Nurses' attitudes towards communication with patients: a hybrid concept analysis

Nurses' attitudes towards communication with patients plays a crucial role in determining the effectiveness of these interactions and is central to the nurse-patient relationship. However, a standardized definition of nurses' attitudes towards communication with patients is required. This study aims to theoretically define nurses' attitudes towards communication with patients, providing a theoretical foundation for developing measurement tools and nurse-patient communication training programs.

A mixed method design was applied in the concept analysis to explore the meaning of nurses' attitudes towards communication with patients in clinical settings. The analysis followed the three-phase procedure of the hybrid concept analysis approach. In the theoretical phase, systematic Literature searches were performed across Chinese and English databases, and the included Literature was reviewed to identify the attributes, antecedents, and consequences of the concept. For the fieldwork phase, semi-structured interviews were conducted with 18 nurses, and the data were analyzed using content analysis with Nvivo software. During the final analytic phase, the results of the two previous phases were integrated. The reporting of qualitative findings was guided by the Consolidated Criteria for Reporting Qualitative Research checklist.

Five conceptual attributes were identified: based on professional values and norms, emotional responses and evaluations, expression through language and expression, polarity, and predictive of communicative behaviors. Nurses' attitudes towards communication with patients are influenced by factors related to the nurses themselves, their work environment, and the patients. It impacts patients' psychological status and health outcomes, nursing service quality, nurses' professional fulfillment, career advancement and personal well-being, while also influencing the evolution of nurse-patient relationships.

Nurses' attitudes towards communication with patients exhibit a three-dimensional attribute characteristic. These attitudes are influenced by factors related to nurses themselves, patients, and the environment, while simultaneously impacting patients, nurses, nursing practice, and nurse-patient relationships. The findings of this study provide a theoretical basis for the development of measurement tools assessing nurses' attitudes towards communication with patients, as well as guidance for nurse-patient communication training.