communication barriers in healthcare essay

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Publications
Account settings
My Bibliography
Collections
Citation manager

Save citation to file

Email citation, add to collections.

Create a new collection
Add to an existing collection

Add to My Bibliography

Your saved search, create a file for external citation management software, your rss feed.

Search in PubMed
Search in NLM Catalog
Add to Search

Dissecting Communication Barriers in Healthcare: A Path to Enhancing Communication Resiliency, Reliability, and Patient Safety

Affiliations.

1 Department of Human Factors and Behavioral Neurobiology, Embry-Riddle Aeronautical University, Daytona Beach, Florida.
2 Armstrong Institute for Patient Safety and Quality, Johns Hopkins School of Medicine, Department of Surgery, Johns Hopkins Hospital, Baltimore, Maryland.
PMID: 30418425
DOI: 10.1097/PTS.0000000000000541

Suboptimal exchange of information can have tragic consequences to patient's safety and survival. To this end, the Joint Commission lists communication error among the most common attributable causes of sentinel events. The risk management literature further supports this finding, ascribing communication error as a major factor (70%) in adverse events. Despite numerous strategies to improve patient safety, which are rooted in other high reliability industries (e.g., commercial aviation and naval aviation), communication remains an adaptive challenge that has proven difficult to overcome in the sociotechnical landscape that defines healthcare. Attributing a breakdown in information exchange to simply a generic "communication error" without further specification is ineffective and a gross oversimplification of a complex phenomenon. Further dissection of the communication error using root cause analysis, a failure modes and effects analysis, or through an event reporting system is needed. Generalizing rather than categorizing is an oversimplification that clouds clear pattern recognition and thereby prevents focused interventions to improve process reliability. We propose that being more precise when describing communication error is a valid mechanism to learn from these errors. We assert that by deconstructing communication in healthcare into its elemental parts, a more effective organizational learning strategy emerges to enable more focused patient safety improvement efforts. After defining the barriers to effective communication, we then map evidence-based recovery strategies and tools specific to each barrier as a tactic to enhance the reliability and validity of information exchange within healthcare.

PubMed Disclaimer

Conflict of interest statement

The authors disclose no conflict of interest.

Related information

Cited in Books

LinkOut - more resources

Full text sources.

Ovid Technologies, Inc.
Wolters Kluwer
MedlinePlus Health Information

Citation Manager

NCBI Literature Resources

MeSH PMC Bookshelf Disclaimer

The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Unauthorized use of these marks is strictly prohibited.

Areas of Focus

Featured Memberships & Services

Alert and recall management system

Technology advisory service

Evidence-based research & guidance

Device ratings, guidance, and alerts

Report & analyze events, improve safety

Patient safety, risk, & quality guidance

Continuum of care risk & safety guidance

Supply & implant purchasing guidance

Effective Communication among Healthcare Providers

Supplementary materials, classifications, executive summary.

The ability to effectively collaborate and transmit information among healthcare providers—as well as between providers and patients—is central to the provision of safe, quality medical care. However, the increasingly complex healthcare environment can complicate the communication process and hinder the information exchanges necessary for optimal care.

Communication breakdowns in healthcare can occur in numerous ways. For example, communication can fail during patient handoffs, either during a shift change or during the transfer to another department or facility. Breakdowns can also occur within the team of caregivers treating a patient in a particular setting, between a patient's attending physician and consulting physicians, or even between the provider and the patient. Communication lapses can also involve family members concerned with the patient's care. And, as experienced during the COVID-19 pandemic, communication breakdowns can be the result of limited nonverbal cues during virtual or telephone appointments or when hindered by wearing face masks (Mheidly et al.).

When communication fails, errors can occur, possibly resulting in patient injury or even death. These errors can lead to malpractice claims, which can be costly for the organization.

Given the close link between patient safety and effective communication, risk managers should work with facility leaders to assess and monitor the quality of communication between providers in their organizations.

This guidance article highlights the consequences of communication failures on patient care to underscore the need for effective communication strategies in healthcare organizations. Strategies described in this article focus on communication among healthcare professionals.

Action Recommendations

Enlist the organization's senior leaders in demonstrating a commitment to a culture of safety.
Support team-based approaches to care to enhance communication among team members, including addressing and eliminating disruptive behaviors.
Assess staff perceptions of the quality of communication in their facilities and identify opportunities for improvement.
Support technology that can transmit information across settings and among providers, but ensure it is planned, implemented, and maintained carefully.
Use structured communication tools to simplify and standardize communication practices.
Adopt standardized handoff processes to communicate essential patient information during care transitions.
Minimize interruptions and distractions during information exchanges.
Limit verbal orders to avoid errors; when verbal orders are unavoidable, require specific practices to minimize mistakes.
Optimize practices for reporting test results, including special procedures for critical tests and critical results

Thank you to Laurie Burns, MSN, RN, CNOR, RNFA, Clinical Nurse Educator, Operating Room, Lankenau Medical Center; Beth Chadwell, Director of Risk Management and Accreditation, Augusta Health; and Karen Flanagan, ACCNS-AG, AGACNP-BC, CEN, Nurse Residency Program Coordinator, Navy Medicine Readiness and Training Command Jacksonville, who reviewed this article.

Who Should Read This

Table of contents.

The Issue in Focus
Action Plan

Leadership Support for Culture of Safety

Staff perceptions about communication, technology solutions, structured communication tools, handoff communication, distractions, verbal and texting orders.

Test Results Reporting

The Issue in Focus


Effective Communication among Healthcare Providers

Effective Communication among Healthcare Providers

For communication to be effective, it must be complete, clear, concise, and timely. However, various factors can interfere with the effective exchange of information. Healthcare risk management and patient safety literature contain numerous accounts of medical errors caused by communication failures.

Information may be missed, ignored, not recorded, or misdirected, but it is also possible to misunderstand the content, either because of hearing impediments (physiological or due to a noisy environment), language or cultural barriers, or due to incomplete information or failure to organize the information. Additional barriers to effective communication can include time constraints, organizational hierarchies, defensiveness, distractions, fatigue, workplace conflict, and workload (ACOG).

Strategies described in this article focus on communication among healthcare professionals. For additional strategies on effective communication between providers and patients, see Supplementary Materials .

Patient Safety

Aggregate results from surveys of hospital staff to evaluate their organization's safety culture reveal the need to enhance strategies to improve communication, including teamwork across different levels of care, effective handoffs from one provider to another, and a culture of openness. Results from the 2022 Agency for Healthcare Research and Quality (AHRQ) survey of hospital patient safety culture indicate that although staff gave high scores to their organizations for fostering teamwork within care units (82% positive response), communication openness (76% positive response), communication about errors (73% positive response), other dimensions indicative of effective communication scored less favorably. For example, staff responses indicated that important information was left out during shift changes (63%) and during patient transfers to another unit (56%). (AHRQ "Hare et al.")

Claims and Lawsuits

Communication failures can have a significant financial impact on the organization if they lead to patient care errors that result in additional care needs and/or legal action.

As illustrated by an analysis of open and closed medical malpractice claims and lawsuits asserted between 2009 and 2013, the most recent data available as of this publication, communication breakdowns were a factor in 30% of the 23,658 analyzed claims. About a third of these cases were closed with payment with an average indemnity of $361,000. Cases resulting from miscommunication between providers were also more likely to result in payment than provider-patient miscommunication (CRICO).

Other findings from the analysis include the following (CRICO):

Thirty-seven percent of all high-severity injury cases involved communication failures.
Communication failure rates differ among care settings with 48% of failures occurring in ambulatory care settings, 44% in inpatient settings, and 8% in the emergency department.
Fifty-seven percent of the cases involving communication failure were triggered by breakdowns in communication between two or more providers, 55% between providers and patients, and 12% involved both provider-to-provider and provider-to-patient communication failures. Common breakdowns between providers include miscommunication (26%), poor documentation (12%), and failure to read the medical record (7%).
The total loss incurred amounted to $1.7 billion.

Regulations and Standards

Risk managers must ensure that their organization's policies and procedures addressing communication—from admission through discharge—comply with federal, state, and local requirements; case law in the organization's jurisdiction; and requirements of accrediting agencies used by the facility.

The Centers for Medicare and Medicaid Services (CMS)

CMS has regulations on verbal orders as part of its Conditions of Participation. Verbal orders can be given face to face or by telephone; however, texting is prohibited.

Verbal orders must be "dated, timed, and authenticated promptly by the ordering practitioner or by another practitioner who is responsible for the care of the patient only if such a practitioner is acting in accordance with state law, including scope-of-practice laws, hospital policies, and medical staff bylaws, rules, and regulations." (42 CFR § 482.24[c][2])

For more information, see Communicating Medication Orders and the discussion Verbal and Texting Orders .

The Joint Commission

With its Sentinel Event Alerts, National Patient Safety Goals (NPSGs), and accreditation requirements, the Joint Commission has supported numerous strategies for improved communication to enhance patient safety. One of the goals for 2023 is the improvement of effective communication among caregivers (Joint Commission "National").

Accreditation requirements address specific measures to improve communication, such as the following (Joint Commission "Comprehensive"):

Maintain a list of prohibited abbreviations, acronyms, symbols, and dose designations that can be misinterpreted and cause errors. For more information, see Medical Abbreviations, Initialisms, and Acronyms .
Limit the use of verbal orders and require a repeat-back process to verify the information. For more information, see Communicating Medication Orders and the discussion Verbal and Texting Orders .
Develop a process for handoff communication that provides the opportunity for discussion between the giver and receiver of patient information regarding the patient's condition, care, treatment, medications, services, and any recent or anticipated changes to any of these. For more information, see the discussion Handoff Communication .

DNV GL Healthcare

Accreditation requirements that address communication include (NIAHO):

"Telephone or verbal orders are to be used infrequently and when used shall be accepted only by personnel authorized by the medical staff and in accordance with federal and state law."
"Verbal orders shall be signed or initialed by the prescribing practitioner [and] shall be authenticated in accordance with federal and state law. If there is not state law that designates a specific timeframe for the authentication of verbal orders, the orders shall be authenticated within a time specified by organization policy."
Avoid "dangerous abbreviations."

Action PLAN

Action Recommendation: Enlist the organization's senior leaders in demonstrating a commitment to a culture of safety.

Frequent and candid communication among providers and staff is a key characteristic of a culture of safety. The ability to speak up, voice concerns, and report near misses and errors in a healthcare organization without fear of reprisal has much to do with how well safety is embedded in the culture.

Therefore, effective communication starts with leadership demonstrating their commitment to a safety culture and taking necessary actions to attain a culture focused on open communication. Such actions include the following:

Making patient safety an urgent organizational priority and communicating the organization's vision for safety excellence to staff
Improving work environments and team functions so that providers and staff do not remain silent about issues that can interfere with patient safety, such as mistakes and intentional deviation from accepted practice
Taking action when concerns are raised
Focusing on systems analysis and processes rather than blaming individuals
Recognizing patient safety successes

communication barriers in healthcare essay

Providing sufficient staff and resources to promote the complete transfer of patient information with the next shift, to a covering colleague, or to another department or unit
Adopting chain of command policies to give providers and staff clear lines of authority and paths of communication to follow for situations that may place patients at risk
Modeling effective communication with all staff, using techniques promoted by the organization

For more detailed information, see Culture of Safety: An Overview .

Action Recommendation: Support team-based approaches to care to enhance communication among team members, including addressing and eliminating disruptive behaviors.

Teambuilding and Training

Traditional hospital hierarchies that place nurses and other support staff at the bottom and physicians at the top can hinder communication. Effective communication is best achieved in an environment in which all providers and staff work together as a team.

Risk managers are uniquely positioned to promote teambuilding efforts in their facilities. Providers and staff should be given opportunities to enhance communication and teamwork skills, which can be done through completion of formal education and training programs. Risk managers should ensure that the training program provides learners with opportunities for active participation through role-playing, simulation, and discussion of effective and ineffective communication techniques. Case studies can be used to stimulate discussion about communication breakdowns.

Many healthcare facilities are already promoting teambuilding skills to break down hierarchies and foster effective communication skills. Drawing on the experience of other complex, high-risk industries, these healthcare facilities have used principle-based interventions and tool-based approaches that improve communication among team members. (Buljac-Samardzic et al.)

The two commonly used approaches for improving communication are Crew Resource Management (CRM) and TeamSTEPPS.

Adopted from the aviation industry, CRM aims to take advantage of all available resources and information, including equipment, time, procedures, and people. It focuses on situational awareness, communication, adaptability, decision making, assertiveness, and leadership. (Gross et al.)

AHRQ and the U.S. Department of Defense have collaborated to develop a team training program called the Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) system, an evidence-based teamwork system to improve communication and teamwork skills among healthcare professionals. The program is available online as a multimedia educational program for healthcare providers and organizations. The TeamSTEPPS 2.0 curriculum includes an essentials course, seven fundamental modules, and an additional five supplemental modules for interdisciplinary team training to help reduce the incidence of medical errors. There is an alternate version as well for self-paced learning (AHRQ "About").

Chain of Command

While healthcare organizations can empower staff at all levels to speak up if there is any concern that an unsafe condition exists, conflicts can still arise. Because of this, healthcare facilities should establish chain of command policies to give providers and staff specific and clear lines of authority and paths of communication to follow for situations that may place patients at risk. For more information, see Chain of Command .

Disruptive Behaviors

Behaviors that intimidate or belittle staff members and hinder open communication are counterproductive to a team environment and a culture of safety. These disruptive behaviors can occur at any level of the healthcare hierarchy (ISMP).

Healthcare organizations must strive to prevent or correct intimidating or disrespectful behaviors as they have a negative effect on the communication and collaboration necessary for safe patient care. The use of communication tools, discussed in Structured Communication Tools , will be much less effective if staff are reluctant to speak up because they are threatened by intimidating behavior.

In addition, disruptive behavior is not only more common during prolonged, stressful situations (e.g., the COVID-19 pandemic) but can also contribute to provider burnout and higher staff turnover (Rehder et al.).

The Joint Commission has drawn attention to the issue with a Sentinel Event Alert and a Quick Safety, both updated in June 2021 (Joint Commission "Behaviors"; Joint Commission "Bullying").

For more information, see Disruptive Practitioner Behavior .

Action Recommendation: Assess staff perceptions of the quality of communication in their facilities and identify opportunities for improvement.

