Nursing Dissertation: Improving Healthcare Communication for Patients

This dissertation proposal focuses on improving healthcare for patients with severe communication defects. The introduction defines communication disorders and their impact, differentiating between various types, including expressive language disorder, mixed receptive-expressive language disorder, and those with conditions like autism and dementia. The proposal highlights the challenges these patients face in expressing their needs and the resulting barriers to person-centered care. It aims to analyze the best approaches for providing healthcare to this population, starting with a background discussion on communication's importance in nursing, especially in the context of patient-centered care. The research questions address the best approach for providing care, aiming to identify suitable communication methods, assess needs, and recommend training for nursing professionals. The proposal will utilize secondary data analysis and address ethical considerations, culminating in a detailed grant chart outlining key research milestones. The references include several sources that are relevant to the topic of communication in nursing, and the proposal will include a narrative review.

Running head: DISSERTATION
Dissertation
Name of the Student
Name of the University
Author Note

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Topic
Providing Healthcare to Patients with Severe Communication Defects
Introduction
Communication disorder is any form of disorder that affects the ability of an
individual to comprehend, detect or to apply proper language and speech in order to express
clear thoughts while in conversation with others. The defects, delay or disorder in
communication mainly ranges from simple sound substitution along with the inability to use
native language properly (Gibson et al. 2013). Disorders and the symptoms included and
excluded under the category of the communication defects differ from source to source. For
example, the definitions offered by the American Speech-Language-Hearing Association
differ from the Diagnostic Statistical Manual 5th Edition (Posar, Resca and Visconti 2015).
The population who are suffering from the communication defects are subdivided into
different sub-population and these include expressive language disorder, mixed receptive-
expressive language disorder, shuttering and phonological disorder. Expressive language
disorder is mainly characterised by difficulty in expressing one-self beyond simple sentences
and with restricted stock to vocabulary in order to express their feelings. Individuals might
have same scope of understanding like any other normal person and have thoughts running
down through their head to express their feelings but due to the limitations of vocabulary,
they are unable to express their feelings or thoughts (Bishop and Leonard 2014). People with
mixed receptive-expressive language disorder suffer problems like comprehending the
commands of others. In such cases if a healthcare professional and the nursing professionals
ask to raise the hand in order to record the blood pressure levels via sphygmomanometer,
they are unable to execute the command. This at times takes a tool in the patience of the
healthcare professionals and thereby affecting the process of care (Bishop and Leonard

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2014). Then there are people who are differently able (hearing loss or speech loss) or are
unable to speak and people with autism spectrum disorders or dementia which hampers the
overall course of communication. Videbeck and Videbeck (2013) highlighted mental health
complications like severe depressive syndrome or neurodegenerative disorders like
Alzheimer’s, schizophrenia and Parkinson’s also hampers the communication skills severely.
While receiving care, these people either become conscious or are unable to express creating
a barrier in receiving person-centred care.
According to Nicolaidis et al. (2015) people with communication defects suffer from
challenges like expressing their thoughts, symptoms and pain to the healthcare provider. For
example, people with autism. Other problems highlighted by the people with communication
defects include difficulty in expressing their thoughts with right terms. Nicolaidis et al.
(2015) further stated that people with certain communication defects like with autism
spectrum disorder experiences problem like slow processing of information and challenges in
organizing their thoughts. It is due to the delay in processing the information; the majority of
their concerns remain unheard or unrecognised. Moreover, by the time they gather the
required verbal thoughts to express their particular feelings, the healthcare professional
consider those questions to be "not applicable" or "insignificant in this specific domain of
care and overlook the importance of the same. This gap in the information hampers the
overall process of care. At times, the healthcare professionals fail to grab proper gestures
expressed through non-verbal communication and this in turn affects the overall process of
care (Nicolaidis et al. 2013).
Thus, in order to provide a comprehensive care to this group of population with
communication defects, it is the duty of the nursing professionals to devise a specific
communication style depending on the need to the person. The following research proposal
mainly aims to analyse the best approach that is required to be undertaken in to provide

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healthcare to the people with severe communication defects. The proposal will mainly initiate
with the background of the study via discussing the severe communication defects in wider
contexts and followed by the rational of conducting the proposed research. The proposal will
then highlight the methods that are required to be cited in order to carry out the research in a
successful manner. The proposal will be mainly based on the secondary data and thus will
discuss the approach of analysing the secondary data. Finally the research proposal will
highlighted the four core ethical issues associated with this secondary research and the who
and the dissemination strategy that will be suitable for this domain. The proposal will
conclude with a detailed grant chart stating key time that will be allocated against each
milestones of the research.
Background chapter
Communication is an important aspect of health care domain especially for the
nursing professionals. The main principle for the nursing professionals is to serve the best
need to the patients taking into consideration of the bio-psychological and spiritual needs
(Foronda, MacWilliams and McArthur 2016). In order to execute the duties of the nursing,
proper scientific knowledge, interpersonal communication skills and technical skills are
mandate. Among these skills, communication is a vital element in nursing. Here
communication denotes both verbal and non-verbal communication. Proper communication
skills help in execution of the interventions like framing person centred therapy,
rehabilitation planning and patient education (Dooley, Bailey and McCabe 2015). In nursing
the main component of communication include exchange of quality information, thoughts
and feelings from the patients. Thus communication in nursing is regarded as an important
source of extracting significant information from the patient that can be used in the process of
care. Alternatively, it can be stated that therapeutic practice is an important aspect of nursing

