Therapeutic Communication Methods Targeting Families and Family Members: A Literature Review

Background and Purpose: Therapeutic communication is a new term in family health care nursing, defined by Hohashi (2019) as a method of family intervention, and characterized by inclusion of not only verbal conversation but also nonverbal interaction. However, specific therapeutic communication methods have not been systematized. The purpose of this study was to clarify therapeutic communication methods for families/family members from the perspectives of verbal communication and non-verbal communication through a review of existing literature. Methods: We conducted a search using the medical literature databases PubMed and Ichushi-Web using the keywords “therapeutic communication”. Analysis was performed on seven articles from PubMed and 14 articles from Ichushi-Web that described therapeutic communication methods performed by healthcare professionals for families/family members. Through directed content analysis, therapeutic communication methods were subcategorized, and classified into three categories: verbal communication, non-verbal communication, and verbal/non-verbal communication. Results: A total of 23 subcategories were extracted. Verbal communication included 11 subcategories, such as “asking questions using the communicatee’s words as they are”. Non-verbal communication included five subcategories, such as “noticing changes in the content of the communicatee’s story”. And verbal/non-verbal communication featured seven subcategories, such as “making the communicatee aware of one’s own beliefs”. Conclusion: Therapeutic communication methods included basic care/caring in family interviews/meetings, as well as verbal communication and non-verbal communication that act on family/family members’ beliefs. It is believed that changes in family/family members’ beliefs can be used to eliminate, reduce, or improve problematic conditions in the family. .

Effect of family caregiver nursing education on patients with rheumatoid arthritis and its impact factors:A randomized controlled trial

BACKGROUND Rheumatoid arthritis(RA)is a common autoimmune disease.Nursing education for family caregivers is considered a workable and effective intervention,but the validity of this intervention in RA has not been reported.AIM To explore whether family caregiver nursing education(FCNE)works on patients with RA and the factors that influence FCNE.METHODS In this randomized controlled study,a sample of 158 pairs was included in the study with 80 in the intervention group and 78 in the control group.Baseline data of patients and caregivers was collected.The FCNE intervention was admi-nistered to caregivers,and inflammation level indicators,disease activity indicators and mood disorder indicators of patients were followed up and analyzed.RESULTS Baseline characteristics of the intervention and the control groups had no significant difference.Indicators were significantly reduced in the intervention group compared to the control group.The intervention group showed significant differences in stratification of relationship,education duration and age.CONCLUSION The effect of FCNE on RA is multifaceted,weakening inflammation level,alleviating disease activity and relieving mood disorder.Relationship between caregiver and patient,caregiver’s education level and patient’s age may act as impact factors of FCNE.

Nurses’experiences of the ethical values of home care nursing:A qualitative study

Objective Considering the importance of out-of-hospital services,the emergence of home care nursing,and the need for an ethical framework in nursing practice,the present study aimed to explore the nurses’experience of ethical values of home care nursing.Methods The data of the study was collected using face-to-face individual interviews.Through purposive sampling,20 nurses who worked in the home care centers in four cities of Iran in 2020 were interviewed.They shared their experiences of the ethical values of home care nursing.Then,the interviews were analyzed based on the content analysis approach and using Graneheim and Lundman method.Results In the present study,416 codes were extracted.Merging these codes based on the similarity,seven main themes,and 16 sub-themes were extracted.The themes included perception of the professional identity,respect for the client’s autonomy,respecting privacy,establishing human interaction,maintaining mutual safety,observance of justice,and cultural-religious competence.The sub-themes included responsibility,development of professional and inter-professional interactions,maintaining the professional status at home,providing the holistic artistic care,patient’s privacy,nurse’s privacy,and maintaining the confidentiality of information,respect for the client’s choice,honestly informing,empathetic interaction,adjusting the power positions,client's safety,nurse’s safety,establishing justice,respect for the religious beliefs at home and cultural sensitivity.Conclusion The participants stated that due to entering the patient’s privacy in the home care cases,the ethical values such as perception of the professional identity,privacy,family interactions’management,mutual security,and cultural-religious competence became doubly important compared to the hospital caring.