Organizations should periodically elicit feedback from staff to assess the quality of communication in their facilities and to identify opportunities for improvement. Given that effective communication is a key characteristic of a culture of safety, surveys designed to evaluate an organization's safety culture should include questions about the organization's approach to communication.

By conducting surveys at regular intervals, organizations can also monitor year-to-year changes in staff attitudes regarding communication and the effectiveness of any communication improvement initiatives.


ECRI's assessment tools provide a multidisciplinary perspective for identifying and managing risks related to this topic and other healthcare services. These web-based tools provide an easy-to-use, unbiased method to survey staff ranging from frontline nurses to organizational leaders. The tools generate reports, benchmarking data, and recommendations. For more information, email ECRI at

Hospitals can use the AHRQ Hospital Survey on Patient Safety Culture 2.0 to survey their staff on their attitudes regarding the organization's culture of safety. The survey has a section on communication within a unit or work area, which includes seven questions related to interprofessional communication (AHRQ "Hospital").

Other survey questions address characteristics that can foster effective communication such as the ability to work as a team and respectful treatment of staff.

Action Recommendation: Support technology that can transmit information across settings and among providers, but ensure it is planned, implemented, and maintained carefully.

When used properly, technology that transmits information across settings and among providers supports consistent and coordinated communication. Electronic health records (EHRs) can provide caregivers with readily accessible patient information, such as confirmation that a newly ordered medication was administered, lab tests were completed, or a do-not-resuscitate order is in place. Additionally, health information technology (IT), such as computerized physician order-entry systems, may reduce confusion regarding handwritten medical orders, orders for laboratory tests, and treatment orders.

If not planned and implemented carefully, however, health IT may jeopardize effective communication and patient safety.

For example, ECRI has identified data entry errors in the patient record as among the most frequent type of error associated with health IT (ECRI and the ISMP PSO). While these errors are sometimes the result of human factors (e.g., a provider inadvertently accessing the wrong patient record) these errors can also occur when software and system flaws cause the wrong data to be associated with a patient record.

Interoperability failures can also lead to patient harm. Failure to properly build the interfaces between two health IT systems can prevent important information from transferring from one record to another (e.g., a critical result from a laboratory test fails to transfer from a laboratory information system to the patient's EHR).

For more information, see Electronic Health Records: Operational Issues .

Action Recommendation: Use structured communication tools to simplify and standardize communication practices.

Tools that simplify and standardize communication practices, as well as to serve as reminders, particularly during complex procedures, have been shown to enhance patient safety by reducing communication breakdowns which may lead to complications and adverse events (AHRQ "Implement").

Briefings, debriefings, safety huddles, repeat- and teach-back techniques, and checklists provide healthcare teams an opportunity to review a care plan or an approach to a particular procedure and ensure all team members are aware of pertinent information.

Debriefings—a key feature of high-performing teams—provide structured formats to evaluate and improve team performance. Debriefings should be done regularly—not just when things go poorly—and built into the team workflow (Edwards et al.).

Safety huddles provide opportunities for staff to exchange patient information, make and share plans to ensure coordinated patient care, and address particular issues as a team (AHRQ Shaikh).

Checklists may be used to improve team communication and reinforce safety practices; however, it is important to guard against completing checklists quickly or carelessly. Therefore, organizations should judiciously identify which processes and procedures may be guided by a checklist in order to prevent checklist fatigue. All activity should cease and everyone on the team should be attentive while the elements of the safety checklist are completed. This enables anyone with questions, concerns, or information about the patient's safety to speak up and provide input before a process or procedure commences (Russ et al.).

Action Recommendation: Adopt standardized handoff processes to communicate essential patient information during care transitions.

Patient handoffs are important aspects of care coordination. A handoff is the transfer of patient information, as well as responsibility, from one clinician to another during transitions across the healthcare continuum. The process should include an opportunity for discussion between the transferring and the receiving clinician, as well as the opportunity to ask questions and clarify information (ACOG).


Patient confidentiality must be protected during handoff discussions. Only those involved in direct patient care should be able to hear or view protected health information. For more information, see .

Handoffs can occur multiple times each day for patients—during shift changes, when a patient transfers to a different level of care, when a patient is sent to another department or unit, and when a physician transfers responsibility for caring for a hospitalized patient (referred to as a "sign out" procedure) to another physician. Consequently, thousands of patient handoffs occur daily in every hospital.

However, a study of malpractice claims from 2001 to 2011 showed that 49% of claims were associated with communication failures. Of these claims, 40% included a failed handoff, the majority of which were identified as potentially avoidable by using a handoff tool (Humphrey et al.). The Joint Commission has issued a sentinel alert as a result of patient safety risks due to inadequate handoff communications (Joint Commission "Inadequate").

Hospitals must have a process in place for healthcare providers to share and receive information about patients. This process should include (ACOG):

Interactive communication
Limited interruptions
A process to verify information
The opportunity to review information

The following information should be included during a handoff exchange:

Patient identifying information (e.g., name, age, sex), date of admission, and location
Results from physical examination
Current condition
Changes in condition and treatment
Patient's code status, medical and surgical history, active medications, and allergies
Recent and pending laboratory tests
Immediate patient care concerns
Recommendations

A consistent format for handoff reports helps staff members accurately record and recall information. One such format that can be used is the SBAR (Situation, Background, Assessment, and Recommendation) technique. According to SBAR, the caregiver conducts the handoff by addressing the following (IHI):

S ituation—define what is going on with the patient
B ackground—keep information brief, relevant, and on point
A ssessment—summarize what the caregiver found
R ecommendation—provider recommendations or actions for the receiver to complete

Another mnemonic tool to structure handoffs is I-PASS the BATON. The tool prompts the following exchange of information (AHRQ "Pocket"):

I ntroduction—introduce caregiver and their role
P atient—provide patient's name, age, sex, and location
A ssessment—present chief complaint, vital signs, symptoms, and diagnosis
S ituation—describe current status, circumstances, code status, recent changes, and response to treatment
S afety concerns—identify critical lab values, socioeconomic factors, allergies, and alerts, such as falls risk and isolation precautions
B ackground—describe comorbidities, current medications, previous episodes, and family history
A ctions—identify actions taken or required and provide brief rationale
T iming—address level of urgency, timing, and prioritization of actions
O wnership—identify care team responsible for patient and patient/family responsibilities
N ext—discuss plan for patient, what will happen next, anticipated changes, and contingency plans

A third handoff mnemonic, I-PASS, focuses on key information (Blazin et al.):

I llness severity
P atient summary
A ction list for the next team
S ituation awareness and contingency plans
S ynthesis and "read-back" of the information

Action Recommendation: Minimize interruptions and distractions during information exchange.

Borrowing from the aviation industry, some organizations have adopted the idea of a "sterile cockpit" during the transfer of patient information. Just as the cockpit crew is prohibited from performing nonessential duties and activities during key phases of flight, healthcare providers must focus their attention on exchanging essential patient information and limit interruptions during the handoff (Connor et al.). The transfer of patient information should take priority over all other duties except emergencies.

High noise levels in busy areas, such as the operating room and emergency department, can impair staff communication and negatively affect patient safety (Anzan et al). Risk managers should work with their organizations to identify and implement strategies to reduce noise in these busy environments (Peng et al.) or should consider designating an area (e.g., conference room) for these exchanges to take place (ACOG).

Even handheld devices intended to promote communication can be a source of distraction. One study found that healthcare providers who use smartphones during attending rounds can become distracted during moments of important information transfer (Katz-Sidlow et al.). While an outright ban on smartphone use is likely impractical—and possibly even counterproductive, since these devices offer many legitimate benefits—effective policies regarding smartphone use are essential. The success of such policies will depend on support from leadership and cooperation from staff. For more information, see Personal Electronic Devices in Healthcare .

Action Recommendation: Limit verbal orders to avoid errors; when verbal orders are unavoidable, require specific practices to minimize mistakes.


CMS allows the use of texting as a communication tool restricted to the exchange of information through a secure platform but prohibits texting patient orders (CMS). However, concerns about the Health Insurance Portability and Accountability Act (HIPAA) violations will need to be considered. For more information see .

Verbal and telephone orders for medications and medical care are susceptible to error. Consider the environment of a busy clinical setting—caregivers coming and going, multiple conversations being held concurrently, the sounds of equipment operating, telephones ringing, and alarms sounding. Further, different accents, dialects, and pronunciation can make communicating important information even more challenging. All of these factors contribute to the possibility that orders or test results communicated verbally or by telephone will be heard incorrectly or misunderstood. This is particularly true with orders for medications that have sound-alike drug names.

Verbal orders should be avoided, when possible, as required by Joint Commission accreditation standards. When it is highly impractical or impossible for the prescriber to write down orders or enter them into a computerized provider order-entry system at the time they are given, verbal or telephone orders may be the only alternative. The receiver of the order must then write down the verbal or telephone orders as they are given and read back the information as it is written for confirmation (Joint Commission "Comprehensive"). The ordering practitioner must also promptly authenticate, date, and time the order (42 CFR § 482.24[c][2]).

Methods to demonstrate that the verbal order was written down and read back vary among healthcare organizations. Some opt to have the receiver of the orders document "verbal order read-back" in the patient medical record, while others use forms designed to capture the verbal order read-back process with a check-off and signature.

It is important that compliance with the read-back process be monitored through observation and/or record audits.

For more information, see Communicating Medication Orders .

Test Results Reporting

Action Recommendation: Optimize practices for reporting test results, including special procedures for critical tests and critical results.

Patient treatment delays and failures to follow up on important abnormal diagnostic tests have occurred because of communication delays or breakdowns in the reporting of test results. Delays, failures, and inaccuracies in reporting test results place patients at risk for treatment delays, omissions, and errors.

To address potential test result communication breakdowns, the Joint Commission established an NPSG to improve communication among caregivers that requires accredited organizations to report critical results of tests and diagnostic procedures on a timely basis (Joint Commission "National").

The Joint Commission requires the reporting of critical results of tests and diagnostic procedures on a timely basis. Critical results are defined as those that "fall significantly outside the normal range and may indicate a life-threatening situation." (Joint Commission "National")

The Joint Commission requires facilities to develop procedures that address the following (Joint Commission "National"):

Definitions for critical results of tests and diagnostic procedures
By whom and to whom critical results of tests and diagnostic procedures are reported
Acceptable time lapse between the availability of and reporting of critical results

Organizations also need a process for implementing their reporting procedures as well as a mechanism to evaluate the timeliness of reports. (Joint Commission "National")

The procedures should address measures for reporting results to a backup healthcare provider if the ordering clinician is unavailable. Additionally, the procedures should incorporate repeat-back practices if the results are reported verbally. Refer to the discussion Verbal and Texting Orders for information on repeat-back methods.

Risk managers should also ensure organizational policy addresses the communication of other test results, including normal and abnormal (a test result that requires the ordering provider's attention, but is not urgent or life-threatening). Test turnaround times should be periodically monitored and evaluated, and risk managers should investigate instances in which all results—normal, abnormal, and critical—are not properly communicated, and implement improvements when needed.

For more information see Test Tracking and Follow-Up .

Bibliography

42 CFR § 482.24(c)(2)

ACOG committee opinion No. 517: communication strategies for patient handoffs. Obstet Gynecol 2012;119(2 Pt 1):408-411. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2012/02/communication-strategies-for-patient-handoffs doi:10.1097/AOG.0b013e318249ff4f

Agency for Healthcare Risk and Quality (AHRQ):

About TeamSTEPPS. 2019 Jun [cited 2022 Nov 22]. https://www.ahrq.gov/teamstepps/about-teamstepps/index.html Hare R, Tapia A, Tyler ER, Fan L, Ji S, Yount ND, Sorra J, Famolaro T. Surveys on patient safety culture TM (SOPS ® ) hospital survey 2.0: 2022 user database report. 2022 Oct [cited 2022 Nov 21]. https://www.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/hospital/2022-hsops2-database-report.pdf Hospital survey on patient safety culture. 2022 Nov [cited 2022 Nov 22]. https://www.ahrq.gov/sops/surveys/hospital/index.html Implement teamwork and communication. 2018 Jul. [cited 2022 Nov 22] https://www.ahrq.gov/hai/cusp/modules/implement/index.html Pocket guide: TeamSTEPPS. 2020 Jan [cited 2022 Nov 22]. https://www.ahrq.gov/teamstepps/instructor/essentials/pocketguide.html Shaikh U. Improving patient safety and team communication through daily huddles. 2020 Jan 29 [cited 2022 Nov 22]. https://psnet.ahrq.gov/primer/improving-patient-safety-and-team-communication-through-daily-huddles

Anzan M, Alwhaibi M, Almetwazi M, Alhawassi TM. Prescribing errors and associated factors in discharge prescriptions in the emergency department: A prospective cross-sectional study. PLoS One 2021;16(1):e0245321 PubMed: https://pubmed.ncbi.nlm.nih.gov/33434202/ doi:10.1371/journal.pone.0245321

Blazin LJ, Sitthi-Amorn J, Hoffman JM, Burlison JD. Improving patient handoffs and transitions through adaptation and implementation of I-PASS across multiple handoff settings. Pediatr Qual Saf 2020 Jul 23;5(4):e323. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC738254 7 doi: 10.1097/pq9.0000000000000323

Buljac-Samardzic M, Doekhie KD, van Wijngaarden JDH. Interventions to improve team effectiveness within health care: a systematic review of the past decade. Hum Resour Health 2020;18(1):2. PubMed: https://pubmed.ncbi.nlm.nih.gov/31915007/ doi:10.1186/s12960-019-04

Centers for Medicare and Medicaid Services (CMS). Texting of patient information among healthcare providers. 2017 Dec 28 [cited 2022 Dec 5]. https://www.cms.gov/medicare/provider-enrollment-and-certification/surveycertificationgeninfo/downloads/survey-and-cert-letter-18-10.pdf

Connor JA, Ahern JP, Cuccovia B, Porter CL, Arnold A, Dionne RE, Hickley PA. Implementing a distraction-free practice with the Red Zone medication safety initiative. Dimens Crit Care Nurs 2016;35(3):116-124. PubMed: https://pubmed.ncbi.nlm.nih.gov/27043397/ doi:10.1097/DCC.0000000000000179

CRICO. Malpractice risks in communication failures: 2015 annual benchmarking report. 2015 [cited 2022 Dec 5]. https://cdn2.hubspot.net/hubfs/217557/Documents%20-%20CBS%20Report%20PDFs/Malpractice%20Risks%20in%20Communication%20Failures%202015.pdf