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that involves oral communication of the healthcare professionals or the nursing professionals
with the patients and their relation (Shafakhah et al. 2015). Thus communication is two way
process where the patient’s conveys their fear or concerns to the nursing professionals and the
nurses in turn record certain significant information from gamut information provided by the
client in drafting the care plan or they channelize the required information to the doctors or
the concerned physicians (Shafakhah et al. 2015). Moreover, under the process of effective
communication between the nursing professionals and the patients, the nurses take in
required information and in turn transmits other valuable information in the process of care to
the patients with discretion and delicacy as to the kind of disease and at the same time advises
with treatment and rehabilitation plan for the further health promotion (Shafakhah et al.
2015).
Kourkouta and Papathanasiou (2014) highlighted that effective communication
requires a proper understanding of the patient’s experience and expression along with sincere
intention of the nursing professional to understand the concerns of the patients.
Understanding the mindset of the patient is not comprehensive but making it clear that he or
she is understandable and approachable is also important. Effective communication is mainly
the reflection of knowledge of the participations and the manner in which they think and feel
along. However, the common approach of effective communication in nursing is not
applicable for the patients which severe communication defects (Kourkouta and
Papathanasiou 2014). This is because, the person with severe communication defects are
unable to express their thought process clearly and this hampers the two way communication
process. For example, the people who are unable to speak since birth or have undergone
communication defects post stroke or population with autism, Parkinson’s disease or
dementia are unable to express their feelings or concerns clearly and in a succinct manner.
Unavailability of the proper information while communicating with the population with

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severe communication defects hampers the total process of care (Kourkouta and
Papathanasiou 2014). However, according to the National competency standards for the
registered nurse by the Nursing and the Midwifery Board of Australia, it is the duty of the
healthcare professionals to use a range of effective communication techniques while
providing care for the patients (standard 9). Furthermore, the standard 9 also highlights the
nurses must interact with the patients with a supportive manner while respecting the dignity
of the individual while showing trust and empathy. However, the analysis of the literature
highlighted that the effective communication styles or the communication approach that are
suitable for the population with the severe communication defects are not collated in order an
organised manner. There are no definite researches showing a preferable communication
styles that will be suitable in accessing healthcare needs of the patients with severe
communication defects. This gap in the synthesis of the research creates a barrier in
providing comprehensive care to the population with severe communication problem.
Research question
What is the best approach of providing care to the population with severe communication
defects?
Aims and objective of the research
 Identification and assessment of communication disorder
 Assessment of the mental needs to these service users
 Identification of suitable communication approaches in order to holistic care to
services users with communication defects
 Recommendation towards training nursing professionals in adapting person-centred
communication approach

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The improvement
The improvement that can be gained via conducting the research or the rationale
behind conducting the research is, having a detailed lay out of the communication style that
will be suitable for providing care to the population with severe communication defects will
help to improve the mental and physical needs of that population. Defining proper mode of
communication for the population with severe communication defects help to identify the
principles of communication (Judd 2013). According to Kourkouta and Papathanasiou
(2014), communication is an intrinsic factor and it is not possible to communicate effectively
without understanding the content, approach and need of the client. In order to increase the
overall process of healthcare for people with severe communication problem a detailed layout
of the communication style is important depending on the communication difficulty for that
particular individual. Thus conducting this secondary research based on the narrative review
will help to evaluate those concerns associated with healthcare in population with severe
communication defects.

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References
Bishop, D.V. and Leonard, L. eds., 2014. Speech and language impairments in children:
Causes, characteristics, intervention and outcome. Psychology press.
Dooley, J., Bailey, C. and McCabe, R., 2015. Communication in healthcare interactions in
dementia: a systematic review of observational studies. International psychogeriatrics, 27(8),
pp.1277-1300.
Foronda, C., MacWilliams, B. and McArthur, E., 2016. Interprofessional communication in
healthcare: An integrative review. Nurse education in practice, 19, pp.36-40.
Gibson, J., Adams, C., Lockton, E. and Green, J., 2013. Social communication disorder
outside autism? A diagnostic classification approach to delineating pragmatic language
impairment, high functioning autism and specific language impairment. Journal of Child
Psychology and Psychiatry, 54(11), pp.1186-1197.
Judd, M., 2013. Broken communication in nursing can kill: teaching communication is
vital. Creative nursing, 19(2), pp.101-104.
Kourkouta, L. and Papathanasiou, I.V., 2014. Communication in nursing practice. Materia
socio-medica, 26(1), p.65.
Nicolaidis, C., Raymaker, D., McDonald, K., Dern, S., Boisclair, W.C., Ashkenazy, E. and
Baggs, A., 2013. Comparison of healthcare experiences in autistic and non-autistic adults: a
cross-sectional online survey facilitated by an academic-community partnership. Journal of
general internal medicine, 28(6), pp.761-769.
Nicolaidis, C., Raymaker, D.M., Ashkenazy, E., McDonald, K.E., Dern, S., Baggs, A.E.,
Kapp, S.K., Weiner, M. and Boisclair, W.C., 2015. “Respect the way I need to communicate

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with you”: Healthcare experiences of adults on the autism spectrum. Autism, 19(7), pp.824-
831.
Nursing and the Midwifery Board of Australia. (2012). National competency standards for
the registered nurse. Access date: 6th September 2018. Retrieved from:
http://www.nursingmidwiferyboard.gov.au/Search.aspx?
q=National+competency+standards+for++++++Registered+Nurse.+
Posar, A., Resca, F. and Visconti, P., 2015. Autism according to diagnostic and statistical
manual of mental disorders 5th edition: The need for further improvements. Journal of
pediatric neurosciences, 10(2), p.146.
Shafakhah, M., Zarshenas, L., Sharif, F. and Sarvestani, R.S., 2015. Evaluation of nursing
students’ communication abilities in clinical courses in hospitals. Global journal of health
science, 7(4), p.323.
Videbeck, S. and Videbeck, S., 2013. Psychiatric-mental health nursing. Lippincott Williams
& Wilkins.