The validity and reliability of a new scale to measure patient-determined communication barriers in hospitals

Yıl 2017, Cilt: 15 Sayı: 3, 187 - 200, 05.01.2018

Emine Şahin , Bayram Oğuz Aydın Murat Taner Gülşen Seval Kul

https://doi.org/10.20518/tjph.375335

Cited By: 1

Öz

Abstract

Objective: Creating an environment that boosts effective communication between patients and healthcare personnel, and identifying factors that impair good communication, have favorable results on the quality of healthcare services. The primary goal of this study was to develop a new valid and reliable scale that could be used to identify communication barriers at the patient level. Method: The study was conducted with 421 patients receiving healthcare services at Gaziantep University Şahinbey Research and Practice Hospital. The respondents varied in age, gender, education level and by the department to which they were admitted. Descriptive statistics, exploratory factor analysis, confirmatory factor analysis and Cronbach’s alpha test were utilized. Results: Based on the analysis of the data collected, a new valid and reliable scale (Cronbach’s alpha= 0.81) was constructed, consisting of 28 items and 7 sub-dimensions. Conclusion: The proposed scale showed that the main factors leading to the creation of communication barriers were waiting times, fear and anxiety experienced by the patients, security staff, patients’ need for attention, lack of trust towards healthcare personnel, concern and need for being informed and prejudice.

Anahtar Kelimeler

Health communication, communication barriers, patients, healthcare personnel

Hastanelerde hastalar tarafından belirlenen iletişim engellerini ölçen yeni bir ölçeğin geçerlik ve güvenilirliği

Öz

Amaç: Hasta ve sağlık çalışanları arasındaki iletişimi engelleyen faktörleri belirlemenin ve etkili
bir iletişim ortamı oluşturmanın sağlık hizmetleri üzerinde olumlu sonuçları bulunmaktadır. Bu
çalışmanın temel amacı hastalar tarafından belirlenen iletişim engellerini ortaya koymada
kullanılabilecek geçerli ve güvenilir yeni bir ölçek geliştirmektir. Yöntem: Çalışma hastanede
sağlık hizmeti alan cinsiyet, yaş, eğitim durumu ve başvurduğu sağlık birimine göre farklılık
taşıyan 421 hasta ile gerçekleştirilmiştir. Tanımlayıcı istatistikler, açımlayıcı faktör analizi,
doğrulayıcı faktör analizi ve Cronbach’s alpha testi uygulanmıştır. Bulgular: Yapılan çalışmada
toplanan verilerin analizi neticesinde 28 madde ve 7 alt boyuttan oluşan geçerli ve güvenilir
(Cronbach’s alpha= .81) yeni bir ölçek ortaya konulmuştur. Sonuç: Çalışma neticesinde ortaya
konan ölçekte hasta düzeyinde iletişimi engelleyen faktörler; bekleme süresi, hastadaki kaygı ve
endişe, güvenlik personeli, hastanın ilgi ihtiyacı, sağlık personeline duyulan güvensizlik,
merak/bilgi ihtiyacı ve ön yargı olarak belirlenmiştir.