ECRI and the ISMP PSO. PSO Navigator: Wrong-record, wrong-data errors with health IT systems. 2015 May 1. https://www.ecri.org/components/PSOCore/Pages/PSONav0515.aspx

Edwards JJ, Wexner S, Nichols A. Debriefing for clinical learning. 2021 Nov 18 [cited 2022 Nov 22]. https://psnet.ahrq.gov/primer/debriefing-clinical-learning

Gross B, Rusin L, Kiesewetter J, Zottman JM, Fischer MR, Pruchner S, Zech A. Crew resource management training in healthcare: a systematic review of intervention design, training conditions and evaluation. BMJ Open 2019;9(2):e025247. PubMed: https://pubmed.ncbi.nlm.nih.gov/30826798/ doi:10.1136/bmjopen-2018-47

Humphrey, KE; Sundberg, M; Milliren, CE; Graham, DA; Landrigan, CP. Frequency and nature of communication and handoff failures in medical malpractice claims. J Pat Safety. 2022 Mar;18(2):130-137. PubMed: https://pubmed.ncbi.nlm.nih.gov/35188927/ doi: 10.1097/PTS.0000000000000937

Institute for Healthcare Improvement (IHI). SBAR tool: situation-background-assessment-recommendation. [cited 2022 Nov 22]. https://www.ihi.org/resources/Pages/Tools/SBARToolkit.aspx

Institute for Safe Medication Practices (ISMP). Disrespectful behavior in healthcare: has it improved? 2021 Sep 9 [cited 2022 Nov 22]. https://www.ismp.org/resources/disrespectful-behavior-healthcare-has-it-improved-please-take-our-survey

Joint Commission:

Bullying has no place in health care. 2021 Jun [cited 2022 Nov 22]. https://www.jointcommission.org/-/media/tjc/newsletters/quick-safety-issue-24-june-2016-6-2-21-update.pdf Comprehensive accreditation manual for hospitals. Joint Commission Resources. 2022 [cited 2022 Dec 7]. National patient safety goals ® effective January 2023 for the hospital program. 2022 Oct 27 [cited 2022 Nov 22]. https://www.jointcommission.org/-/media/tjc/documents/standards/national-patient-safety-goals/2023/npsg_chapter_hap_jan2023.pdf Sentinel event alert: behaviors that undermine a culture of safety. 2022 Jun 18 [cited 2021 Nov 22]. https://www.jointcommission.org/-/media/tjc/documents/resources/patient-safety-topics/sentinel-event/sea-40-intimidating-disruptive-behaviors-final2.pdf Sentinel event alert: inadequate hand-off communication. 2017 Sep 12 [cited 2022 Nov 22]. https://www.jointcommission.org/-/media/tjc/documents/resources/patient-safety-topics/sentinel-event/sea_58_hand_off_comms_9_6_17_final_(1).pdf

Katz-Sidlow RJ, Ludwig A, Miller S, Sidlow R. Smartphone use during inpatient attending rounds: prevalence, patterns and potential for distraction. J Hosp Med. 2012;7(8):595-9. PubMed: https://pubmed.ncbi.nlm.nih.gov/22744793/ doi:10.1002/jhm.1950

Kellogg KM, Puthumana JS, Fong A, Adams KT, Ratwani RM. Understanding the types and effects of clinical interruptions and distractions recorded in a multihospital patient safety reporting system. J Patient Saf. 2021;17(8):e1394-e1400. PubMed: https://pubmed.ncbi.nlm.nih.gov/29994817/ doi:10.1097/PTS.0000000000000513

Mheidly N, Fares MY, Zalzale H, Fares J. Effect of face masks on interpersonal communication during the COVID-19 pandemic. Front Public Health 2020;8:582191. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7755855/ doi:10.3389/fpubh.2020.582191

National Integrated Accreditation for Healthcare Organizations (NIAHO). Accreditation requirements, interpretive guidelines and surveyor guidance for hospitals - Revision 20-1. DNV GL Healthcare USA, Inc. 2020 Sep 21 [cited 2023 Jan 17]. https://brandcentral.dnvgl.com/original/gallery/dnvgl/files/original/ecd238b80cbd46c9addf668e7e8c55b0.pdf

Peng L, Chen J, Jiang H. The impact of operating room noise levels on stress and work efficiency of the operating room team: a protocol for systematic review and meta-analysis. Medicine 2022;101(3):e28572. PubMed: https://pubmed.ncbi.nlm.nih.gov/35060517/ doi:10.1097/MD.0000000000028572

Rehder KJ, Adair KC, Hadley A, McKittrick K, Frankel A, Leonard M, Frankel TC, Sexton JB. Associations between a new disruptive behaviors scale and teamwork, patient safety, work-life balance, burnout, and depression. Jt Comm J Qual Patient Saf 2020;46(1):18-26. PubMed: https://pubmed.ncbi.nlm.nih.gov/31706686/ doi:10.1016/j.jcjq.2019.09.004

Russ S, Rout S, Sevdalis N, Moorthy K, Darzi A, Vincent C. Do safety checklists improve teamwork and communication in the operating room? a systematic review. Ann Surg. 2013 Dec;258(6):856-71. PubMed: https://pubmed.ncbi.nlm.nih.gov/24169160/ doi: 10.1097/SLA.0000000000000206

Resource List

Risk manager's toolbox.

Essentials: Care Coordination

Guidance, Assessments, and Training

Communicating Medication Orders
Medical Abbreviations, Initialisms, and Acronyms
Culture of Safety: An Overview
Chain of Command
Test Tracking and Follow-Up
Disruptive Practitioner Behavior
Electronic Health Records: Operational Issues
The HIPAA Privacy Rule
The HIPAA Security Rule
Personal Electronic Devices in Healthcare

Communicating with Patients and Caregivers

Strategies described in this article focus on communication between healthcare professionals. Additional strategies for communication between providers and patients and caregivers can be found in the following related articles:

Culturally and Linguistically Competent Care
Discharge Planning
Disclosure of Unanticipated Outcomes in Health Systems
Health Literacy
Informed Consent in Acute Care
Informed Refusal
Patient Satisfaction
Managing Patient Complaints and Grievances

Related Resources

Topics and metadata, caresetting, clinical specialty, information type, phase of diffusion, technology class, clinical category, sourcebase supplier, product catalog, disease/condition, publication history.

Published March 22, 2023

Your email address

Recipient's email address, an optional note to your recipient.

ECRI. Effective communication among healthcare providers. Health Syst Risk Manage 2023 Mar 22. https://www.ecri.org/components/HRC/Pages/Effective-Communication-among-Healthcare-Providers.aspx

Share on Social Media

This website is intended for healthcare professionals

{ $refs.search.focus(); })" aria-controls="searchpanel" :aria-expanded="open" class="hidden lg:inline-flex justify-end text-gray-800 hover:text-primary py-2 px-4 lg:px-0 items-center text-base font-medium"> Search

Search menu

Abdolrahimi M, Ghiyasvandian S, Zakerimoghadam M, Ebadi A. Therapeutic communication in nursing student: a Walker and Avant concept analysis. Electron Physician.. 2017; 9:(8)4968-4977 https://doi.org/10.19082/4968

Communication skills 1: benefits of effective communication for patients. 2017. https://tinyurl.com/y3nzu222 (accessed 10 August 2020)

Communication skills 3: non-verbal communication. 2018. https://tinyurl.com/y5ay4uhd (accessed 10 August 2020)

Bandura A. Self-efficacy: toward a unifying theory of behavior change. Psychol Rev.. 1977; 84:191-215 https://doi.org/10.1016/0146-6402(78)90002-4

Barratt J. Developing clinical reasoning and effective communication skills in advanced practice. Nurs Stand.. 2019; 34:(2)37-44 https://doi.org/10.7748/ns.2018.e11109

Bergdahl E, Berterö CM. Concept analysis and the building blocks of theory: misconceptions regarding theory development. J Adv Nurs.. 2016; 72:(10)2558-2566 https://doi.org/10.1111/jan.13002

Bloomfield J, Pegram A. Care, compassion and communication. Nurs Stand.. 2015; 29:(25)45-50 https://doi.org/10.7748/ns.29.25.45.e7653

Bramhall E. Effective communication skills in nursing practice. Nurs Stand.. 2014; 29:(14)53-59 https://doi.org/10.7748/ns.29.14.53.e9355

Brown R. An analysis of loneliness as a concept of importance for dying persons. In: McKenna H, Cutcliffe J (eds). Philadelphia (PA): Elsevier Churchill Livingstone; 2005

Burley D. Better communication in the emergency department. Emerg Nurse.. 2011; 19:(2)32-36 https://doi.org/10.7748/en2011.05.19.2.32.c8509

Cambridge University Press. Effective. 2018. https://tinyurl.com/y7dqcypc (accessed 10 August 2020)

Campbell JD, Lavallee LF. Who am I? The role of self-concept confusion in understanding the behavior of people with low self-esteem. In: Baumeister RF (ed). New York (NY): Plenum Press; 1993

Carment DW, Miles CG, Cervin VB. Persuasiveness and persuasibility as related to intelligence and extraversion. Br J Soc Clin Psychol.. 1965; 4:(1)1-7 https://doi.org/10.1111/j.2044-8260.1965.tb00433.x

Casey A, Wallis A. Effective communication: principle of nursing practice E. Nurs Stand.. 2011; 25:(32)35-37 https://doi.org/10.7748/ns2011.04.25.32.35.c8450

Daly L. Effective communication with older adults. Nurs Stand.. 2017; 31:(41)55-62 https://doi.org/10.7748/ns.2017.e10832

Department of Health and Social Care. Essence of care 2010: benchmarks for the fundamental aspects of care. 2010. https://tinyurl.com/y3z8grqe (accessed 10 August 2020)

Dithole KS, Thupayagale-Tshweneagae G, Akpor AO, Moleki MM. Communication skills intervention: promoting effective communication between nurses and mechanically ventilated patients. BMC Nurs.. 2017; 16:(74)1-6 https://doi.org/10.1186/s12912-017-0268-5

Draper P. A critique of concept analysis. J Adv Nurs.. 2014; 70:(6)1207-1208 https://doi.org/10.1111/jan.12280

Duldt BW, Giffin K, Patton BR. Interpersonal communication in nursing: a humanistic approach.Philadelphia (PA): FA Davis; 1983

Fakhr-Movahedi A, Salsali M, Negharandeh R, Rahnavard Z. Exploring contextual factors of the nurse-patient relationship: a qualitative study. Koomesh.. 2011; 13:(1)23-34

Fleischer S, Berg A, Zimmermann M, Wuste K, Behrens J. Nurse-patient interaction and communication: a systematic literature review. J Public Health.. 2009; 17:339-353 https://doi.org/10.1007/s10389-008-0238-1

Foley A, Davis A. A guide to concept analysis. Clin Nurse Spec.. 2017; 31:(2)70-73 https://doi.org/10.1097/NUR.0000000000000277

Gadamer HG. Philosophical hermeneutics. Translated by DE Linge.Berkeley (CA): University of California Press; 1976

Gallagher L. Continuing education in nursing: a concept analysis. Nurse Educ Today.. 2007; 27:(5)466-473 https://doi.org/10.1016/j.nedt.2006.08.007

Ghafouri R, Rafii F, Oskouie F, Parvizy S, Mohammadi N. Nursing professional regulation: Rodgers' evolutionary concept analysis. Int J Med Res Health Sci. 2016; 5:(9S)436-442

Griffiths J. Person-centred communication for emotional support in district nursing: SAGE and THYME model. Br J Community Nurs.. 2017; 22:(12)593-597 https://doi.org/10.12968/bjcn.2017.22.12.593

Hazzard A, Harris W, Howell D. Taking care: practice and philosophy of communication in a critical care follow-up clinic. Intensive Crit Care Nurs.. 2013; 29:(3)158-165 https://doi.org/10.1016/j.iccn.2013.01.003

Jevon P. Clinical examination skills.Chichester: Wiley-Blackwell Publications; 2009

Jones A. The foundation of good nursing practice: effective communication. J Renal Nurs.. 2012; 4:(1)37-41 https://doi.org/10.12968/jorn.2012.4.1.37

Kelton D, Davis C. The art of effective communication. Nurs Made Incred Easy.. 2013; 11:(1)55-56 https://doi.org/10.1097/01.NME.0000423378.98763.96

Kourkouta L, Papathanasiou IV. Communication in nursing practice. Mater Sociomed.. 2014; 26:(1)65-67 https://doi.org/10.5455/msm.2014.26.65-67

McCabe C. Nurse patient communication: an exploration of patients' experiences. J Clin Nurs.. 2004; 13:41-49 https://doi.org/10.1111/j.1365-2702.2004.00817.x

McCabe C, Timmins F. Communication skills for nursing practice, 2nd edn. Basingstoke: Palgrave; 2013

McCarthy DM, Buckley BA, Engel KG, Forth VE, Adams JG, Cameron KA. Understanding patient-provider conversations: what are we talking about?. Acad Emerg Med.. 2013; 20:(5)441-448 https://doi.org/10.1111/acem.12138

McCroskey JC, Richmond VP. Willingness to communicate: differing cultural perspectives. South Commun J.. 1990; 56:(1)72-77 https://doi.org/10.1080/10417949009372817

McCuster M. Apathy: who cares? A concept analysis. Ment Health Nurs.. 2015; 36:693-697 https://doi.org/10.3109/01612840.2015.1022844

McKenna HP. Nursing theories and models.London: Routledge; 1997

McKinnon J. The case for concordance: value and application in nursing practice. Br J Nurs.. 2013; 22:(13)16-21 https://doi.org/10.12968/bjon.2013.22.13.766

Miller L. Effective communication with older people. Nurs Stand.. 2002; 17:(9)45-50 https://doi.org/10.7748/ns2002.11.17.9.45.c3298

Newell S, Jordan Z. The patient experience of patient-centered communication with nurses in the hospital settings: a qualitative systematic review protocol. JBI Database System Rev Implement Rep.. 2015; 13:(1)76-87 https://doi.org/10.11124/jbisrir-2015-1072

Norouzinia R, Aghabarari M, Shiri M, Karimi M, Samami E. Communication barriers perceived by nurses and patients. Glob J Health Sci.. 2016; 8:(6)65-74 https://doi.org/10.5539/gjhs.v8n6p65

Nuopponen A. Methods of concept analysis: a comparative study. LSP.. 2010; 1:(1)4-12