The Process of Support by Nursing Professionals for Families Having a Member with Borderline Personality Disorder

The purpose of this study was to explore the process of family support provided by nurses to families with a borderline personality disorder (BPD) patient. Semi-structured interviews were conducted with 16 nurses who had provided care to BPD patients. Data obtained from the interviews were qualitatively analyzed using a modified grounded theory approach. As an overall core category of family support processes practiced by nurses for families with BPD patients, family support practiced without awareness that the nurses were supporting families was extracted. Through this process, nurses held perceptions that were premises for family support, which were formed through their individual nursing experiences and perspectives. Nurses also had diverse perceptions concerning the image of families. Through the integration of perceptions that were premises for family support and perceptions of an image of the family, nurses underwent a process of “determination and ambivalence about the need for family support.” Then, nurses provided “family support practice” when they acknowledged the need for family support. During the “family support practice,” nurses had difficulties in providing family support. When family support was not successfully provided, nurses provided “family support practice with seeking more effective ways through trial and error.” For cases in which nurses did not acknowledge the need for intervention, they intentionally chose “not to provide family support.” Furthermore, during the “family support practice,” nurses had contradictory perspectives of family support. Such family support processes ultimately led to an awareness of the same family support required for the future. Family support was provided with “family support practice” and “family support practice with seeking more effective ways through trial and error.” In some cases, however, the process ended in “not to provide family support intentionally.” Experiences and perspectives in providing family support are important factors in carrying out future family support. Developing the positive implications of these factors and reducing psychological strain on nurses may ensure smooth implementation of family support. Thus, nurses need to recognize that they are supporting the family, which is identified as a core category.

A family nurse-led intervention for reducing health services’utilization in individuals with chronic diseases:The ADVICE pilot study

Objectives:Intensive health services'utilization is common in older individuals affected by chronic diseases.This study assessed whether a structured family nurse-led educational intervention would be effective in reducing health services'use(readmissions and/or emergency service access)among older people affected by chronic conditions.Methods:This is a non-randomized before-after pilot study.A sample of 78 patients was recruited from two general practices in Italy and 70 among them were followed for 8 months.Standard home care was provided during the first four months'period(months 1-4),followed by the educational intervention until the end of the study(months 5-8).The intervention,based on the teach-back method,consisted of by-weekly 60-min home sessions targeting aspects of the disease and its treatment,potential complications,medication adherence,and health behaviours.Rates of health services'use were collected immediately before(T0),and after the interventions(T1).Differences in utilization rates were examined by the McNemar's test.Potential factors associated with the risk of health services'use were explored with a Cox proportional hazard regression model.Results:The sample(n=78)was predominantly female(n=50,64.1%),and had a mean age of 76.2(SD=4.8)years.Diabetes mellitus was the most frequent disease(n=27,34.6%).McNemar's test indicated a significant reduction in health services'use at T1(McNemar χ^(2)==28.03,P<0.001).Cox regressions indicated that time and patient education,as well as their interaction,were the only variables positively associated with the probability of health services'use.Conclusion:A teach-back intervention led by a family nurse practitioner has the potential to reduce health services'use in older patients with chronic diseases.

Nurses’ Perception of Privacy in the NICU and GCU: A Qualitative Descriptive Study

Purpose: The purpose of this study was to identify the perceptions that determine the nursing practices of nurses working in NICU and GCU to protect the privacy of the affected children and their families, and the perceptions that arise in relation to their practices. Further to obtain information on current issues and future suggestions for nursing practice. Method: Semi-structured interviews were conducted with six nurses of Clinical Ladder I or higher currently working in the NICU and GCU, and content analysis was conducted. Result: The study identified five categories, 16 subcategories, and 63 codes: “keeping in mind to act in accordance with the characteristics of the NICU and GCU”, “trying to secure a space only for the affected children and families depending on the situation”, “feeling the need for consideration for the affected children and families”, “feeling puzzled and frustrated through the relationship with families”, “having a dilemma between the environment they want to realize for the affected children and families and the fact that it cannot be realized”. Conclusion: In considering nursing care in NICU and GCU, including consideration for privacy, the need to reflect on daily nursing care and share it with other staff members was suggested.

Social- and Health-Care Professionals＇ Meetings with Multiple-Birth Families--Challenges and the Need for More Training and Education

Background： A systematic literature review shows there is a need to study how professionals work with multiple-birth families in different kinds of nursing contexts. Objective： The aim is to describe public-health nurses＇ （n = 8） experiences of supporting multiple-birth families and to contribute to the understanding of working with such families. Methodology： The qualitative research study is guided by the phenomenological hermeneutic and van Manen＇s methods have been used. The phenomenon was described through the concept of lifeworld： time, body, relations, and space. The data include participants＇ interviews and written documents, as well as the researcher＇s notes. Results： The phenomena of supporting multiple-birth families, as described by public-health nurses, can be expressed by ＂Recognizing the strain＂, ＂Lightening the load of daily life＂ and ＂Targeting special needs＂. Conclusions： The social-and health-care professionals met challenges in supporting multiple-birth families, and disclosed their need for training and education. There is a need for more understanding of the unique relevant needs and life situations of such families. Wellbeing and caring involves giving guidance and providing the parents with the special knowledge they need. Further research could concentrate on how evidence-based research guides the work of professionals in multi-professional teams.

