Guidelines to enhance communication skills of nurses caring for patients diagnosed with Tuberculosis at public health facilities in the Khomas region of Namibia
The overarching purpose of this study was to explore and describe how nurses communicate with patients diagnosed with tuberculosis (TB) at public health facilities in the Khomas Region of Namibia, and to develop guidelines for communication that would enhance the communication skills of nurses. To address the purpose of the study, a research project was conducted, which was quantitative, exploratory, descriptive, and contextual in nature. The study was conducted in four phases, starting with an exploration and description of communication process between nurses and patients diagnosed with tuberculosis in Phase 1, followed by the development of a conceptual framework for effective communication in phase two. Phase 3 involved the process of developing guidelines, and Phase 4 focused on the implementation and evaluation of these guidelines. The population and the sample of the study were the same (thirty nurses and thirty patients diagnosed with TB from all the public health facilities in the Khomas Region). The data collection method employed was observation using a checklist, followed by individual semi-structured face-to-face interviews with nurses, and also with the patients diagnosed with tuberculosis. The quality of research and research instrument were determined by its validity and reliability. Data obtained were analysed by using the Epi InfoTM software package, and content analysis. The main findings established that nurses who were caring for patients diagnosed with tuberculosis exhibited inadequate communication skills in the following areas: creating a conducive environment for communication, assessing and understanding the patients’ mood and level of understanding, listening, questioning, constructive feedback, understanding of non-verbal communication, respect, and empathy for patients. The study results also revealed that patients diagnosed with tuberculosis had inadequate knowledge about TB. The majority of patients diagnosed with TB did not know the type of TB they had and they perceived alcohol and smoking as the causes of TB. From the findings, the researcher developed guidelines for communication that were reviewed and validated by the guidelines development group. The nurses were trained to apply guidelines on communication during their daily interaction with patients diagnosed with tuberculosis. Three months after training, evaluation results indicated a significant improvement in reducing the aforementioned communication limitations of the nurses, while the patients’ knowledge of TB was also improving. All patient participants knew that TB was caused by the bacteria/germs, and all of them knew the type of TB they had. The researcher recommends that the TB policymakers integrate these communication guidelines into TB policies, guidelines, and manuals.
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