Nursing and Midwifery Council. The code: professional standards of practice and behaviour for nurses, midwives and nursing associates. 2018. https://tinyurl.com/zy7syuo (accessed 10 August 2020)

O'Hagan S, Manias E, Elder C What counts as effective communication in nursing? Evidence from nurse educators' and clinicians' feedback on nurse interactions with simulated patients. J Adv Nurs.. 2013; 70:(6)1344-1355 https://doi.org/10.1111/jan.12296

Orem DE. Nursing: concepts of practice, 4th edn. St. Louis (MO): Mosby-Year Book; 1991

Oxford University Press. Communication. 2018. https://tinyurl.com/y7k22yxb (accessed 10 August 2020)

Communication barriers. 2016. https://tinyurl.com/y3sn342h (accessed 10 August 2020)

Reader TW, Gillespie A, Roberts J. Patient complaints in healthcare systems: a systematic review and coding taxonomy. BMJ Qual Saf.. 2014; 23:(8)678-689 https://doi.org/10.1136/bmjqs-2013-002437

Rodgers BL. Concepts, analysis and the development of nursing knowledge: the evolutionary cycle. J Adv Nurs.. 1989; 14:(4)330-335 https://doi.org/10.1111/j.1365-2648.1989.tb03420.x

Rodgers BL, Knafi KA. Concept development in nursing: foundations, techniques and applications, 2nd edn. Philadelphia (PA): WB Saunders; 2000

Royal College of Nursing. Communication-end of life care. 2015. https://tinyurl.com/go28vsm (accessed 10 August 2020)

Schirmer JM, Mauksch L, Lang F Assessing communication competence: a review of current tools. Fam Med.. 2005; 37:(3)184-192

Skär L, Söderberg S. Patients' complaints regarding healthcare encounters and communication. Nurs Open.. 2018; 5:(2)224-232 https://doi.org/10.1002/nop2.132

Snowden A, Martin C, Mathers B, Donnell A. Concordance: a concept analysis. J Adv Nurs.. 2014; 70:(1)46-59 https://doi.org/10.1111/jan.12147

Tay LH, Ang E, Hegney D. Nurses' perceptions of the barriers in effective communication with inpatient cancer adults in Singapore. J Clin Nurs. 2011; 21:(17-18)2647-2658 https://doi.org/10.1111/j.1365-2702.2011.03977.x

Thompson CJ. Nursing theory and philosophy terms: a guide.South Fork (CO): CJT Consulting and Education; 2017

Tofthagen R, Fagerstrøm LM. Rodgers' evolutionary concept analysis – a valid method for developing knowledge in nursing science. Scand J Caring Sci. 2010; 24:21-31 https://doi.org/10.1111/j.1471-6712.2010.00845.x

Nursing, admission assessment and examination. 2018. https://tinyurl.com/y4ykv2uo (accessed 10 August 2020)

Walker LO, Avant KC. Strategies for theory construction in nursing, 5th edn. Norwalk (CT): Appleton and Lange; 2011

Webb L. Exploring the characteristics of effective communicators in healthcare. Nurs Stand.. 2018; 33:(9)47-51 https://doi.org/10.7748/ns.2018.e11157

Wikström B, Svidén G. Exploring communication skills training in undergraduate nurse education by means of a curriculum. Nurs Rep.. 2011; 1:(1) https://doi.org/10.4081/nursrep.2011.e7

Effective communication between nurses and patients: an evolutionary concept analysis

Dorothy Afriyie

Student Nurse, University of West London, Brentford

View articles · Email Dorothy

Communication can be considered as the basis of the nurse-patient relationship and is an essential element in building trust and comfort in nursing care. Effective communication is a fundamental but complex concept in nursing practice. This concept analysis aims to clarify effective communication and its impact on patient care using Rodgers's (1989) evolutionary framework of concept analysis. Effective communication between nurses and patients is presented along with surrogate terms, attributes, antecedents, consequences, related concepts and a model case. Effective communication was identified to be a multifactorial concept and defines as a mutual agreement between nurses and patients. This influences the nursing process, clinical reasoning and decision-making. Consequently, promotes high-quality nursing care, positive patient outcome and patient's and nurse's satisfaction of care.

Communication is an essential element of building trust and comfort in nursing, and it is the basis of the nurse–patient relationship ( Dithole et al, 2017 ). Communication is a complex phenomenon in nursing and is influenced by multiple factors, such as relationship, mood, time, space, culture, facial expression, gestures, personal understanding and perception ( McCarthy et al, 2013 ; Kourkouta and Papathanasiou, 2014 ). Effective communication has been linked to improved quality of care, patient satisfaction and adherence to care, leading to positive health outcomes ( Burley, 2011 ; Kelton and Davis, 2013 ; Ali, 2017 ; Skär and Söderberg, 2018 ). It is an important part of nursing practice and is associated with health promotion and prevention, health education, therapy and treatment as well as rehabilitation ( Fakhr-Movahedi et al, 2011 ). The Nursing and Midwifery Council (NMC) (2018) emphasised effective communication as one of the most important professional and ethical nursing traits. Nonetheless, communication remains a complicated phenomenon in nursing, and most patient-reported complaints in healthcare are around failed communication ( Reader et al, 2014 ). The aim of the present concept analysis is to explore and clarify the complexity of establishing effective communication between nurses and patients in practice.

Register now to continue reading

Thank you for visiting Community Nursing and reading some of our peer-reviewed resources for district and community nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

Limited access to clinical or professional articles

New content and clinical newsletter updates each month

Signing in with your registered email address

‘I hope the next Darzi report will be a positive story about NHS progress’

STEVE FORD, EDITOR

You are here: Assessment skills

Communication skills 2: overcoming the barriers to effective communication

18 December, 2017 By Moi Ali

This article, the second in a six-part series on communication skills, a discusses the barriers to effective communication and how to overcome them

Competing demands, lack of privacy, and background noise are all potential barriers to effective communication between nurses and patients. Patients’ ability to communicate effectively may also be affected by their condition, medication, pain and/or anxiety. Nurses’ and patients’ cultural values and beliefs can also lead to misinterpretation or reinterpretation of key messages. This article, the second in a six-part series on communication skills , suggests practical ways of overcoming the most common barriers to communication in healthcare.

Citation: Ali M (2017) Communication skills 2: overcoming barriers to effective communication Nursing Times ; 114: 1, 40-42.

Author: Moi Ali is a communications consultant, a board member of the Scottish Ambulance Service and of the Professional Standards Authority for Health and Care, and a former vice-president of the Nursing and Midwifery Council.

This article has been double-blind peer reviewed
Scroll down to read the article or download a print-friendly PDF here
Click here to see other articles in this series
Read Moi Ali’s comment

Introduction

It is natural for patients to feel apprehensive about their health and wellbeing, yet a survey in 2016 found that only 38% of adult inpatients who had worries or fears could ‘definitely’ find someone in hospital to talk to about them (Care Quality Commission, 2017). There are numerous barriers to effective communication including:

Time constraints;
Environmental issues such as noise and privacy;
Pain and fatigue;
Embarrassment and anxiety;
Use of jargon;
Values and beliefs;
Information overload.

Time constraints

Time – or lack of it – creates a significant barrier to communication for nurses (Norouzinia et al, 2016). Hurried communication is never as effective as a leisurely interaction, yet in pressured workplaces, nurses faced with competing demands may neglect the quality of communication.

It is important to remember that communication does not need to be time-consuming – a smile, hello, or some ‘small talk’ about the weather may suffice. Even when there is no pressing news to tell individual patients, taking the time to get to know them can prepare the ground for difficult conversations that may need to take place in the future.

In a pressured ward or clinic, conversations between patients and nurses may be delayed or interrupted because of the needs of other patients – for example, they may need to respond to an emergency or pain relief. This can be frustrating for patients who may feel neglected.

If interruptions occur it is important to explain to patients that you have to leave and why. Arranging to return within a specified time frame may be enough to reassure them that you are aware that their concerns are important (Box 1).

Box 1. Making time for communication

Nurse Amy Green was allocated a bay of four patients and two side wards for her shift. Halfway through the morning one of her patients in a side ward became very ill and Amy realised that she needed to spend a lot of time with him. She quickly visited her other patients to explain what was happening, and reassured them that she had not forgotten about them. She checked that they were comfortable and not in pain, asked them to ring the call bell if they needed her, and explained that she would return as soon as she could. The patients understood the situation and were reassured that their immediate needs had been assessed and they were not being neglected.

Environmental factors

You may be so familiar with your surroundings that you no longer notice the environmental factors that can create communication difficulties. Background noise in a busy clinic can affect patients’ ability to hear, and some may try to disguise this by nodding and ‘appearing’ to hear.

If you think your patient has hearing problems, reduce background noise, find a quiet corner or step into a quiet side room or office. Check whether your patient uses physical aids, such as hearing aids or spectacles and that these are in working order.

Noise and other distractions can impede communication with patients with dementia and other cognitive impairments, who find concentration challenging. If you have to communicate an important message to a patient with poor concentration, it is useful to plan ahead and identify the best place and time to talk. It can be helpful to choose a time when you are less busy, without competing activities such as medicine rounds or meal times to interrupt your discussion.

Patients may be reticent to provide sensitive personal information if they are asked about their clinical history within earshot of other people, such as at a busy reception desk or in a cubicle with just a curtain for privacy. It is important to avoid asking sensitive questions where others may hear patients’ replies.

Consider alternative ways of gathering pertinent information, such as asking the patient to complete a written form – but remember that some patients struggle with reading and writing or may need the form to be provided in a different language or have someone translate for them.

Pain and fatigue

We often need to gain important information from patients when they are acutely ill and distressed, and symptoms such as pain can reduce concentration. If you urgently need to gather information, it is important to acknowledge pain and discomfort: “I know that it is painful, but it’s important that we discuss.”

Patients may also be tired from a sleepless night, drowsy after an anaesthetic or experiencing the side-effects of medicines. Communicating with someone who is not fully alert is difficult, so it is important to prioritise the information you need, assess whether it is necessary to speak to the patient and ask yourself:

Is this the best time for this conversation?
Can my message wait?
Can I give part of the message now and the rest later?

When patients cannot give their full attention, consider whether your message could be broken down into smaller pieces so there is less to digest in one go: “I will explain your medication now. I’ll return after lunch to tell you about how physiotherapy may help.” Ask if they would like any of the information repeated.

If you have to impart an important piece of information, acknowledge how the patient is feeling: “I know that you’re tired, but …”. Showing empathy can build rapport and make patients more receptive. It may also be useful to stress the need to pay attention: “It’s important that you listen because …”.

Consider repeating the message: “It can be difficult to take everything in when you’re tired, so I just wanted to check that you’re clear about …”. If the communication is important, ask the patient to repeat it back to you to check it has been understood.

Embarrassment and anxiety

Would you feel comfortable undressing in front of a complete stranger, or talking about sex, difficult family circumstances, addictions or bowel problems? Patients’ and health professionals’ embarrassment can result in awkward encounters that may hamper effective communication.

However, anticipating potential embarrassment, minimising it, and using straightforward, open communication can ease difficult conversations. For example, in a clinic, a patient may need to remove some clothes for an examination.

It is important to be direct and specific. Do not say: “Please undress”, as patients may not know what to remove; give specific instructions: “Please remove your trousers and pants, but keep your shirt on”. Clear directions can ease stress and embarrassment when delivered with matter-of-fact confidence.

Patients may worry about embarrassing you or themselves by using inappropriate terms for anatomical parts or bodily functions. You can ease this embarrassment by introducing words such as “bowel movements” or “penis” into your questions, if you think they are unsure what terminology to use. Ambiguous terms such as “stool”, which have a variety of everyday meanings, should be avoided as they may cause confusion.

Many patients worry about undergoing intimate procedures such as bowel and bladder investigations. Explain in plain English what an examination involves, so that patients know what to expect. Explaining any side-effects of procedures – such as flatulence or vomiting – not only warns patients what to expect but reassures them that staff will not be offended if these occur.

Box 2 provides some useful tips on dealing with embarrassment.

Box 2. Managing embarrassment

Look out for signs of embarrassment – not just obvious ones like blushing, but also laughter, joking, fidgeting and other behaviours aimed at masking it
Think about your facial expressions when communicating with patients, and use positive, open body language such as appropriate eye contact or nodding
Avoid disapproving or judgmental statements by phrasing questions carefully: “You don’t drink more than 10 glasses of wine a week, do you?” suggests that the ‘right’ or desired answer is ‘no’. A neutral, open question will elicit a more honest response: “How many glasses of wine do you drink in a typical week?”

Some patients are reluctant to ask questions, seek clarification or request that information be repeated for fear of wasting nurses’ time. It is important to let them know that their health or welfare is an integral part of your job. They also need to know that there is no such thing as a silly question.

Encourage questions by using prompts and open questions such as: “You’re bound to have questions – are there any that I can answer for you now?”; “What else can I tell you about the operation?”. It is also possible to anticipate and address likely anxieties such as “Will it be painful?”; “Will I get better?”; or “Will I die?”.

Jargon can be an important communication aid between professionals in the same field, but it is important to avoid using technical jargon and clinical acronyms with patients. Even though they may not understand, they may not ask you for a plain English translation. It is easy to slip into jargon without realising it, so make a conscious effort to avoid it.

A report on health literacy from the Royal College of General Practitioners (2014) cited the example of a patient who took the description of a “positive cancer diagnosis” to be good news, when the reverse was the case.

If you have to use jargon, explain what it means. Wherever possible, keep medical terms as simple as possible – for example, kidney, rather than renal and heart, not cardiac. The Plain English website contains examples of healthcare jargon.

Box 3 gives advice on how to avoid jargon when speaking with patients.

Box 3. Avoiding jargon

Avoid ambiguity: words with one meaning for a nurse may have another in common parlance – for example, ‘acute’ or ‘stool’
Use appropriate vocabulary for the audience and age-appropriate terms, avoiding childish or over-familiar expressions with older people
Avoid complex sentence structures, slang or speaking quickly with patients who are not fluent in English
Use easy-to-relate-to analogies when explaining things: “Your bowel is a bit like a garden hose”
Avoid statistics such as “There’s an 80% chance that …” as even simple percentages can be confusing. “Eight in every 10 people” humanises the statistic

Values, beliefs and assumptions

Everyone makes assumptions based on their social or cultural beliefs, values, traditions, biases and prejudices. A patient might genuinely believe that female staff must be junior, or that a man cannot be a midwife.

