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  • Guideline Summary
  • NGC:009924
  • 2013 Apr 30

Best evidence statement (BESt). The effect of communication skills training on nurses' confidence and competence in providing psychosocial support to patients and families.

Cincinnati Children's Hospital Medical Center. Best evidence statement (BESt). The effect of communication skills training on nurses' confidence and competence in providing psychosocial support to patients and families. Cincinnati (OH): Cincinnati Children's Hospital Medical Center; 2013 Apr 30. 5 p. [9 references]

View the original guideline documentation External Web Site Policy

This is the current release of the guideline.

Major Recommendations

The strength of the recommendation (strongly recommended, recommended, or no recommendation) and the quality of the evidence (1a‒5b) are defined at the end of the "Major Recommendations" field.

It is recommended that communication skills training be provided to nurses to improve their confidence and competence in providing psychosocial support to patients and their families (van Weert et al, 2011 [2a]; Rask et al., 2009 [2b]; Langewitz et al., 2010 [4a]; Boscart, 2009 [4a]; Wilkinson, Linsell, & Blanchard, 2008 [4b]; McGilton et al., 2006 [4a]; Bowles, Mackintosh, & Torn 2001 [4b]).

Definitions:

Table of Evidence Levels

Quality Level Definition
1a† or 1b† Systematic review, meta-analysis, or meta-synthesis of multiple studies
2a or 2b Best study design for domain
3a or 3b Fair study design for domain
4a or 4b Weak study design for domain
5a or 5b General review, expert opinion, case report, consensus report, or guideline
5 Local Consensus

†a = good quality study; b = lesser quality study

Table of Language and Definitions for Recommendation Strength

Language for Strength Definition

It is strongly recommended that…

It is strongly recommended that… not…

When the dimensions for judging the strength of the evidence are applied, there is high support that benefits clearly outweigh risks and burdens (or visa-versa for negative recommendations).

It is recommended that…

It is recommended that… not…

When the dimensions for judging the strength of the evidence are applied, there is moderate support that benefits are closely balanced with risks and burdens.

There is insufficient evidence and a lack of consensus to make a recommendation…

Note: See the original guideline document for the dimensions used for judging the strength of the recommendation.

Clinical Algorithm(s)

None provided

Disease/Condition(s)

Diseases and conditions in any healthcare setting that require nursing care

Guideline Category

Counseling

Clinical Specialty

Nursing

Oncology

Intended Users

Advanced Practice Nurses

Hospitals

Nurses

Physicians

Guideline Objective(s)

To evaluate, among direct care nurses, if communication skills training, compared to no communication skills training, affects nurses' confidence and competence in providing psychosocial support to patients and families

Target Population

Nurses caring for patients and providing psychosocial support in any healthcare setting

Interventions and Practices Considered

Communication skills training for direct care nurses

Major Outcomes Considered

Nurses' confidence and competence in providing psychosocial support to patients and families

Methods Used to Collect/Select the Evidence

Searches of Electronic Databases

Description of Methods Used to Collect/Select the Evidence

Search Strategy

Databases: Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsychINFO, and Cochrane Library

Search Terms: nurses, nursing, psychosocial factors, chronic illness, coping, long-term hospitalization, bone marrow transplant, behavior modification, pediatric oncologic nursing, oncologic nursing, nurse-patient relations, communication skills, communication skills training, psychosocial support, and solution-focused brief therapy

Date Last Search Done: January 13, 2013

Number of Source Documents

Not stated

Methods Used to Assess the Quality and Strength of the Evidence

Weighting According to a Rating Scheme (Scheme Given)

Rating Scheme for the Strength of the Evidence

Table of Evidence Levels

Quality Level Definition
1a† or 1b† Systematic review, meta-analysis, or meta-synthesis of multiple studies
2a or 2b Best study design for domain
3a or 3b Fair study design for domain
4a or 4b Weak study design for domain
5a or 5b General review, expert opinion, case report, consensus report, or guideline
5 Local Consensus

†a = good quality study; b = lesser quality study

Methods Used to Analyze the Evidence

Systematic Review

Description of the Methods Used to Analyze the Evidence

Not stated

Methods Used to Formulate the Recommendations

Expert Consensus

Description of Methods Used to Formulate the Recommendations

Not stated

Rating Scheme for the Strength of the Recommendations

Table of Language and Definitions for Recommendation Strength

Language for Strength Definition

It is strongly recommended that…

It is strongly recommended that… not…

When the dimensions for judging the strength of the evidence are applied, there is high support that benefits clearly outweigh risks and burdens (or visa-versa for negative recommendations).

