Journal of Public Health

, Volume 17, Issue 5, pp 339–353 | Cite as

Nurse-patient interaction and communication: A systematic literature review

  • Steffen Fleischer
  • Almuth Berg
  • Markus Zimmermann
  • Kathleen Wüste
  • Johann Behrens
Review Article

Abstract

Aim

The purpose of this review is to describe the use and definitions of the concepts of nurse-patient interaction and nurse-patient communication in nursing literature. Furthermore, empirical findings of nurse-patient communication research will be presented, and applied theories will be shown.

Method

An integrative literature search was executed. The total number of relevant citations found was 97. The search results were reviewed, and key points were extracted in a standardized form. Extracts were then qualitatively summarized according to relevant aspects and categories for the review.

Results

The relation of interaction and communication is not clearly defined in nursing literature. Often the terms are used interchangeably or synonymously, and a clear theoretical definition is avoided or rather implicit. Symbolic interactionism and classic sender-receiver models were by far the most referred to models. Compared to the use of theories of adjacent sciences, the use of original nursing theories related to communication is rather infrequent. The articles that try to clarify the relation of both concepts see communication as a special or subtype of interaction.

The main intention of communication and interaction in the health setting is to influence the patient’s health status or state of well-being. Identified important structural factors of communication were: role allocation, different use of language and registers, and the nursing setting. The process of communication is often described with a phase model; communication often happens during other interventions and tasks. In general, influencing factors can be organized into the categories of provider variables, patient variables, environmental and situational variables.

Conclusion

The included citations all conclude that communication skills can be learned to a certain degree. Involvement of patients and their role in communication often is neglected by authors. Considering the mutual nature of communication, patients’ share in conversation should be taken more into consideration than it has been until now. Nursing science has to integrate its own theories of nursing care with theories of communication and interaction from other scientific disciplines like sociology.

Keywords

Nurse-patient interaction Nurse-patient communication Nurse-patient relation Literature review 