Be alert to patients’ assumptions that could lead to misinterpretation, reinterpretation, or even them ignoring what you are telling them. Think about how you can address such situations; for example explain your role at the outset: “Hello, I am [your name], the nurse practitioner who will be examining you today.”

It is important to be aware of your own assumptions, prejudices and values and reflect on whether they could affect your communication with patients. A nurse might assume that a patient in a same-sex relationship will not have children, that an Asian patient will not speak good English, or that someone with a learning disability or an older person will not be in an active sexual relationship. Incorrect assumptions may cause offence. Enquiries such as asking someone’s “Christian name” may be culturally insensitive for non-Christians.

Information overload

We all struggle to absorb lots of facts in one go and when we are bombarded with statistics, information and options, it is easy to blank them out. This is particularly so for patients who are upset, distressed, anxious, tired, in shock or in pain.

If you need to provide a lot of information, assess how the patient is feeling and stick to the pertinent issues. You can flag up critical information by saying: “You need to pay particular attention to this because …”.

Box 4 provides tips on avoiding information overload.

Box 4. Avoiding information overload

Consider suggesting that your patient involves a relative or friend in complex conversations – two pairs of ears are better than one. However, be aware that some patients may not wish others to know about their health
Suggest patients take notes if they wish
With patients’ consent, consider making a recording (or asking whether the patient wishes to record part of the consultation on their mobile phone) so they can replay it later or share it with a partner who could not accompany them
Give written information to supplement or reinforce the spoken word
Arrange another meeting if necessary to go over details again or to provide further information

It is vital that all nurses are aware of potential barriers to communication, reflect on their own skills and how their workplace environment affects their ability to communicate effectively with patients. You can use this article and the activity in Box 5 to reflect on these barriers and how to improve and refine your communication with patients.

Box 5. Reflective activity

Think about recent encounters with patients:

What communication barriers did you encounter?
Why did they occur?
How can you amend your communication style to take account of these factors so that your message is not missed, diluted or distorted?
Do you need support to make these changes?
Who can you ask for help?
Nurses need to be aware of the potential barriers to communication and adopt strategies to address them
Environmental factors such as background noise can affect patients’ ability to hear and understand what is being said to them
Acute illness, distress and pain can reduce patients’ concentration and their ability to absorb new information
Anticipating potential embarrassment and taking steps to minimise it can facilitate difficult conversations
It is important to plan ahead and identify the best place and time to have important conversations

Also in this series

Communication skills 1: benefits of effective communication for patients
Communication skills 3: non-verbal communication
Communication 4: the influence of appearance and environment
Communication 5: effective listening and observation skills
Communication skills 6: difficult and challenging conversations

Related files

171220 communication skills 2 overcoming barriers to effective communication.

Add to Bookmarks

Performing a cranial nerve examination and interpreting the findings

Learn the essentials of cranial nerve examination, involving systematic assessment of each nerve to identify abnormalities relating to neurological pathologies.

How to assess and examine a patient with abdominal symptoms

Learn how to conduct an advanced abdominal assessment to give a working diagnosis and guide clinical management.

How to conduct a cardiovascular assessment in advanced practice

Read this article to learn how to conduct an advanced cardiovascular assessment to reveal heart abnormalities and associated symptoms and risk factors.

How to interpret chest radiographs (X-rays): a systematic approach

Chest X-rays are the most common radiological investigation requested in the NHS; this article explains how to interpret the results and identify common abnormalities.

Have your say

Addressing Barriers to Effective Communication Essay

To find inspiration for your paper and overcome writer’s block
As a source of information (ensure proper referencing)
As a template for you assignment

Introduction

Description of communication barriers, proposed strategies for better outcome.

Effective communication is an integral aspect of nursing because nurses constantly interact with patients, families, colleagues, supervisors, and managers in the course of their duties. Rosenblatt and Davis (2009) argue that the nature of communication determines the quality of care that patients receive. In essence, effective communication leads to poor quality of nursing care, while effective communication leads to improved quality nursing care. In this view, healthcare centers must enhance the effectiveness of the communication process so that they can improve the quality of nursing care that patients receive.

Marquis and Huston (2012) analyze the communication process and identify media of communication and environment as factors that determine the effectiveness of communication. In the factor of environment, there is an external environment, which comprises power, status, and authority, while the internal environment comprises feelings, values, emotions, stress, and temperament.

The media of transmitting information that affects the effectiveness of communication are verbal, written, and non-verbal means. Therefore, the essay examines a case study of ineffective communication and describes barriers with a view of proposing strategies that are applicable in promoting better outcomes.

In an incident that depicts the ineffectiveness of communication in nursing care, a home health aide, who was providing nursing care to a patient with pressure ulcers, did not communicate effectively with the authorities and colleagues. In the first instance, the aide did not report to the home health agency regarding the presence of a patient with pressure ulcers, who required special care. Furthermore, the aide took the weekend off without reporting to the home health agency and left the patient unattended to by other aides.

After two days, the condition of the patient worsened and led to the development of multiple pressure ulcers. The worsening pressure ulcers caught the attention of another home health agency, which reported the incident to the state and have the patient admitted for further treatment for a couple of days. When asked about the situation, the aide stated that the caregiver prohibited her to report the pressure ulcers and did not allow her to take the weekend off.

The communication barriers that are present in the case study related to the reporting of pressure ulcers and allowing the aide to ask permission for the weekend off. The home health agency does not provide for the procedure of reporting pressure ulcers as the aide stated that the caregiver disallowed her from reporting the existence of the patient with pressure ulcers.

The communication barrier is the absence of a communication channel through which the aide can report the occurrence of pressure ulcers among patients to the authority. Robinson, Gorman, Slimmer, and Yudkowsky (2010) cite the nature of hierarchical authority structure as a barrier to effective communication between healthcare providers and their respective authorities. Moreover, the unprofessional practice of excusing oneself from work is an apparent barrier to effective communication.

According to Marquis and Huston (2012), communication entails the transmission of information from sender to receiver via written, verbal, or non-verbal means. Hence, from the case study, the caregiver acts as a personal and institutional barrier to communication between the aide and the home health agency. Overall, the case study presents personal and institutional barriers to effective communication.

The first proposed strategy that is applicable in improving the outcome of communication in nursing is the training of nurses to acquire professional skills of communication. Thomas, Bertram, and Johnson (2009) recommend the training of nursing students to enhance their communication skills so that they can communicate professionally. The aide lacked professional communication skills for she took the weekend off without seeking permission from the authority.

The second proposed strategy is that the home health agency should provide channels of communication so that nurses can communicate freely with authority or amongst themselves. Boscart (2009) argues that the enhancement of the quality of interactions improves the quality of nursing care. In this view, the aide and the caregiver poorly interacted, and thus led to the worst outcomes of nursing care.

Communication is an integral aspect of nursing because it influences the quality of care that patients receive. Usually, nurses have to communicate with patients, families, colleagues, and other healthcare providers in the course of their duties. The effectiveness of communication is dependent on many factors such as organizational structure, regulations, professionalism, and personal issues. In the case study, it is evident that the lack of organizational channels that allow nurses to communicate with their supervisors and authorities hinders the delivery of quality care.

The aide did not report the case of pressure ulcers because the caregiver disallowed her from doing so. Moreover, lack of professional skills of communication made the aide take the weekend off without seeking permission from the agency. Therefore, to address barriers to effective communication in the case study, training of nurses in the aspect of professional communication and provision of communication channels that improve quality of interaction and consequently the quality of communication is essential.

Boscart, V. (2009). A communication intervention for nursing staff in chronic care. Journal of Advanced Nursing, 65 (9), 1823-1832. Web.

Marquis, B. L., & Huston, C. J. (2012). Leadership roles and management functions nursing: Theory and application. Philadelphia, PA: Lippincott, Williams & Wilkins. Web.

Robinson, F., Gorman, G., Slimmer, L., & Yudkowsky, R. (2010). Perceptions of effective and ineffective Nurse-physician communication in hospitals. Nursing Forum, 45 (3), 206-216. Web.

Rosenblatt, C. L., & Davis, M. S. (2009). Effective communication techniques for nurse managers. Nursing Management, 40 (6), 52-54. Web.

Thomas, C. M., Bertram, E., & Johnson, D. (2009). The SBAR communication technique: Teaching nursing students professional communication skills. Nurse Educator, 34 (4), 176-180. Web.

The Communication Processes at St. Duke’s Hospital
Friendship in the Analects and Zhuangzi Texts
Business Administration in Healthcare Field
Counterterrorism: The Amerithrax Investigation of 2001
The Life of James Oglethorpe
Group Communication: Main Types
Community Consultation in Resource Management
Blogging: Reasons and Kinds
Misinterpretation of Information and Its Effects
Technical Communication Methods and Practices of Criminal Justice
Chicago (A-D)
Chicago (N-B)

IvyPanda. (2022, April 13). Addressing Barriers to Effective Communication. https://ivypanda.com/essays/addressing-barriers-to-effective-communication/

"Addressing Barriers to Effective Communication." IvyPanda , 13 Apr. 2022, ivypanda.com/essays/addressing-barriers-to-effective-communication/.

IvyPanda . (2022) 'Addressing Barriers to Effective Communication'. 13 April.

IvyPanda . 2022. "Addressing Barriers to Effective Communication." April 13, 2022. https://ivypanda.com/essays/addressing-barriers-to-effective-communication/.

1. IvyPanda . "Addressing Barriers to Effective Communication." April 13, 2022. https://ivypanda.com/essays/addressing-barriers-to-effective-communication/.

Bibliography

IvyPanda . "Addressing Barriers to Effective Communication." April 13, 2022. https://ivypanda.com/essays/addressing-barriers-to-effective-communication/.

IvyPanda uses cookies and similar technologies to enhance your experience, enabling functionalities such as:

Basic site functions
Ensuring secure, safe transactions
Secure account login
Remembering account, browser, and regional preferences
Remembering privacy and security settings
Analyzing site traffic and usage
Personalized search, content, and recommendations
Displaying relevant, targeted ads on and off IvyPanda

Please refer to IvyPanda's Cookies Policy and Privacy Policy for detailed information.

Certain technologies we use are essential for critical functions such as security and site integrity, account authentication, security and privacy preferences, internal site usage and maintenance data, and ensuring the site operates correctly for browsing and transactions.

Cookies and similar technologies are used to enhance your experience by:

Remembering general and regional preferences
Personalizing content, search, recommendations, and offers

Some functions, such as personalized recommendations, account preferences, or localization, may not work correctly without these technologies. For more details, please refer to IvyPanda's Cookies Policy .

To enable personalized advertising (such as interest-based ads), we may share your data with our marketing and advertising partners using cookies and other technologies. These partners may have their own information collected about you. Turning off the personalized advertising setting won't stop you from seeing IvyPanda ads, but it may make the ads you see less relevant or more repetitive.

Personalized advertising may be considered a "sale" or "sharing" of the information under California and other state privacy laws, and you may have the right to opt out. Turning off personalized advertising allows you to exercise your right to opt out. Learn more in IvyPanda's Cookies Policy and Privacy Policy .

Open access
Published: 16 May 2024

Comparison of barriers to effective nurse-patient communication in COVID-19 and non-COVID-19 wards

Hamed Bakhshi ORCID: orcid.org/0009-0008-7865-0149 1 ,
Mohammad Javad Shariati ORCID: orcid.org/0009-0000-5518-698X 1 ,
Mohammad Hasan Basirinezhad ORCID: orcid.org/0000-0002-3672-556X 2 &
Hossein Ebrahimi ORCID: orcid.org/0000-0001-5731-7103 3

BMC Nursing volume 23 , Article number: 328 ( 2024 ) Cite this article

1309 Accesses

Metrics details

Communication is a basic need of humans. Identifying factors that prevent effective nurse-patient communication allows for the better implementation of necessary measures to modify barriers. This study aims to compare the barriers to effective nurse-patient communication from the perspectives of nurses and patients in COVID-19 and non-COVID-19 wards.

Materials and methods

This cross-sectional descriptive study was conducted in 2022. The participants included 200 nurses (by stratified sampling method) and 200 patients (by systematic random sampling) referred to two conveniently selected hospitals in Shahroud, Iran. The inclusion criteria for nurses were considered having at least a bachelor’s degree and a minimum literacy level for patients to complete the questionnaires. Data were collected by the demographic information form and questionnaire with 30 and 15 questions for nurses and patients, which contained similar questions to those for nurses, based on a 5-point Likert scale. Data were analysis using descriptive indices and inferential statistics (Linear regression) in SPSS software version 18.

The high workload of nursing, excessive expectations of patients, and the difficulty of nursing work were identified by nurses as the main communication barriers. From the patients’ viewpoints, the aggressiveness of nurses, the lack of facilities (welfare treatment), and the unsanitary conditions of their rooms were the main communication barriers. The regression model revealed that the mean score of barriers to communication among nurses would decrease to 0.48 for each unit of age increase. Additionally, the patient’s residence explained 2.3% of the nurses’ barriers to communication, meaning that native participants obtained a mean score of 2.83 units less than non-native nurses, and there was no statistically significant difference between the COVID and non-COVID wards.

In this study, the domain of job characteristics was identified by nurses as the major barrier, and patients emphasized factors that were in the domain of individual/social factors. There is a pressing need to pay attention to these barriers to eliminate them through necessary measures by nursing administrators.

Peer Review reports

First observed in Wuhan, China, the COVID-19 pandemic is an acute and very severe respiratory syndrome that the World Health Organization has raised as a health problem because of its high spread rate and consequences on an international scale. The number of COVID-19 patients is increasingly on the rise [ 1 , 2 ]. Illness and hospitalization are usually stressful and associated with bad experiences for patients and their family members [ 3 ].