It is recommended that…

It is recommended that… not…

When the dimensions for judging the strength of the evidence are applied, there is moderate support that benefits are closely balanced with risks and burdens.

There is insufficient evidence and a lack of consensus to make a recommendation…

Note: See the original guideline document for the dimensions used for judging the strength of the recommendation.

Cost Analysis

A formal cost analysis was not performed and published cost analyses were not reviewed.

Method of Guideline Validation

Peer Review

Description of Method of Guideline Validation

This Best Evidence Statement has been reviewed against quality criteria by two independent reviewers from the Cincinnati Children's Hospital Medical Center (CCHMC) Evidence Collaboration.

References Supporting the Recommendations

Boscart VM. A communication intervention for nursing staff in chronic care. J Adv Nurs. 2009 Sep;65(9):1823-32. PubMed External Web Site Policy

Bowles N, Mackintosh C, Torn A. Nurses' communication skills: an evaluation of the impact of solution-focused communication training. J Adv Nurs. 2001 Nov;36(3):347-54. PubMed External Web Site Policy

Langewitz W, Heydrich L, Nubling M, Szirt L, Weber H, Grossman P. Swiss Cancer League communication skills training programme for oncology nurses: an evaluation. J Adv Nurs. 2010 Oct;66(10):2266-77. PubMed External Web Site Policy

McGilton K, Irwin-Robinson H, Boscart V, Spanjevic L. Communication enhancement: nurse and patient satisfaction outcomes in a complex continuing care facility. J Adv Nurs. 2006 Apr;54(1):35-44. PubMed External Web Site Policy

Rask MT, Jensen ML, Andersen J, Zachariae R. Effects of an intervention aimed at improving nurse-patient communication in an oncology outpatient clinic. Cancer Nurs. 2009 Jan-Feb;32(1):E1-11. PubMed External Web Site Policy

van Weert JC, Jansen J, Spreeuwenberg PM, van Dulmen S, Bensing JM. Effects of communication skills training and a Question Prompt Sheet to improve communication with older cancer patients: a randomized controlled trial. Crit Rev Oncol Hematol. 2011 Oct;80(1):145-59. PubMed External Web Site Policy

Wilkinson S, Linsell L, Blanchard K. Communication skills training for nurses working with patients with heart disease. Br J Card Nurs. 2008;3(10):475-81.

Type of Evidence Supporting the Recommendations

The type of supporting evidence is identified and graded for each recommendation (see the "Major Recommendations" field).

Potential Benefits

Communication skills training has been shown to be effective at increasing nurses' ability to provide psychosocial support to patients, confidence in providing psychosocial support, confidence in handling conflicts and criticism, and communication-related self-efficacy.

Potential Harms

Not stated

Qualifying Statements

This Best Evidence Statement addresses only key points of care for the target population; it is not intended to be a comprehensive practice guideline. These recommendations result from review of literature and practices current at the time of their formulation. This Best Evidence Statement does not preclude using care modalities proven efficacious in studies published subsequent to the current revision of this document. This document is not intended to impose standards of care preventing selective variances from the recommendations to meet the specific and unique requirements of individual patients. Adherence to this Statement is voluntary. The clinician in light of the individual circumstances presented by the patient must make the ultimate judgment regarding the priority of any specific procedure.