References

  1. Aguilera DC (1967) Relationship between physical contact and verbal interaction between nurses and patients. J Psychiatr Nurs Ment Health Serv 5:5–21PubMedGoogle Scholar
  2. Allen CI, Turner PS (1991) The effect of an intervention programme on interactions on a continuing care ward for older people. J Adv Nurs 16:1172–1177PubMedCrossRefGoogle Scholar
  3. Altschul A (1972) Patient-nurse interaction: A study of interaction patterns in acute psychiatric wards. Churchill Livingstone, EdinburghGoogle Scholar
  4. Anderson ND (1979) Human interaction for nurses. Superv Nurse 10(44):48–50Google Scholar
  5. Aranda SK, Street AF (1999) Being authentic and being a chameleon: nurse-patient interaction revisited. Nurs Inq 6:75–82PubMedCrossRefGoogle Scholar
  6. Armstrong-Esther CA, Browne KD (1986) The influence of elderly patients’ mental impairment on nurse-patient interaction. J Adv Nurs 11:379–387PubMedCrossRefGoogle Scholar
  7. Barrere CC (2007) Discourse analysis of nurse-patient communication in a hospital setting: implications for staff development. J Nurses Staff 23:114–122 quiz 123–124CrossRefGoogle Scholar
  8. Berg L, Skott C, Danielson E (2007) Caring relationship in a context: fieldwork in a medical ward. Int J Nurs Pract 13:100–106PubMedCrossRefGoogle Scholar
  9. Bourhis RY, Roth S, MacQueen G (1989) Communication in the hospital setting: a survey of medical and everyday language use amongst patients, nurses and doctors. Soc Sci Med 28:339–346PubMedCrossRefGoogle Scholar
  10. Breeze JA, Repper J (1998) Struggling for control: the care experiences of, difficult’ patients in mental health services. J Adv Nurs 28:1301–1311PubMedCrossRefGoogle Scholar
  11. Brown JM (1997) Manipulativeness and dialogue. J Psychiatr Ment Health Nurs 4:137–144PubMedCrossRefGoogle Scholar
  12. Burgio LD, Allen-Burge R, Roth DL, Bourgeois MS, Dijkstra K, Gerstle J, Jackson E, Bankester L (2001) Come talk with me: improving communication between nursing assistants and nursing home residents during care routines. Gerontologist 41:449–460PubMedGoogle Scholar
  13. Canales M (1997) Narrative interaction: creating a space for therapeutic communication. Issues Ment Health Nurs 18:477–494PubMedCrossRefGoogle Scholar
  14. Caris-Verhallen WM, Kerkstra A, Bensing JM (1997) The role of communication in nursing care for elderly people: a review of the literature. J Adv Nurs 25:915–933PubMedCrossRefGoogle Scholar
  15. Caris-Verhallen WM, Kerkstra A, van der Heijden PG, Bensing JM (1998) Nurse-elderly patient communication in home care and institutional care: an explorative study. Int J Nurs Stud 35:95–108PubMedCrossRefGoogle Scholar
  16. Caris-Verhallen WM, de Gruijter IM, Kerkstra A, Bensing JM (1999a) Factors related to nurse communication with elderly people. J Adv Nurs 30:1106–1117PubMedCrossRefGoogle Scholar
  17. Caris-Verhallen WM, Kerkstra A, Bensing JM (1999b) Non-verbal behaviour in nurse-elderly patient communication. J Adv Nurs 29:808–818PubMedCrossRefGoogle Scholar
  18. Carlson S (1972) Communication and social interaction in the aged. Nurs Clin North Am 7:269–279PubMedGoogle Scholar
  19. Castledine G (2004) The importance of the nurse-patient relationship. Br J Nurs 13:231PubMedGoogle Scholar
  20. Chatwin J (2008) Hidden dimensions: the analysis of interaction in nurse-patient encounters. Qual Prim Care 16:109–115PubMedGoogle Scholar
  21. Cleary M, Edwards C (1999) ‘Something always comes up’: nurse-patient interaction in an acute psychiatric setting. J Psychiatr Ment Health Nurs 6:469–477PubMedCrossRefGoogle Scholar
  22. Cleary M, Edwards C, Meehan T (1999) Factors influencing nurse-patient interaction in the acute psychiatric setting: an exploratory investigation. Aust N Z J Ment Health Nurs 8:109–116PubMedCrossRefGoogle Scholar
  23. Cossette S, Cote JK, Pepin J, Ricard N, D’Aoust L (2006) A dimensional structure of nurse-patient interactions from a caring perspective: refinement of the Caring Nurse-Patient Interaction Scale (CNPI-Short Scale). J Adv Nurs 55:198–214PubMedCrossRefGoogle Scholar
  24. Darmann I (2000) Anforderungen der Berufswirklichkeit an die kommunikative Kompetenz von Pflegekräften. Pflege 13:219–225PubMedCrossRefGoogle Scholar