According to Tabandeh Sadeghi et al. (2011) “Communication is a basic need of humans. Any interaction is an opportunity to achieve effective communication and participation in understanding the issue, which leads to the achievement of mutual goals by individuals.” [ 4 ]. The three important aspects of communication that are emphasized the most are the message’s sender, the receiver, and the environment. Communicating is an interaction between the sender and the receiver of the message, and the environment affects them [ 5 , 6 ]. In the context of a hospital, these three aspects of communication can be defined as nurse, patient, and hospital environment, and all three should be considered when examining the obstacles [ 7 ]. “According to Ali Fakhr Movahedi et al. (2012)” Communication is considered a central concept in nursing and an essential part of nursing work [ 8 ]. Patients perceive interaction with nurses as the basis of their treatment [ 9 ]. Nurse-patient communication is an interpersonal process that is created between these two groups during treatment. This process generally includes the start, work, and end stages. Effective communication is an essential aspect of patient care by nurses, and many nursing tasks cannot be performed without this activity [ 10 ]. Effective communication consists of explicit transmission and receipt of message content, in which information is consciously and unconsciously produced by a person and communicated to the recipient through verbal and non-verbal patterns [ 11 ]. The non-verbal aspect of communication plays an essential role and is more important than the verbal aspect of language in emergencies. The mandatory use of face masks during the COVID-19 pandemic negatively influenced nurse-patient communication, notably because this tool significantly reduced the messages arising from non-verbal communication channels [ 12 ]. In this regard, Vitale et al. investigated wearing face masks as a communication barrier between nurses and patients. The results showed no differences in the patients’ opinions before and during the COVID-19 pandemic; patients believed that the mask was not a communication barrier, while nurses thought that wearing masks was a communication barrier [ 12 ]. Unfavorable communication can hamper the patient’s recovery and may even permanently deprive the patient of health or life.

In comparison, good communication affects the patient’s recovery more than medication. In fact, nurses will succeed in their tasks when they can communicate well with their patients [ 13 ]. Effective communication can affect pain control, adherence to a treatment regimen, and the patient’s mental health and play an important role in reducing the patient’s anxiety and fear and faster recovery [ 14 ]. During good communication, patients can disclose and express sensitive and personal information. Consequently, nurses can also transfer necessary information, attitudes, or skills [ 4 ]. Identifying factors that prevent effective nurse-patient communication allows for the better implementation of measures required to adjust obstacles [ 15 ].

The first published reports of the deaths of coronavirus-infected doctors during caring for patients indicate that the virus transmission to healthcare workers in healthcare centers is a hazardous issue [ 16 , 17 ]. Under these stressful conditions, nurses must manage long shift hours and the fear of contagion and overcome communication difficulties through layers of personal protective equipment. These problems may disrupt communication with patients and cause less focus of health workers on the psychosocial well-being of patients [ 18 , 19 ]. Baillie states that the lack of time is a clear barrier to communication between emergency nurses and patients [ 20 ]. Meehan et al. also reported that nurses mentioned the lack of time, fatigue, and workload of personnel to be the factors preventing nurse-patient interaction. In the same research, patients cited the issue of gender as a factor preventing their interaction with nurses. However, male and female patients had difficulty communicating with male nurses [ 21 ].

Identifying factors that prevent effective nurse-patient communication makes it possible to elucidate the direction of necessary measures for the planners and executives of the health sector to eliminate or modify barriers. In particular, when these barriers are identified and expressed with a realistic approach, i.e., from nurses’ and patients’ perspectives [ 22 ]. Before this, no study compared barriers to nurse-patient communication in COVID and non-COVID wards. Therefore, this research aims to compare the barriers to effective nurse-patient communication from nurses’ and patients’ perspectives in COVID-19 and NON-COVID-19 wards. Hopefully, identifying these obstacles and planning to solve them as soon as possible will make us have nurses in the future who can communicate well with patients and improve service delivery.

Study design

This cross-sectional descriptive research was conducted on 200 nurses and 200 patients at hospitals affiliated with the Shahroud University of Medical Sciences. The participants included nurses and patients from different wards of two conveniently selected hospitals in Shahroud. To sample nurses by the stratified method, the sample size was first divided by the total number of nurses in the mentioned hospitals to obtain the sampling fraction. According to Mohammadi et al. study, standard deviations reported for all subscales for barrier’s to effective communication (individual/social factors = 6.22), job characteristics = 6.74, patient’s clinical conditions = 4.22), and environmental factors = 9.09) were utilized to estimate the sample size [ 23 ]. Estimation error was considered 0.15 of standard deviation values. The confidence levels and power were considered at 0.95 and 0.8 respectively with a 15% dropout probability. Also, another sample size was calculated similarly using the standard deviation reported in Norouzinia et al. study for patient’s questionnaire equal to 1.96 [ 24 ]. Finally, among the estimated values; the largest number (200) was considered as the sample size of the present study for nurses and patients.

Considering that the total number of nurses is around 700 and the sample size calculated by the statistics consultant is 200 nurses, our sampling fraction was calculated as $\frac{2}{7}$ . Therefore, $\frac{2}{7}$ personnel of each department were included in the study. The patients were sampled by a systematically random method using the hospital list, file number, and dates of admission and discharge. The inclusion criteria for nurses were a bachelor’s degree or higher and a minimum literacy level for patients to complete the questionnaire. Moreover, the questionnaire contained questions about the nurses’ work experience or no experience in COVID-19 wards. The duration of working in COVID-19 wards was included in the questionnaire questions, and the duration was considered in the analysis. Data were collected using a questionnaire provided to the nurses through daily visits to various wards of the mentioned hospitals, including emergency, surgery, special care, internal medicine, gastroenterology, cardiology, urology, orthopedics, ICU, CCU, and other wards. The questionnaire was also provided to the patients hospitalized in surgery, special care, internal medicine, gastroenterology, cardiology, urology, ICU, and CCU wards, among others. Due to the reduced coronavirus spread during that period, the information on COVID-19 patients was accessed using hospital information by obtaining permission, and the questionnaire was completed through phone calls.

Measurements

Demographic information form.

It contained questions about information related to age, gender, marital status, language, and residence.

Communication barrier questionnaire

The barriers to effective nurse-patient communication were investigated using the same questionnaire designed by Anoosheh et al. This questionnaire contains 30 items for nurses and aims to evaluate nurses’ views about the barriers to effective nurse-patient communication. The response of this questionnaire is in the Likert range (completely false = 1, false = 2, I have no opinion = 3, agree = 4, and completely agree = 5). The nurses’ questionnaire contains four dimensions, and the question numbers of each dimension include individual/social factors (1–8), occupational characteristics (9–17), patient’s clinical conditions (18–21), and environmental factors (22–30). The domain of individual/social factors includes questions such as the gender difference between the patient and the nurse, age difference, aggressiveness of nurses, etc. The domain of job characteristics includes questions about the high workload of nursing, the difficulty of nursing work, the low salaries of nurses, etc. The domain of the patient’s clinical condition also includes questions such as the severity of the disease, the presence of the patient’s companion, etc. The domain of environmental factors: where communication occurs is important. The nurse and the patient should feel calm and safe in the treatment environment. This domain also includes questions such as the Lack of facilities (welfare - treatment) for patients, the unsanitary condition of the patient’s room, the High cost of treating patients, etc. A pilot study was carried out to assess the face validity among nurses. In addition, the content validity was assessed by estimation of content validity ratio and content validity index among nursing educators. The internal consistency for the present questionnaire assessed by Cronbach’s alpha coefficient equal to 0.96 [ 25 ].

The patient questionnaire contains 15 questions and aims to evaluate the patients’ views about the barriers to effective nurse-patient communication. The response of this questionnaire is in the Likert range (completely false = 1, false = 2, I have no opinion = 3, agree = 4, and completely agree = 5). No separate dimension was considered for the patient questionnaire. The reliability based on internal consistency was reported using Cronbach’s alpha equal to 0.91 [ 25 ]. The total score of the questionnaire is obtained by summing up the total scores of all questions. The score of each dimension is obtained from the sum of scores for each question of that dimension. Higher scores in each dimension indicate the greater strength of that dimension as a barrier to effective nurse-patient communication and vice versa. After completing the communication barrier questionnaire, a separate question was asked from the patients and nurses about whether or not the face mask was a communication barrier. This question was scored with a Likert scale (completely false = 1, false = 2, I have no opinion = 3, agree = 4, and completely agree = 5). The score of this question was measured separately from the nurse-patient communication barrier questionnaire.

Ethical considerations

Initially, necessary permissions were obtained from the Vice Chancellor of Research and Technology and the Research Ethics Council (code of ethics: IR.SHMU.REC.1401.140) at the Shahroud University of Medical Sciences. Necessary coordination was also made with the administrators of two conveniently selected hospitals in Shahroud. After explaining the purpose of the research and answering the questions of nurses and patients regarding the questionnaire and how to complete them, enough time was given to answer them.

Statistical analysis

Data were analyzed using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential tests (Linear regression) in SPSS software version 18. All variables with a significance level of less than 0.2 are included in the final regression model. A significance level of 0.05 was considered. Considering that one of the purposes of this study is to determine the barriers to effective nurse-patient communication based on demographic information, three participants were excluded from the data analysis due to a lack of demographic information completion.

The average ages of nurses and patients were respectively 33.28 and 38.57 years, and most nurses (85.3%) and patients (61.5%) were females and males, respectively. Other demographic characteristics are listed in Table 1 .

In this study, the mean score obtained for each domain of the barriers to nurse-patient communication was determined from the nurses’ point of view. According to these results, the highest score with an average of 32.41 ± 6.75 related to the domain of job characteristics, and the lowest score with an average of 11.76 ± 3.17 related to the domain of Patient’s Clinical Conditions. Additional information is presented in Table 2 .

The excessive patients’ expectations in the domain of individual/social factors, the high workload of nursing in the domain of job characteristics, the severity of the disease in the domain of the patient’s clinical conditions, and no appreciation for nurses by authorities in the domain of environmental factors were the major communication barriers. The patient-nurse age difference from the domain of individual/social factors, the patient’s contact with multiple nurses with different attitudes from the domain of job characteristics, previous hospitalization history from the domain of the patient’s clinical conditions, and the high cost of patient treatment from the domain of environmental factors were the least important barriers to communication from the nurses’ viewpoints. From the patients’ views, the aggressiveness of nurses and the patient-nurse age difference were the major and the minor barriers to communication, respectively. Face masks were among the minor barriers to nurse-patient communication from the viewpoints of both groups (Table 3 ); this table is placed at the end of the article.

The relationship between nurses’ age and communication barriers was investigated using a regression model. This model was first run as a univariate type, and variables with a significance of < 0.2 were introduced into a multivariate model using the backward method. Finally, the model showed that the nurses’ age variable explained 3.8% of the score variance. In other words, the regression model revealed that the mean score of nurses would decrease to 0.486 for each year of age increase, and there is no statistically significant difference between the COVID and non-COVID wards (Table 4 ).

Additionally, the patient’s residence variable explained 2.3% of the score variance, meaning that native people obtained a mean score of 2.813 units less than non-native people, and there is no statistically significant difference between the COVID and non-COVID wards (Table 5 ).

The present study aimed to determine the barriers to effective nurse-patient communication from the viewpoints of nurses and patients in COVID-19 and non-COVID-19 wards in hospitals affiliated with the Shahroud University of Medical Sciences. The results of this study showed that in the domains of barriers to effective communication, nurses reported the highest score in job characteristics and the lowest score in the patient’s clinical conditions. In a study on nursing students at Urmia Midwifery School of Nursing, Habibzadeh et al. (2017) reported the highest and the lowest mean scores for questions related to occupational characteristics and the patient’s clinical conditions [ 26 ], which corresponds to our results. Work congestion conditions increase the work pressure of nurses, leading to fatigue, a situation in which nurses lack enough time to discover the patient’s concerns [ 27 ]. Stress and pressure caused by time constraints often result in miscommunication and reduce the satisfaction of nurses and patients [ 28 ].

The results of this study showed that the high workload of nursing and excessive expectations of patients are mentioned as two major obstacles to effective communication with patients from the point of view of nurses. Anoushe et al. (2015) and Baraz Pordanjani et al. (2016) investigated barriers to effective nurse-patient communication. They reported that nurses identify their workload as a major barrier to effective patient communication [ 15 , 22 ]. However, Habibzadeh et al. (2017) claimed that nurses’ lack of information and skills in patient communication was identified as the main communication barrier [ 26 ]. A possible reason for this discrepancy might be that the current study was conducted during the COVID-19 pandemic, concurrent with the increased workload of nurses compared to the pre-pandemic period.

The difficulty of nursing work, the psychophysical fatigue of nurses, the lack of comfort facilities for nurses, and no appreciation for nurses by administrators are in the next ranks of importance. Similarly, Anoushe et al. (2005) reported the difficulty of nursing work, the lack of comfort facilities for nurses, and psychophysical fatigue among the barriers with more emphasis by nurses [ 22 ]. The notable point is that nurses do not have the opportunity to establish effective communication with patients due to their workload. Furthermore, their work type is hard and tiring, and they do not receive proper benefits or appreciation. In such a situation, one cannot expect good nurse-patient communication, and the conditions affect patients’ moods. As expressed by the patients, this issue also negatively affects the quality of their relationships with patients [ 15 ].

The aggressiveness of nurses mentioned as the main obstacle to effective communication with patients from the patients’ point of view. Likewise, Baraz Pordanjani et al. (2009) found a statistically significant difference between the aggressiveness of nurses from the perspectives of nurses and patients [ 15 ].

Regarding the communication barriers from the patient’s perspective, the lack of facilities (welfare treatment) for them and the unsanitary condition of their rooms were among the factors more emphasized by patients than by the nurses. Interestingly, Baraz Pordanjani et al. observed that nurses believed more than patients that the lack of comfort facilities for patients and the unsanitary condition of their rooms would hinder effective communication [ 15 ]. This contradictory result can result from the difference in facilities and health/treatment conditions of the studied hospitals.

The viewpoints of both nurse and patient groups show that age and class differences do not negatively influence their relationships. Since nurses are responsible for initiating and maintaining communication with patients, it can be claimed that they perform their professional tasks, including communication establishment, regardless of the social class and age of patients, who also acknowledge this issue.

The face mask also obtained a low score from the viewpoints of patients and nurses. Vitale et al. investigated the use of face masks as a communication barrier between nurses and patients. The results indicated no difference in the patients’ opinions before and during the COVID-19 pandemic; that is, patients did not consider the mask a communication barrier, which is consistent with the present study. However, nurses thought that using a mask would be a communication barrier [ 12 ].

The present results revealed a significant relationship between the age of nurses and the barriers to effective nurse-patient communication; as such, the total score of nurses decreased for each year of age increase; However, no statistically significant difference was observed in the comparison of COVID and non-COVID wards. In this regard, Gopichandran et al. (2021) aimed to determine communication barriers between doctors and patients during the COVID-19 pandemic in India. They claimed that communication barriers decreased with age [ 29 ]. Nurses gain more experience and skills with rising age. Enough experience is also a characteristic that patients consider necessary for nursing work [ 30 ]. “According to Aram Feizi et al. (2006)” Mark (2001) concluded that the experience of the nursing unit could create satisfaction in both nurses and patients [ 30 ]. The possible reason for obtaining different results could be that the COVID-19 vaccination process was carried out slowly in Iran. For this reason, the nurses, both in the COVID and non-COVID wards, considered all patients with unique viewpoints (all of the patients considered potential cases of COVID-19). For this reason, there was no statistical difference between the communication barriers of the COVID and non-COVID departments.

