Abstract
Background & Purpose
Effective communication is essential to understand the needs of patients and to provide patient-centered care. However, in cases of perinatal loss, which tend to occur unexpectedly, clinicians often experience difficulty communicating effectively as they need to deal with both the patients' emotions and their own emotional reactions. The purpose of the present study was to develop and to evaluate the effectiveness of a communication skills training based on cognitive behavioral theory (CBT) designed for nurses who work with parents who lost their babies during the perinatal period.
Methods
This is a single-group experiment with a pre- and post-test research design. Licensed nurses and midwives who provided perinatal loss care were recruited for this study. The training goal was to precipitate changes in attitudes and behaviors of the clinicians. The effectiveness of the training was assessed by measuring self-efficacy (SE), sense of difficulty, compassion satisfaction (CS), compassion fatigue (CF), attitude about communication, and communication behaviors. These were measured at three points: pre- and post-intervention as well as at a one-month follow-up.
Results
Forty-seven nurses and midwives participated in the study and received a one-day communication skills training, of which 37 (78.7%) completed the questionnaires given at the pre- and post-intervention as well as at a one-month follow-up. The results included the following: (1) SE significantly increased after the training (p=.000), and SE remained higher at the one-month follow-up compared to pre-intervention (p=.000); (2) sense of difficulty significantly decreased after the training (p=.000) and at the follow-up (p=.000); (3) although no changes in CS and CF were found, the additional subgroup analysis revealed that participants who had low SE and high sense of difficulty prior to the intervention (n=13) reported significantly reduced secondary traumatic stress, which is one of the element of CF, after the training (p=.001); and (4) at one month following the training, 28 participants (75.7%) reported that they experienced changes in their attitudes and behaviors toward communication.
Conclusion
Nurses and midwives who received the CBT-based communication skills training reported increased self-efficacy and reduced sense of difficulty in providing perinatal loss care, and these changes were maintained one month after the intervention. The findings also suggested that the training program may contribute to changes in perinatal loss care providers' cognition, attitudes, and behaviors toward patient-clinician communication.