  25. Darmann I (2002) Bewegung als Interaktion – Systemisch-konstruktivistische Sichtweise von Bewegung und Konsequenzen für die Pflege. Pflege 15:181–186PubMedCrossRefGoogle Scholar
  26. Daubenmire MJ, Searles SS, Ashton CA (1978) A methodologic framework to study nurse-patient communication. Nurs Res 27:303–310PubMedCrossRefGoogle Scholar
  27. Davies P (1994) Non-verbal communication with patients. Br J Nurs 3:220–223PubMedGoogle Scholar
  28. Dean M, Misra P, Kakkar DN, Kaur J (1982) Hospital interactions: communication by nursing personnel. Nurs J India 73:254–258PubMedGoogle Scholar
  29. Diers D, Schmidt RL, McBride MA, Davis BL (1972) The effect of nursing interaction on patients in pain. Nurs Res 21:419–428PubMedGoogle Scholar
  30. Dornheim J (2003) Verbesserung der kommunikativen Kompetenz von Pflegenden und Gepflegten. Projektbericht. http://www.bosch-stiftung.de
  31. Edberg AK, Nordmark Sandgren A, Hallberg IR (1995) Initiating and terminating verbal interaction between nurses and severely demented patients regarded as vocally disruptive. J Psychiatr Ment Health Nurs 2:159–167PubMedCrossRefGoogle Scholar
  32. Flaskerud JH (1986) On ‘toward a theory of nursing action: skills and competency in nurse-patient interaction’. Nurs Res 35:250–252PubMedCrossRefGoogle Scholar
  33. Fosbinder D (1994) Patient perceptions of nursing care: an emerging theory of interpersonal competence. J Adv Nurs 20:1085–1093PubMedCrossRefGoogle Scholar
  34. Fry A (1994) Effective communication with people with visual disabilities. Nurs Times 90:42–43PubMedGoogle Scholar
  35. Gastmans C (1998) Interpersonal relations in nursing: a philosophical-ethical analysis of the work of Hildegard E. Peplau. J Adv Nurs 28:1312–1319CrossRefGoogle Scholar
  36. Gilbert DA (1998) Relational message themes in nurses’ listening behavior during brief patient-nurse interactions. Sch Inq Nurs Pract 12:5–21PubMedGoogle Scholar
  37. Goode ML (2004) Communication barriers when managing a patient with a wound. Br J Nurs 13:49–52PubMedGoogle Scholar
  38. Graneheim UH, Norberg A, Jansson L (2001) Interaction relating to privacy, identity, autonomy and security. An observational study focusing on a woman with dementia and ‘behavioural disturbances’, and on her care providers. J Adv Nurs 36:256–265PubMedCrossRefGoogle Scholar
  39. Hansebo G, Kihlgren M (2002) Carers’ interactions with patients suffering from severe dementia: a difficult balance to facilitate mutual togetherness. J Clin Nurs 11:225–236PubMedCrossRefGoogle Scholar
  40. Harding KP (1987) Implications of social interaction. Nursing (Lond) 3:suppl 4–6Google Scholar
  41. Heineken J (1998) Patient silence is not necessarily client satisfaction: communication problems in home care nursing. Home Healthc Nurse 16:115–120PubMedCrossRefGoogle Scholar
  42. Hewison A (1995a) Nurses’ power in interactions with patients. J Adv Nurs 21:75–82PubMedCrossRefGoogle Scholar
  43. Hewison A (1995b) Power of language in a ward for the care of older people. Nurs Times 91:32–33PubMedGoogle Scholar
  44. Hollinger LM, Buschmann MB (1993) Factors influencing the perception of touch by elderly nursing home residents and their health caregivers. Int J Nurs Stud 30:445–461PubMedCrossRefGoogle Scholar
  45. Jones A (2003) Nurses talking to patients: exploring conversation analysis as a means of researching nurse-patient communication. Int J Nurs Stud 40:609–618PubMedCrossRefGoogle Scholar
  46. Jones DC, van Amelsvoort Jones GM (1986) Communication patterns between nursing staff and the ethnic elderly in a long-term care facility. J Adv Nurs 11:265–272PubMedCrossRefGoogle Scholar
  47. Kaakinen J, Shapiro E, Gayle BM (2001) Strategies for working with elderly clients: a qualitative analysis of elderly client/nurse practitioner communication. J Am Acad Nurse Pract 13:325–329PubMedCrossRefGoogle Scholar
  48. Kettunen T, Poskiparta M, Gerlander M (2002) Nurse-patient power relationship: preliminary evidence of patients’ power messages. Patient Educ Couns 47:101–113PubMedCrossRefGoogle Scholar
