The Application Of CICARE Communication Model Between Nurses And Patients During Visiting Period In ICU

ObjectiveTo explore the current situation and main influence factors of the communication between Intensive Care Unit(ICU) nurses and family members of patients; and to evaluate the impact of CICARE communication mode on the ICU nurses' communication ability and the degree of families satisfaction; and to provide clinical reference basis for establishing ICU CICARE communication mode and promoting the application of this model in clinical nursing.Methods(1)Twelve ICU nurses were extracted from the comprehensive ICU of four tertiary hospitals in Hengyang by purpose sampling. Using the phenomenological study technique, ICU nurses were investigated by semi-structured interview, then data were analyzed by means of content analysis.(2)A total of 80 ICU nurses who extracted conveniently from two partition were divided into the intervention group(n=40) and the control group(n=40). There were 38 nurses in the control group and 39 nurses in the intervention group, who finished the study. The nurses of two groups were trained by traditional method and used routine communication way. More specifically, there were communication theory training and department specialty knowledge training for once every month and routine communication way. Apart form traditional training way, CICARE was applied as a fortifier in the intervention group. And more specifically, they were trained by the CICARE communication theory and used it in nurse-patient communication between ICU nurses and families during visiting time. CICARE communication model contained connect, introduce, communicate, ask, respond,exit, and so on.(3)Firstly, according to the content of the communication training project, we established test papers. Assessment on nurses' communication theoretical knowledge were held before intervention, and after 3 months and 6 months intervention, then averaging results of theoretical tests after intervention. The averaged grades of two groups were compared. Secondly, the families of patients were investigated with the family's satisfaction questionnaire after 6 months intervention. At the same time, the nurses were investigated with the nurse clinical communication competence scale before the intervention, and after 3 months and 6 months intervention.(4)The data were analyzed by the statistical software SPSS 18.0. Statistical methods included descriptive analysis, Wilcoxon rank sum test, t-test, chi-square test, repetitive measures ANOVA and so on.Results(1)A total of four themes for 12 ICU nurses were summarized, they were communication environment, communication consciousness, confident communication, emotional response.(2)Before intervention,there was no statistically significant difference on basic information, the score of theoretical tests and the score of nurse clinical communication skill between control and intervention groups(P>0.05).(3)After 3 months intervention, the mean score of encourage families participate in care(2.52±0.48) and validate feeling(2.38±0.31) in the intervention group were significant higher than those in the control group [(2.31±0.42)?(2.23±0.32)], the differences were statistically significant(P<0.05); the mean score of nurse clinical communication skill(2.57±0.22) and establish harmoniously relationship(2.74±0.30), subtly listening(2.73±0.34), identify the families' problems(2.53±0.40),deliver effective information(2.38±0.46) were compared with those in the control group[(2.52±0.27)?(2.79±0.36)?(2.79±0.34)?(2.48±0.33)?(2.33±0.44)], there were no statistically significant differences(P>0.05). After 6 months intervention, the mean score of nurse clinical communication skill(2.81±0.21) and identify the families' problems(2.81±0.36), encourage families participate in care(2.71±0.38), deliver effective information(2.74±0.48), validate feeling(2.70±0.33) in the intervention group were obviously higher than those in the control group [(2.59±0.19) ?(2.54±0.35) ?(2.41±0.38) ?(2.39±0.46) ?(2.37±0.35)](P<0.05); establish harmoniously relationship(2.95±0.30) and subtly listening(2.89±0.33) were compared with those of the control group [(2.83±0.24) ?(2.83±0.35)], there were no statistically significant differences(P>0.05).(4)After 6 months intervention, the score of theoretical tests in the intervention group(79.29±2.75) was statistically higher than the control group(77.26±2.79), the mean score of families' satisfaction in the intervention group(3.00±0.14) was higher than that in the control group(2.73±0.16), the differences were statistically significant(P<0.05).Conclusions(1)The main influential factors of communication between ICU nurses and patents' family members were mainly for the obstacle factors what involved poor communication environment, lack of communication consciousness(inadequate preparation before communication, ignore the active communication, and so on), lack of confident communication(lack of professional knowledge, short of communication skills), negative emotional response(job burnout and compassion fatigue).(2)CICARE communication model can effectively improve the clinical communication skills of ICU nurses and the families' satisfaction.