No statistically significant difference was observed between the scores of male and female nurses and the barriers to effective nurse-patient communication. Unlike this result, Mohammadi et al. (2013) reported a significant difference between job characteristics, patients’ clinical conditions, environmental factors, and the gender of nurses [ 23 ]. The discrepant results might be caused by the heterogeneous distribution of participants in terms of gender, as 56% of the nurses were male in the study of Mohammadi et al. In comparison, less than 20% of the participants were male nurses in the present study.

The present results showed that the patients’ residence was significantly related to the barriers to effective nurse-patient communication, and native people obtained a lower mean score than non-native people: However, there was no any no significant difference between COVID and NON-COVID wards This result might be because nurses are more informed of the accents and dialects of native patients. Caring for patients speaking different languages and accents can lead to problems in the quantity and quality of nurse-patient communication. When patients and caregivers have different cultural values and languages, communication can cause the inability to exchange information [ 27 ]. Tilki and Okoughan presented evidence that differences in spoken language could hinder effective communication [ 31 ]. On the other hand, the results of the study by Vitale et al. showed that there was no difference between the patients before and during the covid-19 pandemic, which is consistent with the results of the present study [ 12 ].

Limitations

Among the limitations of this study, we can mention the low response rate by nurses and patients, which was completed with the continuous presence of the researcher. Since this research is conducted only in public medical centers affiliated to Shahroud University of Medical Sciences, the results may not be generalizable to centers affiliated with other universities of medical sciences in Iran and non-academic centers such as private medical centers. It is recommended that future research be conducted in larger settings.

This study demonstrated that nurses identified the domain of job characteristics as the most critical barrier among the four domains of barriers to effective nurse-patient communication. Patients more emphasized factors that were in the domain of individual/social factors. There is a pressing need to pay attention to these barriers to eliminate them through necessary measures by nursing officials. Hopefully, the elimination of these barriers in the future will lead to nurses who can communicate well with patients and improve service delivery.

Implications

This research helps to identify barriers to effective communication between nurses and patients. In the field of policy and management, the results of this research can help to plan for effective nurse-patient communication. In the field of education, according to the results of this article, necessary training should be given to nurses and patients regarding communication barriers to help improve communication. There will be a basis for further, more comprehensive research in the field of research. Hopefully, these results can help nursing officials and nurses remove communication barriers and improve service delivery.

Data availability

The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.

Driggin E, Madhavan MV, Bikdeli B, Chuich T, Laracy J, Biondi-Zoccai G, et al. Cardiovascular considerations for patients, Health Care Workers, and Health systems during the COVID-19 pandemic. J Am Coll Cardiol. 2020;75(18):2352–71.

Article CAS PubMed PubMed Central Google Scholar

WHO. Coronavirus disease (COVID-19). Situation Report– 161. 2020.[cited 2020 June 29] https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200629-covid-19-sitrep-161.pdf?sfvrsn=74fde64e_2 .

Sheldon LK, Barrett R, Ellington L. Difficult communication in nursing. J Nurs Scholarsh. 2006;38(2):141–7.

Article PubMed Google Scholar

Sadeghi T, Dehghan Nayyeri N, Karimi R. Nursing-patient relationship: a comparison between nurses and adolescents perceptions. Iran J Med Ethics History Med. 2011;4(3):69–78.

Google Scholar

Caris-Verhallen WM, De Gruijter IM, Kerkstra A, Bensing JM. Factors related to nurse communication with elderly people. J Adv Nurs. 1999;30(5):1106–17.

Article CAS PubMed Google Scholar

Kopp P. Better communication with older patients. Professional nurse (London, England). 2001;16(8):1296-9.

Aghamolaei T, Hasani L. Communication barriers among nurses and elderly patients. Hormozgan Med J. 2011;14(4):312–8.

Fakhr-Movahedi A, Negarandeh R, Salsali M. Exploring nurse-patient communication strategies. J Hayat. 2013;18(4):28–46.

Kettunen T, Poskiparta M, Gerlander M. Nurse-patient power relationship: preliminary evidence of patients’ power messages. Patient Educ Couns. 2002;47(2):101–13.

Hagerty BM, Patusky KL. Reconceptualizing the nurse-patient relationship. J Nurs Scholarsh. 2003;35(2):145–50.

Clancy CM, Farquhar MB, Sharp BA. Patient safety in nursing practice. J Nurs Care Qual. 2005;20(3):193–7.

Vitale E, Giammarinaro MP, Lupo R, Archetta V, Fortunato RS, Caldararo C, et al. The quality of patient-nurse communication perceived before and during the COVID-19 pandemic: an Italian pilot study. Acta Biomed. 2021;92(S2):e2021035.

CAS PubMed PubMed Central Google Scholar

Jan Mohamady S, Salami S, Abasi Marei F, Masror D, Nazary Jobrany M. F J. Civilization and Nursing.Tehran: Publication Salemi2002. 107-9 p.

Maskor NA, Krauss SE, Muhamad M, Nik Mahmood NH. Communication competencies of oncology nurses in Malaysia. Asian Pac J Cancer Prev. 2013;14(1):153–8.

Baraz Pordanjani S, Shariati A, Alijani H, Moein Mosavi B. Assessing barriers of nurse-patient’s effective communication in educational hospitals of Ahwaz. Iran J Nurs Res. 2010;5(16):45–52.

Bowdle A, Munoz-Price LS. Preventing infection of patients and Healthcare workers should be the New Normal in the era of Novel Coronavirus Epidemics. Anesthesiology. 2020;132(6):1292–5.

Wax RS, Christian MD. Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-nCoV) patients. Can J Anaesth. 2020;67(5):568–76.

Fritzsche K, Scheib P, Ko N, Wirsching M, Kuhnert A, Hick J, et al. Results of a psychosomatic training program in China, Vietnam and Laos: successful cross-cultural transfer of a postgraduate training program for medical doctors. Biopsychosoc Med. 2012;6(1):17.

Article PubMed PubMed Central Google Scholar

Eltaybani S, Igarashi A, Cal A, Lai CK, Carrasco C, Sari DW et al. Long-term care facilities’ response to the COVID‐19 pandemic: An international, cross‐sectional survey. J Adv Nurs. 2023.

Baillie L. An exploration of nurse-patient relationships in accident and emergency. Accid Emerg Nurs. 2005;13(1):9–14.

Cleary M, Edwards C, Meehan T. Factors influencing nurse–patient interaction in the acute psychiatric setting: an exploratory investigation. Aust N Z J Mental Health Nurs. 1999;8(3):109–16.

Article CAS Google Scholar

Anoosheh M, Zarkhah S. Investigating barriers to effective nurse-patient communication. Teb Tazkie. 2006;15(2):49–57.

Mohammadi I, Mozafari M, Beigi EJ, Kaikhavani S. Barriers to effective nurse- patient communication from perspective of nurses employed in Educational hospitals of Ilam. J Neyshabur Univ Med Sci. 2015;2(3):20–7.

Norouzinia R, Aghabarari M, Shiri M, Karimi M, Samami E. Communication barriers perceived by nurses and patients. Glob J Health Sci. 2015;8(6):65–74.

Anoosheh M, Zarkhah S, Faghihzadeh S, Vaismoradi M. Nurse-patient communication barriers in Iranian nursing. Int Nurs Rev. 2009;56(2):243–9.

Habibzadeh H, Dehgannejad J, Hoseinzadeghan F, Bafandehzendeh M. Barriers to establishing Effective Communication between Nurse and Patient according to nursing students’ viewpoints Urmia nursing and midwifery Faculty. Nurs Midwifery J. 2019;17(9):696–704.

Mazhariazad F, Taghadosi M, Erami E. Challenges of nurse-patient communication in Iran: a review study. Sci J Nurs Midwifery Paramedical Fac. 2019;4(4):15–29.

Jahromi MK, Ramezanli S. Evaluation of barriers contributing in the demonstration of an effective nurse-patient communication in educational hospitals of Jahrom, 2014. Global J Health Sci. 2014;6(6):54.

Gopichandran V, Sakthivel K. Doctor-patient communication and trust in doctors during COVID 19 times-A cross sectional study in Chennai, India. PLoS ONE. 2021;16(6):e0253497.

Feizi A, Mohammadi R, Nikravesh M. Factors causing patient’s Trust in Nurse from patients’ perspective. Razi J Med Sci. 2006;13(52):177–87.

Okougha M, Tilki M. Experience of overseas nurses: the potential for misunderstanding. Br J Nurs. 2010;19(2):102–6.

Download references

Acknowledgements

The present study is a research project approved under the number 14010048 at Shahroud University of Medical Sciences. The researchers are grateful to the Vice Chancellor of Research and Technology at Shahroud University of Medical Sciences for the necessary financial support of the present study and the participating nurses and patients.

No funding.

Author information

Authors and affiliations.

Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran

Hamed Bakhshi & Mohammad Javad Shariati

Department of Epidemiology and Biostatistics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

Mohammad Hasan Basirinezhad

Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran

Hossein Ebrahimi

You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the writing of the article: design and writing of the article (HB, HE), data collection (HB, MS), analysis and interpretation of data (HB, MB), final approval of the submitted version (HE, HB).

Corresponding author

Correspondence to Hossein Ebrahimi .

Ethics declarations

Ethics approval and consent to participate.

In order to observe ethical considerations, after explaining the study objectives and method to nurses and patients, written informed consent was obtained from them. It should be noted that the principles of the Helsinki Declaration, including the right to enter the research freely, no harm or loss to participants, maintaining the right to withdraw from the study, and confidentiality of information, were observed in this study. Besides, the researchers committed themselves to adhering to the principles of the Committee on Publication Ethics (COPE) set out for the publication of the results. This cross-sectional study was approved by the ethics committee of Shahroud University of Medical Sciences with the registration number: IR.SHMU.REC.1401.140.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article.

Bakhshi, H., Shariati, M., Basirinezhad, M. et al. Comparison of barriers to effective nurse-patient communication in COVID-19 and non-COVID-19 wards. BMC Nurs 23 , 328 (2024). https://doi.org/10.1186/s12912-024-01947-4

Download citation

Received : 05 August 2023

Accepted : 18 April 2024

Published : 16 May 2024

DOI : https://doi.org/10.1186/s12912-024-01947-4

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

Communication barriers
Communication
Nurse–patient communication

BMC Nursing

ISSN: 1472-6955

General enquiries: [email protected]

Adobe Fonts

7 barriers to effective communication in healthcare.

Are you a healthcare provider who finds it challenging to communicate well with patients? You’re not alone. Many providers face the same challenge.

What’s the downside of poor healthcare communication?

When you don’t communicate well with patients, it causes problems for you, your employer, and your patients. Poor healthcare communication results in:

Worse patient self-management, which leads to worse health outcomes.

Inappropriate use of healthcare services, which leads to costlier, less efficient healthcare.

Lower patient satisfaction.

Lower rewards from value-based programs for you and your employer.

More legal problems for you and your employer.

7 communication barriers

Many providers find it challenging to communicate well with patients. Here are seven common barriers:

Medical words

Language differences

Cultural differences

Disabilities and other challenges

Low health literacy

Complexity of health topics

Lack of time

We’ll look at each of these barriers in turn.

Barrier 1: Medical words

You may be comfortable using medical words such as “hypertension” and “CBC.” You probably learned these words during your education and training. You may use them when you communicate with other people in the medical field. Your patients, however, may find these words confusing.

Barrier 2: Language differences

You and your patients may not use the same language, or may not use it with the same ease. For instance, a patient may use Urdu, while you may prefer English.

Barrier 3: Cultural differences

You may have patients from a different culture. That is, you and your patients may have different beliefs and practices. These differences can make it harder to understand and trust each other.

Barrier 4: Disabilities and other challenges

Some patients have disabilities and other challenges that make it harder to communicate about health. For instance, they may have trouble seeing, hearing, talking, reading, or thinking.

Barrier 5: Low health literacy

Many people have low health literacy . That means they have trouble finding, understanding, and using health information. Even strong health literacy skills can falter at times of stress — such as a health crisis. And you can’t always tell when someone has low health literacy.

Barrier 6: Complexity of health topics

Health topics are complex, and the knowledge base is always changing. As a result, you may have trouble sharing health information in a way that your patients can understand and use.

Barrier 7: Lack of time

Finally, good health communication takes time. Yet your employer may limit how much time you spend with patients during and between visits.

You can overcome these barriers

Fortunately, there are ways to overcome these communication barriers. To find strategies, check out the related content on this page .

We extend our sincere gratitude to Carolyn Cutilli and Sophia Wong , for their invaluable peer review and expert feedback, which significantly contributed to the enhancement of this article.

Permanent Hyperlink to Share

Learning lab.

What is Health Literacy

IHA Conference Archive

Certificate Program

Information

Author Services

Initiatives

You are accessing a machine-readable page. In order to be human-readable, please install an RSS reader.

All articles published by MDPI are made immediately available worldwide under an open access license. No special permission is required to reuse all or part of the article published by MDPI, including figures and tables. For articles published under an open access Creative Common CC BY license, any part of the article may be reused without permission provided that the original article is clearly cited. For more information, please refer to https://www.mdpi.com/openaccess .

Feature papers represent the most advanced research with significant potential for high impact in the field. A Feature Paper should be a substantial original Article that involves several techniques or approaches, provides an outlook for future research directions and describes possible research applications.

Feature papers are submitted upon individual invitation or recommendation by the scientific editors and must receive positive feedback from the reviewers.

Editor’s Choice articles are based on recommendations by the scientific editors of MDPI journals from around the world. Editors select a small number of articles recently published in the journal that they believe will be particularly interesting to readers, or important in the respective research area. The aim is to provide a snapshot of some of the most exciting work published in the various research areas of the journal.

Original Submission Date Received: .