Anahtar Kelimeler

Sağlık iletişimi, iletişim engelleri, hasta, sağlık çalışanları, hastane

Kaynakça

• 1. Corcoran N. Communicating Health: Strategies for Health Promotion. Corcoran N. Ed. Thousand Oaks, CA: Sage; 2007: 5.
• 2. Street RL Jr. Information-giving in medical consultations: The influence of patients' communicative styles and personal characteristics. SocSci Med 2002;32(5):541-548.
• 3. Benbassat J, Pilpel D, Tidhar M. Patients’ preferences for participation in clinical decision making: a review of published surveys. Ann Behav Med 1998; 24: 81–88.
• 4. Dickert NW, Kass NE. Understanding respect: learning from patients. J Med Ethics 2009;35:419–423.
• 5. Arora NK. Interacting with cancer patients: the significance of physicians’ communication behavior. SocSci Med 2003; 791–806.
• 6. Speedling EJ, Rose DN. Building an effective doctor-patient relationship: From patient satisfaction to patient participation. Soc Sci Med1985;21(2):115-120.
• 7. Roter DL, Hall JA, Katz NR. Relations between physicians' behaviors and analogue patients' satisfaction, recall, and impressions. Med Care 1987;25:437-451.
• 8. King A, Hoppe RB. Best practice for patient-centered communication: a narrative review. J Grad Med Educ 2013;5(3):385-393.
• 9. Dutta-Bergman MJ. The relation between health-orientation, provider-patient communication, and satisfaction: An individual-difference approach. J Health Commun 2005;18(3):291–303.
• 10. Stevenson FA, Barry CA, Britten N, Barber N, Bradley CP. Doctor–patient communication about drugs: the evidence for shared decision making. Soc Sci Med 2000;50(6):829-840.
• 11. Ong LM L, De Haes I JCJM, Hoos AM, Lammes FB. Doctor-patient communication: a review of the literature. Soc Sci Med 1995;40(7):903-918.
• 12. Burton D, Blundell N, Jones M, Fraser A, Elwyn G. Shared decision-making incardiology: do patients want it and do doctors provide it? Patient Educ Couns 2010;80(2):173-179.
• 13. Lowel LB. Physician communication: Barriers to achieving shared understanding and shared decision making with patients. J Particip Med 2010;2:2-12.
• 14. Charles C, Gafni A, & Whelan, T. Decision-making in the physician-patient encounter: Revisiting the shared treatment decision-making model. Soc Sci Med 1999;49:651–661.
• 15. Kreps LG. Consumer/provider communication research: a personal pleato address issues of ecological validity, relational development, message diversity and situational constraints. Journal of Health Psychol 2001;5:597-601.
• 16. Mira JJ, Guilabert M, Pe´rez-Jover V and Lorenzo S. Barriers for an effective communication around clinical decision making: an analysis of the gaps between doctors’ and patients’ point of view. Health Expect 2012;17:826–839.
• 17. Seijo R, Gomez H and Freidenberg J. Language as a communication barrier in medical care for Hispanic patients. Hisp J Behav Sci 1991; 13(4): 363-376.
• 18. Ferguson JW and Candib JW. Culture, language, and the doctor-patient relationship. FMCH 2002;34(5):353-361.
• 19. Taylor S, Nicoll C and Maguire M. Cross-cultural communication barriers in healthcare. Nurs Stand 2013;27(31):35-43.
• 20. Karliner LS, Auerbac A, Nápoles A, Schillinger D, Nickleach D, Pérez-Stable EJ and Eliseo J. Language barriers and understanding of hospital discharge instructions. Med Care 2013;50(4):283–289.
• 21. Anoosheh M, Zarkhah S, Faghihzadeh S, Vaismoradi M. Nurse–patient communication barriers in Iranian nursing. Int Nurs Rev 2009;56:243–249.
• 22. Burnard P, Naiyapatana W. Culture and communication in the nursing: A report of an ethnographic study. Int J Nurs Stud 2004;41:755–765.
• 23. Park E, Song M. Communication barriers perceived by older patients and nurses. Int J Nurs Stud 2005;42:159–166.
• 24. Farahani MA, Sahragard R, Carroll JK, Mohammadi E. Communication barriers to patient education incardiacin patient care: A qualitative study of multiple perspectives. Int J Nurs Pract 2011;17:322–328.
• 25. Graham S and Brookey J. Do patients understand?. Perm J.2008; 12(3): 67-69.
• 26. Jain P, Krieger JL. Moving beyond the language barrier: The communication strategies used by international medical graduates in inter cultural medical encounters. Patient Educ Couns 2011;84:98–104.
• 27. Bakker DA, Fitch MI, Gray R, Reed E, Bennett J. Patient–health care provider communication during chemo therapy treatment: the perspectives of women with breast cancer. Patient Educ Couns 2001;43:61–71.
• 28. Parker PA, Baile WF, Moor C, Lenzi R, Kudelkaand AP, Cohen L. Breaking bad news about cancer: patients’ preferences for communication. J Clin Oncol 2001;19(7):2049-2056.
• 29. Council NH and MR. Communicating with Patients: Advice for Medical Practitioners [Internet]. 2009 [cited 2016 Jul 3]. Available from: https://www.nhmrc.gov.au/guidelines-publications/e58
• 30. Begum, T. Doctor patient communication: a review. J Bangladesh Coll Phys Surg 2014;32(2):83-88.
• 31. Shah F, Burack O, Boockvar KS. Perceived barriers to communication between hospital and nursing home at time of patient transfer. J Am Med Dir Assoc 2010;11(4):239-244.
• 32. Ruan J, Lambert VA. Differences in perceived communication barriers among nurses and elderly patients in China. Nurs Health Sci 2008;10:110–116.
• 33. Aydın BO, Şahin E. A model offer for solving the communication problems at a level of the patient and the patient’s relatives at a hospital. ODUSOBİAD 2016;15:64-93.
• 34. Hemsley B, Balandin S, Worrall L. Nursing the patient with complex communication needs: time as a barrier and a facilitator to successful communication in hospital. J Adv Nurs 2012;68(1):116–126.
• 35. Ünlüsoy DN. Hemşirelerin işyeri şiddetine maruz kalma durumları ile iş doyumları ve işten ayrılma eğilimleri. [Doktora Tezi], Ankara: Hacettepe Üniversitesi Sağlık Bilimleri Enstitüsü, (2010).
• 36. Özcan NK, Bilgin H. Türkiye’de sağlık çalışanlarına yönelik şiddet: Sistematik derleme. Türkiye Klinikleri J Med Sci 2011;31(6):1442-56.
• 37. Büyükbayram A, Okçay H. Sağlık çalışanlarına yönelik şiddeti etkileyen sosyo-kültürel etmenler. Psy Nurs 2013;4(1):46-53.
• 38. Al B, Zengin S, Deryal Y, Gökçen C, Yılmaz DA. Sağlık çalısanlarına yönelik artan şiddet. JAEM 2012;11(2):115-124.
• 39. Ayrancı U, Yenilmez Ç, Balcı Y, Kaptanoglu C. Identification of violence in Turkish health care settings. J Interpers Violence 2006;21:276-296.
• 40. Davis LL. Instrument review: Getting the most from a panel of experts. Appl Nurs Res 1992;97:194-197.
• 41. Hu LT, Bentler PM. Cut off criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modeling 1999;6 (1):1-55.