Nurse-patient communication and its impact on nurses' learning and patient satisfaction in oncology wards: protocol for a focused ethnographic and conversational analysis study.

BACKGROUND: Skilled and sensitive communication with patients who have cancer is essential to nursing practice. Often, Chinese patients with cancer do not explicitly express their concerns and needs. Nurses thus might not be able to respond to or miss cues and concerns expressed by patients. We aimed to investigate this gap, and appraise patterns of nurse-patient communication through cue-responding behaviours, and to explore with nurses ways of enhancing their practice.

METHODS: We aim to assess a sample of oncology nurses working at a government hospital in Hong Kong and their patients. Written consent from those nurses who volunteer to participate and patients will be obtained. Ward observations, interviews with nurses and patients, and a checklist of patients' concerns will be done, and audio of nurse-patient communication and observed non-verbal communication cues will be obtained. Nurses' documentation on communication with patients will also be assessed. Only the events of admission, discharge, and routine care are to be studied. Before the nurses approach patients, a research assistant will complete a checklist of patients' concerns. The nurse-patient conversations during these events will be audio-recorded and the non-verbal communication cues taken in field notes. Patients will then be interviewed for their satisfaction of the communication and asked to complete the checklist again for changes in the extent of concerns or needs. Content analysis will be performed on the field notes, observations, interviews and document review. Cue-responding patterns, number of cues or concerns explored and not explored by nurses will be identified. Statistical analysis will be used to analyse determinants of the nurses' cue-responding behaviours. The study has been approved by the Research Ethics Committees of the Kowloon West Cluster and The Hong Kong Polytechnic University.

FINDINGS: Data collection is underway. 25-30 nurses and 75-90 patients will be recruited. Preliminary findings will be available in late September, 2016.

INTERPRETATION: This study could enhance the quality of time nurses spent with patients and improve patient satisfaction. It might improve patient safety, reduce hospital readmission, and reduce health-care costs.

FUNDING: The General Research Fund of the Research Grants Council in Hong Kong.