| Objectives:By understanding the current situation of ICU nurses’ clinical nursing and patient communication ability,the clinical application effect of CICARE mode combined with the Kolb’s experiential learning theory of communication ability training program was discussed,providing a new idea for ICU nurses’ clinical communication training.Methods:The first stage is the investigation and research stage.A total of 320 registered nurses working in adult ICU from tertiary hospitals in Yunnan Province from June2022 to July 2022 was selected by the convenience sampling method.The nurses’ communication abilities were investigated by Clinical Communication Ability Scale,Jefferson Empathy Scale,the Job Shape Scale,and the Proactive Personality Scale.After data collection,SPSS25.0 software was used to analyze the communication status and influencing factors between ICU nurses and patients’ families,providing ideas for the next stage of training program construction.The second stage is the project construction stage.A research team was established,and a CICARE mode communication scheme was preliminary constructed according to the common communication scenarios of ICU work by using the literature review method combined with the findings of the first stage.In other words,each scene uses the six steps of Connect,Introduce,Communicate,Ask,Respond and Exit to communicate.Then apply Kolb’s four stages of experiential learning theory,namely Concrete Experience(CE),Reflective Observation(RO),Abstract Conceptualization(AC),Active Experimentation(AE)will conduct CICARE mode communication scheme for nurse training.After discussion,demonstration,modification,and improvement of the training program at the expert meeting,the communication training program between ICU nurses and patients’ families based on CICARE model combined with Kolb’s experiential learning theory was finally determined.The third stage,effect evaluation stage.A total of 75 registered nurses working in adult ICU in a Grade-III hospital in Yunnan Province were selected from August 2022 to January 2023 and divided into a control group and an intervention group through the group grouping mode,with 37 in the control group and 38 in the intervention group.ICU responsible nurses in the control group received traditional communication theory training.The intervention groups received unified training of the CICARE model combined with Kolb’s experiential learning theory training program.Before and 6 months after the intervention,the self-compiled communication theory test paper was used to test,and before the intervention,3months and 6 months,the nurses’ communication ability scale and empathy scale were used to questionnaire survey the two groups of nurses.Sixty-seven family members of ICU patients were selected with the Chinese version of the satisfaction scale for family members of critically ill patients was used to conduct a questionnaire survey after the communication between nurses and family members of patients.Results:The first stage,in the investigation of the status quot of communication between ICU nurses and family members of patients,the effective sample size of ICU nurses was 320 cases.There were no statistically significant differences in age,marriage,fertility status,educational background,professional title,level,length of service,ICU working years and specialty qualification of ICU nurses(P> 0.05).Intonation during communication,experience of disputes caused by bad communication,job shaping,empathic ability and proactive personality were significant independent factors influencing nurses’ clinical communication ability(P< 0.05),among which empathic ability had the highest influence on nurses’ clinical communication ability.Through the study of this part,it is found that the overall level of communication between ICU nurses and patients’ families is above average,and the ability to cope with difficult scenarios is insufficient,which has room for improvement.The second stage,The CICARE communication process for new admissions,transfer in or out of the ICU,automatic discharges/deaths,examinations,high-risk patients with pressure injuries,and families of patients using physical restraints,along with six scenario corresponding cases,was constructed to train ICU nurses to internalize knowledge and communication skills using the four stages of Kolb’s empirical learning theory: Concrete Experience,Reflective Observation,Abstract Conceptualization,and Active Practice.Five experts were selected to review and improve the communication process and training methods through expert meetings.According to the calculation of the authority coefficient questionnaire of the expert issued,it is concluded that the experts in this study have a high authority coefficient of 0.895.The results of the expert meeting had high credibility,and the training program was determined through the meeting.The third stage,explore the clinical practical application effect of CICARE model combined with Kolb’s experiential learning theory.In the control group,3patients dropped out of the study due to sick maternity leave,the loss of follow-up rate was 7.5%,and 37 patients completed the study.In the intervention group,2patients dropped out of the study with a loss of follow-up rate of 5%,and 38 patients completed the study.The t-test and variance analysis were conducted on the age,working years,gender,communication training and marriage of the two groups of nurses,and the results showed that there was no statistical significance between the two groups(P> 0.05).Before the intervention,the communication theory performance,communication ability and empathy,and the results showed that the three scores of the two groups were not statistically significant(P> 0.05).After the training of the nurses in the intervention group by using the training program,group comparisons were performed using two independent sample t-tests,results,intervention for 3months,the basic verbal communication ability and basic nonverbal communication ability dimension scored higher than the control group,the difference was statistically significant(P< 0.05),the empathy dimension score of transcended thinking was higher in the intervention group than in the control group,the difference was statistically significant(P< 0.05),6 months after intervention,the six dimensions were higher in the intervention group than in the control group,statistically significant difference(P <0.05),communication skills before and after the intervention,the scores of each dimension in both groups were improved compared with those before the intervention(P <0.05),the scores of empathy ability selection,emotional maintenance and transcended thinking in the intervention group were higher than those in the control group,the difference was statistically significant(P<0.05),nurse and patient communication theory performance before and after the intervention,higher theoretical performance in both groups compared with that before the intervention,statistically significant difference(P <0.05),the theoretical score of the intervention group was higher than that of the control group(P< 0.05).In the investigation of family members of patients,40 questionnaires were issued to the control group,35 were recovered,1 was invalid,and 34 were effectively recovered,with an effective recovery rate of 85%.In the intervention group,40 questionnaires were sent out,36 were recovered,3 were invalid,and 33 were effectively recovered,with an effective recovery rate of 82.5%.The t-test of two independent samples was used for family age,check-in time,APACHE II score,education level,gender and occupation of the two groups,and the results showed that there was no statistical significance between the two groups(P> 0.05).In the comparison of family satisfaction between the two groups,the total mean score and scores of each dimension of family satisfaction in the intervention group were higher than those in the control group,the difference was statistically significant(P< 0.05).Conclusions:(1)The ability of ICU nurses to communicate between nurses and patients is above average and needs to be improved continuously.(2)The CICARE model combined was construct the communication scheme between ICU nurses and patients’ families,the scheme has a certain scientific nature.(3)After the training programs of communication between ICU nurses and patients’ families based on the CICARE model combined with Kolb’s experiential learning theory,nurses have significantly improved their communication skills,empathy ability and theoretical scores,as well as the satisfaction of ICU patients’ families.(4)The CICARE model combined with Kolb’s experiential learning theory can be included in the routine care content of the ICU in order to promote its use in a larger scope. |
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