Tripartite intensive intervention for prevention of rebleeding in elderly patients with hypertensive cerebral hemorrhage

BACKGROUND Hypertensive cerebral hemorrhage(HICH)is the rupture and bleeding of vessels of the cerebral parenchyma caused by continuously elevated or violently fluctuating blood pressure.The condition is characterized by high disability and high mortality.Hematoma formation and resulting space-occupying effects following intracerebral hemorrhage are among the key causes of impaired neurological function and disability.Consequently,minimally invasive clearance of the hematoma is undertaken for the treatment of HICH because it can effectively relieve intracranial hypertension.Therefore,special attention should be given to the quality of medical and nursing interventions in the convalescent period after minimally invasive hematoma clearance.AIM The study aim was to determine the value of intensive intervention,including doctors,nurses,and patient families,for the prevention of rebleeding in elderly patients with HICH during the first hospitalization for rehabilitation after the ictal event METHODS A total of 150 elderly HICH patients with minimally invasive hematoma evacuation in our hospital between May 2018 and May 2020 were selected and equally divided into two groups of 75 each by their planned intervention.The control group was given conventional nursing intervention and the observation group was given tripartite intensive intervention.The length of hospital stay,cost,complication rate,satisfaction rate,and rebleeding rate during hospitalization were recorded.Changes in cerebral blood flow indicators were recorded in both groups.Changes in the National Institutes of Health Stroke Scale(NIHSS)score,quality of life index(QLI)score,and health behavior score were evaluated at the National Institutes of Health.RESULTS Duration of hospitalization was shorter in the in the observation group than in the control group,the hospitalization cost was less than in the control group,and the rate of rebleeding during hospitalization was lower than in the control group(all P<0.05).There were no significant differences between the two groups before treatment(all P>0.05).The mean flow rate(Qmean)and mean velocity(Vmean)of the two groups increased(P<0.05),and the dynamic resistance and peripheral resistance decreased(P<0.05).The Qmean and Vmean in the intervention group were higher than those in the control group(P<0.05).Moreover,the dynamic resistance and peripheral resistance of the blood vessels were also lower in the intervention group than in the control group(P<0.05).The difference in health behavior scores between the two groups before treatment was not significant(P>0.05).In both groups,the scores for healthy behaviors such as emotion control,medication adherence,dietary management,exercise management,and selfmonitoring were higher after than before treatment(P<0.05),and the scores of healthy behaviors in the intervention group were higher than those in the control group(P<0.05).There was no significant difference in the NIHSS and QLI scores between the two groups before treatment(P>0.05).The QLI scores of the two groups increased(P<0.05),and the NIHSS scores decreased(P<0.05).The QLI scores of the intervention group were higher than those of the control group(P<0.05),and the NIHSS score was correspondingly lower than that of the control group(P<0.05).The incidence of respiratory infections,pressure sores,central hyperpyrexia,and deep venous thrombosis was lower in the intervention group than in the control group.Accordingly,the satisfaction rate was higher in the treatment group than that in the control group(P<0.05).CONCLUSION Intensive intervention by doctors,nurses,and families of elderly patients with HICH reduced the rate of rebleeding during hospitalization.It also reduced the incidence of complications,promoted rehabilitation,improved the quality of life,and enhanced nerve function.Additionally,it improved satisfaction and promoted healthy behaviors.

The Hermeneutic Circle Helps to Accumulate Knowledge and Understanding： An Empirical Example of Public Health Nurses＇ Experiences of Supporting Multiple-birth Families

In phenomenological research, the reduction is a complex reflective attentiveness required for phenomenological understanding. A literature review revealed that little research has been done on health care professionals working with multiple-birth families. Van Manen＇s method has been variously used in nursing science. The aim of this article is to describe the hermeneutic circle and the method of reduction, providing an empirical example of the experiences of public health nurses working with multiple-birth families. The data consisted of open interviews （n = 38） with three participant groups--parents of twins, nurses, and family care workers--written output from them and the researcher＇s notes. The phenomena of the lifeworld of multiple-birth families as described by nurses can be expressed as： ＂recognizing the strain＂, ＂targeting special needs＂, and ＂lightening the load of daily life＂. Reduction enables in-depth phenomenological hermeneutic research, helping to see the research stages both as parts and as a whole and the hermeneutic circle that accumulates understanding. Social and health care professionals need to listen more to parents＇ voices to better understand the needs and situation of multiple-birth families. More education and training is needed to empower parents of twins. This article can stimulate discussion on phenomenology, hermeneutic research and reduction.