  49. Klein ER (2005) Effective communication with patients. Pa Nurse 60:14–15PubMedCrossRefGoogle Scholar
  50. Koeniger-Donohue R (2007) Nurse practitioner-client interaction as resource exchange: the nurse’s view (NP-client interaction). J Clin Nurs 16:1050–1060PubMedCrossRefGoogle Scholar
  51. Larsson G, Starrin B (1990) Patient-nurse interactions: relationships between person characteristics, empathy, content of communication, and patients’ emotional reactions. Scand J Caring Sci 4:129–135PubMedGoogle Scholar
  52. Lein C, Wills CE (2007) Using patient-centered interviewing skills to manage complex patient encounters in primary care. J Am Acad Nurse Pract 19:215–220PubMedCrossRefGoogle Scholar
  53. Lomax B (1997) Learning to understand a patient’s silence. Nurs Times 93:48–49PubMedGoogle Scholar
  54. Loveridge CE, Heineken J (1988) Confirming interactions. J Gerontol Nurs 14:27–30PubMedGoogle Scholar
  55. Luhmann N (1993) Das Recht der Gesellschaft. Suhrkamp, Frankfurt am MainGoogle Scholar
  56. Mallett J (1999) Difficulties of filming interactions. Nurs Times 95:49PubMedGoogle Scholar
  57. Martin LL, Barkan H (1989) Clinical communication strategies of nurse practitioners with patients. J Am Acad Nurse Pract 1:77–83PubMedCrossRefGoogle Scholar
  58. Mathews JJ (1983) The communication process in clinical settings. Soc Sci Med 17:1371–1378PubMedCrossRefGoogle Scholar
  59. May C (1990) Research on nurse-patient relationships: problems of theory, problems of practice. J Adv Nurs 15:307–315PubMedCrossRefGoogle Scholar
  60. McCann K, McKenna HP (1993) An examination of touch between nurses and elderly patients in a continuing care setting in Northern Ireland. J Adv Nurs 18:838–846PubMedCrossRefGoogle Scholar
  61. McCutcheon HH, Pincombe J (2001) Intuition: an important tool in the practice of nursing. J Adv Nurs 35:342–348PubMedCrossRefGoogle Scholar
  62. Millard L, Hallett C, Luker K (2006) Nurse-patient interaction and decision-making in care: patient involvement in community nursing. J Adv Nurs 55:142–150PubMedCrossRefGoogle Scholar
  63. Moore E, Kuipers L (1992) Behavioural correlates of expressed emotion in staff-patient interactions. Soc Psychiatry Psychiatr Epidemiol 27:298–303PubMedCrossRefGoogle Scholar
  64. Moreira AS, Rodrigues AR, Coler MS (1997) A model for analysis of the nurse-patient interactive process (MAIP). J Psychiatr Ment Health Nurs 4:303–306PubMedCrossRefGoogle Scholar
  65. Nordby H (2006) Nurse-patient communication: language mastery and concept possession. Nurs Inq 13:64–72PubMedCrossRefGoogle Scholar
  66. Nordby H (2007) Meaning and normativity in nurse-patient interaction. Nurs Philos 8:16–27PubMedCrossRefGoogle Scholar
  67. O’Kelly G (1998) Countertransference in the nurse-patient relationship: a review of the literature. J Adv Nurs 28:391–397PubMedCrossRefGoogle Scholar
  68. Oliver S, Redfern SJ (1991) Interpersonal communication between nurses and elderly patients: refinement of an observation schedule. J Adv Nurs 16:30–38PubMedCrossRefGoogle Scholar
  69. Park E, Song M (2005) Communication barriers perceived by older patients and nurses. Int J Nurs Stud 42:159–166PubMedCrossRefGoogle Scholar
  70. Parsons T (1968) Einige theoretische Betrachtungen zum Bereich der Medizinsoziologie. In: Parsons T (ed) Sozialstruktur und Persönlichkeit. Klotz, Frankfurt am Main, pp 408–449Google Scholar
  71. Routasalo P (1999) Physical touch in nursing studies: a literature review. J Adv Nurs 30:843–850PubMedCrossRefGoogle Scholar
  72. Routasalo P, Isola A (1998) Touching by skilled nurses in elderly nursing care. Scand J Caring Sci 12:170–178PubMedCrossRefGoogle Scholar
  73. Ruan J, Lambert VA (2008) Differences in perceived communication barriers among nurses and elderly patients in China. Nurs Health Sci 10:110–116PubMedCrossRefGoogle Scholar
  74. Ruesch J, Bateson G (1995) Kommunikation: Die soziale Matrix der Psychiatrie. Carl Auer, HeidelbergGoogle Scholar
  75. Rundell S (1991) A study of nurse-patient interaction in a high dependency unit. Intensive Care Nurs 7:171–178PubMedCrossRefGoogle Scholar
  76. Salyer J, Stuart BJ (1985) Nurse-patient interaction in the intensive care unit. Heart Lung 14:20–24PubMedGoogle Scholar
