to 308 cancer Nurses as part of degree/diploma courses. The method used was audiotape nursing assessment with patients was undertaken before and after the course. The results were mean posts course score by 5.9 points (p<0.001) to16.3 (out of a possible 27).this study has demonstrated that an integrated approach to communication skills training has the potential to improve nurses skills, particularly in emotionally laden areas across the spectrum of roles in cancer care7.
A study conducted by Health Research unit, University of Southampton,Highfield,Southampton on Creating and Maintaining Optimism in cancer care communication. This study investigates nurse-patient communication in cancer care context. Interviews with nurses and patients about their communication experiences and audio-recorded nurse-patient conversation were collected and analysed.Nurse-patient interactions were examined in four locations where patients with cancer received in and out-patient radiotherapy and/or chemotherapy. data collection was by audio-tape recording nurse-patient interaction between eight nurses and nine of their patients,totalling 266 minutes of conversation.semiparticipant observation of the day-to-day hospital communication process was performed over 412hr and 56 interviews about communication experiences were held with 50 participants(patients n=26,nurses n=22, relatives n=2).A consistent feature of nurse-patientCommunication and accounts of conversations investigated concerned the optimistic, hopeful nature of the talk and the ward atmosphere8.
A study conducted by Netherlands Institute for Health Services Research,Utrecht,The Netherlands on communication between nurses and simulated patients with cancer: evaluation of a communication training program. In this study the effect of a communication training program on the instrumental and affective communication skills employed by ward nurses during the admittance interview with recently diagnosed cancer patients was investigated. The training focused on teaching nurses skills to discuss and handle patient emotions. For this purpose, 46 nurses participated in 92 videotaped admittance interviews with simulated patients. The study had a randomized pre-test-post-test design.multi-level analysis was used to measure the effects of the training. The results revealed that the trained nurses significantly increased asking open-ended psychosocial questions, which indicate that they were actively exploring patient’s feelings.furthermore, the patients showed a significant increase in affective communication. Inconclusion, the results of this study demonstrate that, althoughlimited; training can induce favorable changes in the communication skills of nurses, and Can even affect patient communication9.
6.3 Statement of the Problem
EVALUATION OF COMMUNICATION SKILLS TRAINING PROGRAM FOR NURSING STUDENTS TO DEVELOPSUPPORTIVE WARD ATMOSPHERE DURING THE CARE OF PATIENTS WITH CANCER IN A SELECTED HOSPITAL AT MANGALORE.
6.4 Objectives of the Study
- To assess the pre and post program communication skills among nursing students.
- To assess the level of supportive ward atmosphere before and after the training program.
- To find out the association between pre-test communication skills and the selected demographic variables.
Evaluation
In this study, it refers to the extent to which the communication skills training program has brought change in the ward atmosphere as perceived by patients with cancer.
Communication Skills Training Program
In this study. it refers to the time bound intensive training program regarding communication skills which includes,
- The Basic Communication Skills
- Cancer Communication Skills which mainly focuses on,
- self-efficacy in oncology-specific communication skills
- Communication outcome expectancies
- Self-perceived support for communication
Patients with cancer
In this study, patients with cancer refers to the patients suffering from any type of cancer, getting treatment and admitted in the selected ward of Father Muller Medical College Hospital.
Nursing students
In this study, Nursing students are refers to 2nd year Basic Bsc Nursing,3rd year Basic Bsc Nursing, and 1st year Post Certificate Bsc Nursing students of Father Muller College of Nursing, Mangalore.
Ward Atmosphere
In this study, it refers to the physical setting of the ward like architecture, colour, chair, table, window, curtain etc including nursing students communicating with the patient.
Supportive Ward Atmosphere
In this study, it refers to the perceived changes in the ward atmosphere assessed by the patients after effective communication with the nursing students undergone Communication Skills Training Program.
6.6 Assumptions
- Therapeutic Communication is a Process.
- Patients with cancer are a special group of clients need special care.
- Study will be conducted according to the students posting.
- Study will be delimited to Female Nursing Students only.
H1: The mean post-test program score of communication skills will be significantly higher than the mean pre-test program score.
H2:There will be significant association between the CommunicationSkills and the selected demographic variables such as age, sex, educationlevel, and years in nursing, ward posting hours.
Material and Methods
7.1 Source of Data
Students of 2nd year Basic Bsc Nursing, 3rd year Basic Bsc Nursing, 1st year Post Certificate Bsc Nursing during their clinical postings in Cancer ward of Father Muller College of Nursing, Mangalore.
7.1.1 Research Design
Evaluative approach
Pre experimental one group pre-test-post-test design
7.1.2 Setting
Study will be conducted in a selected ward of Father Muller Medical College Hospital, Mangalore, is a teaching hospital with 1050 bed strength and it is having a separate oncology department where patients with cancer are getting treatment in both out-patient and in-patient facility, and the patients those who are getting admit to the hospital will be staying in a selected ward.
