An analysis of nonverbal communication between nurses and hospitalised older adults in selected hospitals in Cameroon=Ukuhlaziya ukuxhumana ngezimpawu phakathi kwabahlengikazi nabantu asebekhulile abalaliswe kwezinye zezibhedlela ezikhethiwe zaseCameroon.

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.

Iqoqa Isendlalelo: Ukukhulumisana phakathi kwabahlengikazi neziguli kubalulekile ukuze isiguli silulame kahle. Ngokuphathelene nabantu asebekhulile ngeminyaka, indlela umhlengikazi akwazi ngayo ukuxhumana nabo ibalulekile ngoba abantu abaningi asebekhulile bathembele ekusebenziseni izimpawu lapho bekhuluma, okuyikhono okusemqoka ukuba umhlengikazi abe nalo ukuze kuthuthukiswe ubudlelwane obuhle phakathi kwabahlengikazi neziguli esezikhulile ezimweni lapho kungekho khona uhlelo lokunakekelwa isikhathi reside.

Inhloso: Ukuhlaziya ukuxhumana ngokusebenzisa izimpawu phakathi kwabahlengikazi nabantu asebekhulile ngeminyaka abalaliswe ezibhedlela ezithile zaseCameroon, ukuze kusungulwe inqubo esebenza kahle yokuxhumana ngezimpawu. Izindlela zokwenza: Kulolu cwaningo kusetshenziswe izindlela ezixubile lapho kwabandakanywa khona ababambiqhaza abangama-372 kusetshenziswa uhlelo lokukhetha ngokusobala, ngokulandela indlela yezinjulalwazi nalolo oluvumelana nesimo. Kwabukwa abahlengikazi abangama-27, kwathi abayi-13 kubo kwaxoxwa nabo. Kwabukwa abantu asebekhulile abangama-29, kwase kuthi abayisishiyagalombili kubo kwaxoxwa nabo. Ngaphezu kwalokho, kunabahlengikazi abangamathwasa abangama-316 ababamba iqhaza kule nhlolovo. Ukuhlaziywa kwemininingo eyikhwalithethivu kwakunalezi zinyathelo ezintathu; ukuhluza ulwazi oluqoqiwe ukwenza ucwaningo lube yizingxenye ezincane bese zinikezwa amakhodi, ukuhlela amakhodi olwazi oluhluziwe bese ebekwa ngemikhakha kuye ngokuhlobana kwawo nokuhlobanisa yonke imikhakha ibe umkhakha owodwa owumgogodla kanye nokuhlaziya ngokuqhathanisa, kanye nerekhodi lomcwaningi eliqukethe umbono wakhe, neziphetho afinyelele kuzo nokuphawula. Imininingo eyikhwantithethivu yahlaziywa kusetshenziswa uhlelo lwekhompuyutha i-SPPS version 25, lapho kwenziwa khona ukuhlola okuchazayo nokucabangelayo.

Imiphumela: Okokuqala, bube buncane ubufakazi bokuthi lukhona ucwaningo olwenziwe odabeni lokuxhumana ngokusebenzisa izimpawu phakathi kwabahlengikazi nabantu asebekhulile abalaliswe esibhedlela abanengqondo esebenza ngokugcwele endaweni yokwelapha. Okwesibili, abantu asebekhulile ngeminyaka abalaliswe esibhedlela, ababenezidingo ezithile zokuxhumana ngezimpawu, bakuqonda ngokunembile okwakushiwo abahlengikazi lapho bekhuluma nabo ngezimpawu, kanti kwezinye izimo abazange bakuqonde ngokunembile okwakushiwo. Okwesithathu, abahlengikazi basebenzisa ikakhulukazi ukuthinta, izimpawu zomzimba, nezinga lokuqhelelana noma ukusondelana nomuntu ukuze bakhe ubudlelwano nabantu asebekhulile abalaliswe esibhedlela, bababonise uthando, babanikeze ithemba futhi baxoxe nabo. Ngaphezu kwalokho, abahlengikazi abasengamathwasa babonisa isimo sengqondo esihle kakhudlwana kubantu asebekhulile; nokho, ithuluzi elisetshenzisiwe ukuze kuhlaziywe isimo sabo sengqondo libonise izimpawu zokusebenza kahle. Okokugcina, isibonelo sendlela ephumelelayo yokuxhumana ngezimpawu nabantu asebekhulile abalaliswe esibhedlela satholakala emininingweni futhi sididiyela yonke imikhakha eyisithupha yohlaka lukaStrauss noCorbin.

Isiphetho: Ngokuvamile abahlengikazi basebenzisa izindlela zokuxhumana ngezimpawu ezimbalwa ukuze baxhumane nabantu asebekhulile abalaliswe esibhedlela, ezazingasizi ekudluliseleni umyalezo ngempumelelo. Indlela ehlongozwayo inikeza isiqondiso sokuxhumana ngezimpawu nabantu asebekhulile ngendlela ephumelelayo futhi iyavuma ukuthi indlela abantu asebekhulile abaqonda ngayo izinto nezidingo zabo zokuxhumana ngezimpawu, kuhlanganise nendlela umuntu ababheka ngayo, kunomthelela ekuxhumaneni nabo ngezimpawu ngempumelelo. Kuthenjwa ukuthi abahlengikazi bazokuhlola lokhu ukuze bathuthukise indlela abakhulumisana ngayo ngezimpawu neziguli esezikhulile ezilaliswe esibhedlela ukuze kuthuthukiswe izinga lokwaneliseka kweziguli, kuncishiswe ubude besikhathi ezisihlala esibhedlela futhi kuthuthukiswe izinga lokunakekelwa kwabantu abadala.