  77. Sarvimäki A (1988) Nursing care as a moral, practical, communicative and creative activity. J Adv Nurs 13:462–467PubMedCrossRefGoogle Scholar
  78. Scheiner R, Knipfer E (2006) Miteinander reden: Wege zu einer gelingenden Kommunikation in der Pflege. Pflege Z 59:Suppl. 2–8Google Scholar
  79. Schiereck S (2000) Soziale Interaktion zwischen Pflegekräften und PatientInnen im Organisationsverlauf einer Nursing Development Unit. Pflege 13:234–241PubMedCrossRefGoogle Scholar
  80. Schröck R (2003) Interaktionen zwischen Pflegenden und Patienten – Eine klassische Studie in der akuten Psychiatrie. Pflege 16:17–25PubMedCrossRefGoogle Scholar
  81. Shattell M (2004) Nurse-patient interaction: a review of the literature. J Clin Nurs 13:714–722PubMedCrossRefGoogle Scholar
  82. Sheldon LK, Barrett R, Ellington L (2006) Difficult communication in nursing. J Nurs Scholarsh 38:141–147PubMedCrossRefGoogle Scholar
  83. Smith-Stoner M (1999) Language - as important as documentation! Home Healthc Nurse 17:350–352PubMedCrossRefGoogle Scholar
  84. Spiers JA (2002) The interpersonal contexts of negotiating care in home care nurse-patient interactions. Qual Health Res 12:1033–1057PubMedCrossRefGoogle Scholar
  85. Sumner J (2001) Caring in nursing: a different interpretation. J Adv Nurs 35:926–932PubMedCrossRefGoogle Scholar
  86. Tacke D (1999) Pflege von Menschen mit Aphasie – Eine Literaturstudie. Pflege 12:95–100PubMedCrossRefGoogle Scholar
  87. Tuckett AG (2005) The care encounter: pondering caring, honest communication and control. Int J Nurs Pract 11:77–84PubMedCrossRefGoogle Scholar
  88. Tuckett AG (2007) Stepping across the line: information sharing, truth telling, and the role of the personal carer in the Australian nursing home. Qual Health Res 17:489–500PubMedCrossRefGoogle Scholar
  89. Turnock C (1991) Communicating with patients in ICU. Nurs Stand 5:38–40PubMedGoogle Scholar
  90. Usher K, Monkley D (2001) Effective communication in an intensive care setting: nurses’ stories. Contemp Nurse 10:91–101PubMedGoogle Scholar
  91. van Maanen H (2002) Die Entwicklung einer Pflegefachsprache aus einer pflegewissenschaftlichen Perspektive: Das Warum und Wozu. Pflege 15:198–207PubMedCrossRefGoogle Scholar
  92. Vivian BG, Wilcox JR (2000) Compliance communication in home health care: a mutually reciprocal process. Qual Health Res 10:103–116PubMedCrossRefGoogle Scholar
  93. Walther S (2003) Sprache und Kommunikation in der Pflege. Forschungsarbeiten und Publikationen zur mündlichen und schriftlichen Kommunikation in der Pflege: Eine kommentierte Bibliographie. Gilles und Francke, DuisburgGoogle Scholar
  94. Watson J (2005) Commentary on Shattell M (2004) Nurse-patient interaction: a review of the literature. Journal of Clinical Nursing 13:714–722 J Clin Nurs 14:530–532Google Scholar
  95. Westin L, Danielson E (2007) Encounters in Swedish nursing homes: a hermeneutic study of residents’ experiences. J Adv Nurs 60:172–180PubMedCrossRefGoogle Scholar
  96. Wikström BM (2003) Health professionals’ experience of paintings as a conversation instrument: a communication strategy at a nursing home in Sweden. Appl Nurs Res 16:184–188PubMedCrossRefGoogle Scholar
  97. Williams A (2001) A literature review on the concept of intimacy in nursing. J Adv Nurs 33:660–667PubMedCrossRefGoogle Scholar
  98. Williams CA, Gossett MT (2001) Nursing communication – advocacy for the patient or physician? Clin Nurs Res 10:332–340PubMedCrossRefGoogle Scholar
  99. Williams KN, Ilten TB, Bower H (2005a) Meeting communication needs: topics of talk in the nursing home. J Psychosoc Nurs Ment Health Serv 43:38–45PubMedGoogle Scholar
  100. Williams K, Kemper S, Hummert ML (2005b) Enhancing communication with older adults: overcoming elderspeak. J Psychosoc Nurs Ment Health Serv 43:12–16PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Steffen Fleischer
    • 1
  • Almuth Berg
    • 1
  • Markus Zimmermann
    • 1
  • Kathleen Wüste
    • 1
  • Johann Behrens
    • 1
  1. 1.Institute of Health and Nursing SciencesMartin-Luther University Halle-WittenbergHalleGermany

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