7.1.3 Population
Students studying 2nd year Basic Bsc Nursing, 3rd year Basic Bsc Nursing, 1st year Post Certificate Bsc Nursing in Father Muller College of Nursing, Mangalore.total population is 191 Female Nursing Students.
7.2 Methods of data collection
7.2.1 Sampling Procedure
Systematic Random Sampling
7.2.2 Sample Size
50 Female Nursing students
7.2.3 Inclusion Criteria
- Students studying in the Father Muller College of Nursing
- Students studying 2nd year Basic Bsc Nursing,3rd year Basic Bsc Nursing,1st year Post Certificate Bsc Nursing
- Students those who are interested to participate in the study
- Students from the other nursing institutions.
- Students who will be taking care of patients other than patients with cancer during the study.
1. Baseline Proforma
2. Nurses Basic Communication Skills Scale(NBCSS)
3. Patients Perceived Ward Atmosphere Questionnaire
7.2.6 Data collection method
The investigator will obtain permission from the concerned authority of the Hospital and from the Oncology centre. Informed consent willbe taken from the nursing students and from the patientswith Cancer. The investigator will administer the Nurses Basic Communication Skills Scale (NBCSS) to assess the score before giving communication skills training to the nursing students, and the investigator will be administering the Patient Perceived Ward Atmosphere Questionnaire to the patients with Cancer to assess the level of supportive ward atmosphere before communicating with the trained nursing students. After that, investigator will be administering the Communication Skills Training program to the nursing students. Then the investigator will administer the Patient Perceived Ward Atmosphere Questionnaire to the patients with Cancer to assess the level of Supportive Ward Atmosphere after they communicate with the trained nursing students.
7.2.7 Data analysis plan
Descriptive statistics
Collected data will be analyzed by descriptive statistics such as mean, standard deviation, frequencies and percentages.
Inferential statistics
To evaluate the communication skills training for the nursing students by using Paired‘t’test and χ2 for finding the association between the pre-test communication skills and selected demographic variables.
The results will be presented by frequency table, diagrams and graphs.
7.3 Does the study require any investigation/interventions to be conducted on patients or the human or animals? If so please describe briefly.
Yes, the investigator will administer the communication skills training program to the students.
7.4 Has ethical clearance been obtained from your institution in case of 7.3?
Yes. ethical clearance has been obtained from the ethical committee and consent will be obtained from the nursing students and from the patients with Cancer
List of References:
- Usteen B.Communication Skills Training as Part of Problem-Based Learning Curriculum. Educational Innovation 2006;45(10):421-24
- Arthur D. Assessing Nursing Students Basic Communication and Interviewing Skills: The Development and Testing of Rating Scale. J Adv Nurs 1999;29(3):658-65
- Georgaki S,Kalaidopoulou O,Liarmakapoulos L,Mystakidou K. Nurses Attitudes towards Truthful Communication with Patients with Cancer. Cancer Nurs 2002;25(6):436-41
- Fallowfield L, Saul J, Gilligan B.Teaching Senior Nurses How to Teach Communication Skills in Oncology. Cancer nurs2001;24(3):185-91
- Liu JE, Mok E, Wong T, Xue L, Xue B. Evaluation of an Integrated Communication Skills Training Program for nurses in Cancer Care in Beijing, China. J Nurs Res 2007;56(3):202-09
- Hjorleifsdottir E, Carter DE. Communicating with Terminally ill Cancer Patients and their Families. Nurse Educ Today 2000;20:646-53
- Wilkinson SM, Gambles M, Roberts A. The Essence of Cancer Care: The Impact of Training on Nurses ability to Communicate Effectively. JAdv Nurs 2002;40(6):731-3
- JarrettNJ, Payne SA.Creating and Maintaining ‘Optimism’ in Cancer Care Communication. Int J Nurs Stud2000;37:81-90
- Kruijver IPM, Kerkstra A, Kerssens JJ. Communication between Nurses and Simulated Patients with Cancer: Evaluation of a Communication Training
- National Breast Cancer Centre and National Cancer Control Initiative. Clinical Practice Guidelines for the psychosocial care of adults with Cancer [online]. 2003 [cited 2003 April 10];[219]. Available from: URL:
9 / Signature of the candidate
10 / Remarks of the guide
11 / Name & Designation of
(in block letters)
11.1 Guide / MRS.CHANU BHATTACHARYA M.SC. (N)
PROFESSOR
PSYCHIATRIC NURSING
FATHER MULLER COLLEGE OF NURSING
MANGALORE
11.2 Signature
11.3 Co-guide (if any)
11.4 Signature
12 / 12.1 Head of the Department / MRS.CHANU BHATTACHARYA M.SC. (N)
HEAD OF THE DEPARTMENT
PSYCHIATRIC NURSING
FATHER MULLER COLLEGE OF NURSING
MANGALORE
12.2 Signature
13 / 13.1 Remarks of the Chairman and Principal
13.2 Signature
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