An analysis of nonverbal communication between nurses and hospitalised older adults in selected hospitals in Cameroon.
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Date
2023
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Abstract
Background: Nurse-patient communication has been recognised as one of the most important
aspects of successful patient outcomes. In relation to older adults, whose numbers are growing
worldwide, nurses’ communication with older adults is essential because older adults will seek
medical assistance more than before. Since most rely on nonverbal communication because of
hearing deficits, and changes in attention and coding of information – all restrictions in
interaction and effective verbal communication – nurses’ nonverbal communication will be a
vital skill to develop good nurse-older patient relationships. In a context where there are no
long-term care settings, nurses will be required to achieve effective nonverbal communication
when older adults are admitted to the wards.
Aim: This study aimed at analysing nonverbal communication between nurses and hospitalised
older adults in selected hospitals in Cameroon, to develop a model for effective nonverbal
communication between nurses and older adults.
Methods: A mixed-methods approach was used in this study. A total of 372 participants were
included through overt, theoretical, and convenience sampling. To collect the qualitative data
through participant observations and individual interviews, twenty-seven (27) nurses were
observed, of which 13 nurses were interviewed, and 29 older adults were observed, of which
eight (8) were interviewed. In addition, 316 nursing students participated in the survey.
Qualitative data analysis was composed of open coding, axial coding, and selective coding,
which were intertwined as the researcher moved back and forth between data collection and
data analysis. Additionally, comparative analysis, theoretical sensitivity, and memos were used
during the process of analysing the qualitative data. Quantitative data were analysed using
SPPS version 25, where descriptive and inferential analyses were run. Additionally, an
explanatory factor analysis based on the principal component analysis method with varimax
rotation was conducted, to determine the common factors that explain the order and structure
among measured variables.
Results: Firstly, the results showed that there was limited evidence of studies on nonverbal
communication between nurses and cognitively intact hospitalised older adults in clinical
settings. Secondly, the results showed that hospitalised older adults made both positive and
negative interpretations of nurses’ nonverbal communication. They also had specific nonverbal
communication needs. Thirdly, the results showed that nurses mainly used haptics, kinesics,
and proxemics to communicate nonverbally with hospitalised older adults to build relationships
with them, convey affection, reassure them, and support verbal communication. Further, the
results showed that nursing students held slightly positive attitudes towards older adults; yet,
the tool used to assess their attitudes showed moderate psychometric properties and two factor
loadings. Finally, the results showed that the proposed model for effective nonverbal
communication with hospitalised older adults, which emerged from the data, encompassed all
six categories of Strauss and Corbin’s framework, which are: causal conditions, contextual
conditions, core phenomenon, action/interaction strategies, intervening conditions and
expected outcomes.
Conclusions: This study revealed that nurses mainly use few nonverbal communication
techniques to communicate with hospitalised older adults, which cannot achieve effective
communication, vital in nurse-patient relationships. The proposed model provides a guide for
effective nonverbal communication with older adults and acknowledges that older adults’
interpretations and needs of nonverbal communication, as well as attitudes towards them, all
influence effective nonverbal communication with hospitalised older adults. It is hoped that
nurses will consider these to improve their nonverbal communication with hospitalised older
adults for better patient outcomes such as: patient satisfaction, shorter lengths of stay in
hospitals and improved quality of care.
Description
Doctoral Degree. University of KwaZulu-Natal, Durban.