Description of Implementation Strategy

Applicability Issues

Communication skills trainings can be time-consuming. Trainings ranged from 30 minutes to four days in length. Several of the studies also included follow-up training, ranging from four 4 hours to 1.5 days each. It will be important to allot time for nurses to attend communication skills training and follow-up sessions (if needed), outside of their regular assigned work duties. Additionally, extra funding may be needed to support staff time to conduct and participate in the training. Communication skills training sessions could be implemented during orientation for new nursing employees. In addition, the Therapeutic Collaborative training can also be used as a means to achieve communication skills training for nurses. The Therapeutic Collaborative training is currently given to nurses caring for bone marrow transplant patients in a pediatric institution. It aims to assist nurses in forming therapeutic relationships with their patients and families, addressing professional boundaries, the "zone of helpfulness," and personality style and how it relates to communication. This training has been conducted in a group format over a 4-hour period of time. It is also offered as an internet web-based video, with individual discussion between nurses and their clinical managers. This offers more flexibility for training to be completed and makes it easier from a scheduling standpoint. Communication skills training could be included as a part of the Therapeutic Collaborative training.

Implementation Tools

Audit Criteria/Indicators

For information about availability, see the Availability of Companion Documents and Patient Resources fields below.

IOM Care Need

End of Life Care

Getting Better

Living with Illness

IOM Domain

Effectiveness

Patient-centeredness

Bibliographic Source(s)

Cincinnati Children's Hospital Medical Center. Best evidence statement (BESt). The effect of communication skills training on nurses' confidence and competence in providing psychosocial support to patients and families. Cincinnati (OH): Cincinnati Children's Hospital Medical Center; 2013 Apr 30. 5 p. [9 references]

Adaptation

Not applicable: The guideline was not adapted from another source.

Date Released

2013 Apr 30

Guideline Developer(s)

Cincinnati Children's Hospital Medical Center - Hospital/Medical Center

Source(s) of Funding

No external funding was received for development of this Best Evidence Statement (BESt).

Guideline Committee

Not stated

Composition of Group That Authored the Guideline

Team Leader/Author: Sharon Penko, MSW, LSW, ACHP-SW, Bone Marrow Transplant Social Worker, Cancer & Blood Diseases Institute

Support/Consultant: Mary Ellen Meier, MSN, RN, CPN, Evidence-Based Practice Mentor-Center for Professional Excellence & Business Integration Research & Evidence-Based Practice

Ad Hoc/Content Reviewer: Maureen Donnelly, MSW, LISW-S, Social Work Clinical Manager, Cancer & Blood Diseases Institute; Laura Flesch, RN, MSN, CRNP, Clinical Director, Bone Marrow Transplantation & Immune Deficiency, Cancer & Blood Diseases Institute

Financial Disclosures/Conflicts of Interest

Conflicts of interest were declared for each team member. No financial or intellectual conflicts of interest were found.

Guideline Status

This is the current release of the guideline.

Guideline Availability

Availability of Companion Documents

The following are available:

  • Judging the strength of a recommendation. Cincinnati (OH): Cincinnati Children's Hospital Medical Center; 2008 Jan. 1 p. Available from the Cincinnati Children's Hospital Medical Center External Web Site Policy.
  • Grading a body of evidence to answer a clinical question. Cincinnati (OH): Cincinnati Children's Hospital Medical Center; 1 p.
  • Table of evidence levels. Cincinnati (OH): Cincinnati Children's Hospital Medical Center; 2008 Feb 29. 1 p. Available from the Cincinnati Children's Hospital Medical Center External Web Site Policy.

In addition, suggested process or outcome measures are available in the original guideline document External Web Site Policy.

Patient Resources

None available

NGC Status

This NGC summary was completed by ECRI Institute on September 6, 2013.

Copyright Statement

This NGC summary is based on the original full-text guideline, which is subject to the following copyright restrictions:

Copies of this Cincinnati Children's Hospital Medical Center (CCHMC) Best Evidence Statement (BESt) are available online and may be distributed by any organization for the global purpose of improving child health outcomes. Examples of approved uses of the BESt include the following:

  • Copies may be provided to anyone involved in the organization's process for developing and implementing evidence based care;
  • Hyperlinks to the CCHMC website may be placed on the organization's website;
  • The BESt may be adopted or adapted for use within the organization, provided that CCHMC receives appropriate attribution on all written or electronic documents; and
  • Copies may be provided to patients and the clinicians who manage their care.

Notification of CCHMC at EBDMInfo@cchmc.org for any BESt adopted, adapted, implemented or hyperlinked by the organization is appreciated.

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