Active Journals
Find a Journal
Journal Proposal
Proceedings Series
For Authors
For Reviewers
For Editors
For Librarians
For Publishers
For Societies
For Conference Organizers
Open Access Policy
Institutional Open Access Program
Special Issues Guidelines
Editorial Process
Research and Publication Ethics
Article Processing Charges
Testimonials
Preprints.org
SciProfiles
Encyclopedia

Article Menu

Subscribe SciFeed
Recommended Articles
PubMed/Medline
Google Scholar
on Google Scholar
Table of Contents

Find support for a specific problem in the support section of our website.

Please let us know what you think of our products and services.

Visit our dedicated information section to learn more about MDPI.

JSmol Viewer

Essential skills for health communication, barriers, facilitators and the need for training: perceptions of healthcare professionals from seven european countries.

1. Introduction

2. materials and methods, 2.1. study design, 2.2. setting, 2.3. study sample, 2.4. statistical analysis, 3.1. descriptive characteristics, 3.2. perceptions regarding the need and willingness to participate in hct, 3.3. the benefits of effective communication and the importance of communication skills–reported perceptions, 3.4. barriers to effective health communication, 3.5. facilitators of effective health communication, 3.6. predictors of having received hct, 4. discussion, 5. conclusions, author contributions, institutional review board statement, informed consent statement, data availability statement, acknowledgments, conflicts of interest.

Institute for Healthcare Communication. Impact of Communication in Healthcare. Available online: https://healthcarecomm.org/about-us/impact-of-communication-in-healthcare/ (accessed on 3 November 2021).
Riedl, D.; Schüßler, G. The Influence of Doctor-Patient Communication on Health Outcomes: A Systematic Review. Z. Psychosom. Med. Psychother. 2017 , 63 , 131–150. [ Google Scholar ] [ CrossRef ] [ PubMed ]
SQW Improving Communication between Health Care Professionals and Patients in the NHS in England, Findings of a Systematic Evidence Review and Recommendations for an Action Plan. 2021. Available online: https://www.england.nhs.uk/wp-content/uploads/2021/07/SQW-NHS-England-Improving-communications-report-30June.pdf (accessed on 3 November 2021).
Chandra, S.; Mohammadnezhad, M.; Ward, P. Trust and Communication in a Doctor- Patient Relationship: A Literature Review. J. Healthc. Commun. 2018 , 3 , 36. [ Google Scholar ] [ CrossRef ]
Haskard Zolnierek, K.B.; DiMatteo, M.R. Physician Communication and Patient Adherence to Treatment: A Meta-Analysis. Med. Care 2009 , 47 , 826–834. [ Google Scholar ] [ CrossRef ] [ PubMed ] [ Green Version ]
Jahan, F.; Siddiqui, H. Good Communication between Doctor-Patient Improves Health Outcome. Eur. J. Med. Health Sci. 2019 , 1 , 1–5. [ Google Scholar ] [ CrossRef ] [ Green Version ]
Makaryus, A.N.; Friedman, E.A. Patients’ Understanding of Their Treatment Plans and Diagnosis at Discharge. Mayo Clin. Proc. 2005 , 80 , 991–994. [ Google Scholar ] [ CrossRef ]
Mata, Á.N.D.S.; de Azevedo, K.P.M.; Braga, L.P.; de Medeiros, G.C.B.S.; de Oliveira Segundo, V.H.; Bezerra, I.N.M.; Pimenta, I.D.S.F.; Nicolás, I.M.; Piuvezam, G. Training in Communication Skills for Self-Efficacy of Health Professionals: A Systematic Review. Hum. Resour. Health 2021 , 19 , 30. [ Google Scholar ] [ CrossRef ]
CDC. What Is Health Communications? Gateway to Health Communication. Available online: http://medbox.iiab.me/modules/en-cdc/www.cdc.gov/healthcommunication/healthbasics/../../healthcommunication/healthbasics/WhatIsHC.html (accessed on 3 November 2021).
Levinson, W.; Pizzo, P.A. Patient-Physican Communication: It’s About Time. JAMA 2011 , 305 , 1802–1803. [ Google Scholar ] [ CrossRef ]
Ha, J.F.; Longnecker, N. Doctor-Patient Communication: A Review. Ochsner J. 2010 , 10 , 38–43. [ Google Scholar ]
Osuna, E.; Pérez-Carrión, A.; Pérez-Cárceles, M.D.; Machado, F. Perceptions of Health Professionals about the Quality of Communication and Deliberation with the Patient and Its Impact on the Health Decision Making Process. J. Public Health Res. 2018 , 7 , 1445. [ Google Scholar ] [ CrossRef ] [ Green Version ]
Barry, M.J.; Edgman-Levitan, S. Shared Decision Making—Pinnacle of Patient-Centered Care. N. Engl. J. Med. 2012 , 366 , 780–781. [ Google Scholar ] [ CrossRef ] [ Green Version ]
Elwyn, G.; Frosch, D.; Thomson, R.; Joseph-Williams, N.; Lloyd, A.; Kinnersley, P.; Cording, E.; Tomson, D.; Dodd, C.; Rollnick, S.; et al. Shared Decision Making: A Model for Clinical Practice. J. Gen. Intern. Med. 2012 , 27 , 1361–1367. [ Google Scholar ] [ CrossRef ] [ PubMed ] [ Green Version ]
Travaline, J.M.; Ruchinskas, R.; D’Alonzo, G.E. Patient-Physician Communication: Why and How. J. Osteopath. Med. 2005 , 105 , 13–18. [ Google Scholar ] [ CrossRef ]
World Health Organization. Division of Mental Health Doctor-Patient Interaction and Communication ; World Health Organization: Geneva, Switzerland, 1993. [ Google Scholar ]
H-Com H-Com Health Communication Training for Health Professionals. 2016. Available online: http://h-com.eu/ (accessed on 3 November 2021).
H-Com Online Database on Communication Training for Health Professionals. 2016. Available online: http://h-com.eu/training_database and it was accessed at (accessed on 3 November 2021).
Dalma, A.; Karnaki, P.; Zota, D.; Veloudaki, A.; Ellis-Montalban, P.; Dotsikas, K.; Christophi, C.A.; Ioannidou, E.; Patouris, E.; Themistokleous, S.; et al. Physician-Patient Communication: A Qualitative Study of Perceptions, Barriers, and Needs in Four European Member States. J. Commun. Healthc. 2020 , 13 , 301–313. [ Google Scholar ] [ CrossRef ]
Becker, C.; Zumbrunn, S.; Beck, K.; Vincent, A.; Loretz, N.; Müller, J.; Amacher, S.A.; Schaefert, R.; Hunziker, S. Interventions to Improve Communication at Hospital Discharge and Rates of Readmission: A Systematic Review and Meta-Analysis. JAMA Netw. Open 2021 , 4 , e2119346. [ Google Scholar ] [ CrossRef ] [ PubMed ]
Gasparik, A.I. Clinical Setting Influences Patterns of Interaction between Osteoporosis Patient and Physician. Calcif. Tissue Int. 2014 , 95 , 122–124. [ Google Scholar ] [ CrossRef ] [ PubMed ]
Gasparik, A.I. Relation of Some Communication Parameters to Patients’ Education, Gender and Age. Teaching to Communicate Effectively. Procedia—Soc. Behav. Sci. 2014 , 142 , 367–369. [ Google Scholar ] [ CrossRef ] [ Green Version ]
Matusitz, J.; Spear, J. Effective Doctor–Patient Communication: An Updated Examination. Soc. Work Public Health 2014 , 29 , 252–266. [ Google Scholar ] [ CrossRef ]
Fields, S.K.; Hojat, M.; Gonnella, J.S.; Mangione, S.; Kane, G.; Magee, M. Comparisons of Nurses and Physicians on an Operational Measure of Empathy. Eval. Health Prof. 2004 , 27 , 80–94. [ Google Scholar ] [ CrossRef ]
Setlhare, V.; Madiba, S. Doctor Attributes That Patients Desire during Consultation: The Perspectives of Doctors and Patients in Primary Health Care in Botswana. Healthcare 2023 , 11 , 840. [ Google Scholar ] [ CrossRef ]
Tongue, J.R.; Epps, H.R.; Forese, L.L. Communication Skills for Patient-Centered Care: Research-Based, Easily Learned Techniques for Medical Interviews That Benefit Orthopaedic Surgeons and Their Patients. JBJS 2005 , 87 , 652–658. [ Google Scholar ] [ CrossRef ]
Fleischer, S.; Berg, A.; Zimmermann, M.; Wüste, K.; Behrens, J. Nurse-Patient Interaction and Communication: A Systematic Literature Review. J. Public Health 2009 , 17 , 339–353. [ Google Scholar ] [ CrossRef ] [ Green Version ]
Komatsu, H.; Komatsu, Y. The Role of Nurse on the Treatment Decision Support for Older People with Cancer: A Systematic Review. Healthcare 2023 , 11 , 546. [ Google Scholar ] [ CrossRef ] [ PubMed ]
Lotfi, M.; Zamanzadeh, V.; Valizadeh, L.; Khajehgoodari, M. Assessment of Nurse–Patient Communication and Patient Satisfaction from Nursing Care. Nurs. Open 2019 , 6 , 1189–1196. [ Google Scholar ] [ CrossRef ] [ PubMed ] [ Green Version ]
Amoah, V.M.K.; Anokye, R.; Boakye, D.S.; Acheampong, E.; Budu-Ainooson, A.; Okyere, E.; Kumi-Boateng, G.; Yeboah, C.; Afriyie, J.O. A Qualitative Assessment of Perceived Barriers to Effective Therapeutic Communication among Nurses and Patients. BMC Nurs. 2019 , 18 , 4. [ Google Scholar ] [ CrossRef ]
Korsah, K.A. Nurses’ Stories about Their Interactions with Patients at the Holy Family Hospital, Techiman, Ghana. Open J. Nurs. 2011 , 1 , 1. [ Google Scholar ] [ CrossRef ] [ Green Version ]
Madula, P.; Kalembo, F.W.; Yu, H.; Kaminga, A.C. Healthcare Provider-Patient Communication: A Qualitative Study of Women’s Perceptions during Childbirth. Reprod. Health 2018 , 15 , 135. [ Google Scholar ] [ CrossRef ]
Shafipour, V.; Mohammad, E.; Ahmadi, F. Barriers to Nurse-Patient Communication in Cardiac Surgery Wards: A Qualitative Study. Glob. J. Health Sci. 2014 , 6 , 234–244. [ Google Scholar ] [ CrossRef ] [ Green Version ]
Stanford, J.; Charlton, K.; McMahon, A.-T.; Winch, S. Better Cardiac Care: Health Professional’s Perspectives of the Barriers and Enablers of Health Communication and Education with Patients of Aboriginal and Torres Strait Islander Descent. BMC Health Serv. Res. 2019 , 19 , 106. [ Google Scholar ] [ CrossRef ] [ Green Version ]
Sun, N.; Rau, P.-L.P. Barriers to Improve Physician–Patient Communication in a Primary Care Setting: Perspectives of Chinese Physicians. Health Psychol. Behav. Med. 2017 , 5 , 166–176. [ Google Scholar ] [ CrossRef ] [ Green Version ]
Tay, L.H.; Ang, E.; Hegney, D. Nurses’ Perceptions of the Barriers in Effective Communication with Inpatient Cancer Adults in Singapore. J. Clin. Nurs. 2012 , 21 , 2647–2658. [ Google Scholar ] [ CrossRef ]
Williams, M.V.; Davis, T.; Parker, R.M.; Weiss, B.D. The Role of Health Literacy in Patient-Physician Communication. Fam. Med. 2002 , 34 , 383–389. [ Google Scholar ] [ PubMed ]
Zhao, X. Challenges and Barriers in Intercultural Communication between Patients with Immigration Backgrounds and Health Professionals: A Systematic Literature Review. Health Commun. 2021 , 38 , 824–833. [ Google Scholar ] [ CrossRef ] [ PubMed ]
Rojas-Ocaña, M.J.; Teresa-Morales, C.; Ramos-Pichardo, J.D.; Araujo-Hernández, M. Barriers and Facilitators of Communication in the Medication Reconciliation Process during Hospital Discharge: Primary Healthcare Professionals’ Perspectives. Healthcare 2023 , 11 , 1495. [ Google Scholar ] [ CrossRef ]
Norouzinia, R.; Aghabarari, M.; Shiri, M.; Karimi, M.; Samami, E. Communication Barriers Perceived by Nurses and Patients. Glob. J. Health Sci. 2016 , 8 , 65–74. [ Google Scholar ] [ CrossRef ] [ PubMed ]
Brown, J. How Clinical Communication Has Become a Core Part of Medical Education in the UK. Med. Educ. 2008 , 42 , 271–278. [ Google Scholar ] [ CrossRef ] [ PubMed ]
Peters, S.; Livia, A. Relevant Behavioural and Social Science for Medical Undergraduates: A Comparison of Specialist and Non-Specialist Educators. Med. Educ. 2006 , 40 , 1020–1026. [ Google Scholar ] [ CrossRef ] [ PubMed ]
Brink-Muinen, A.; Maaroos, H.; Tähepold, H. Communication Style in Primary Health Care in Europe. Health Educ. 2008 , 108 , 384–396. [ Google Scholar ] [ CrossRef ] [ Green Version ]
Schulz, P.J.; Hartung, U. Health Communication Research in Europe: An Emerging Field. Health Commun. 2010 , 25 , 548–551. [ Google Scholar ] [ CrossRef ]
Paparella, G. Person-Centred Care in Europe: A Cross-Country Comparison of Health System Performance, Strategies and Structures ; Picker Institute Europe: Oxford, UK, 2016. [ Google Scholar ]
Schäfer, W.L.; Boerma, W.G.; Murante, A.M.; Sixma, H.J.; Schellevis, F.G.; Groenewegen, P.P. Assessing the Potential for Improvement of Primary Care in 34 Countries: A Cross-Sectional Survey. Bull. World Health Organ. 2015 , 93 , 161–168. [ Google Scholar ] [ CrossRef ] [ Green Version ]
Wittenberg, E.; Goldsmith, J.V.; Chen, C.; Prince-Paul, M.; Johnson, R.R. Opportunities to Improve COVID-19 Provider Communication Resources: A Systematic Review. Patient Educ. Couns. 2021 , 104 , 438–451. [ Google Scholar ] [ CrossRef ]
Oxman, A.D.; Fretheim, A.; Lewin, S.; Flottorp, S.; Glenton, C.; Helleve, A.; Vestrheim, D.F.; Iversen, B.G.; Rosenbaum, S.E. Health Communication in and out of Public Health Emergencies: To Persuade or to Inform? Health Res. Policy Syst. 2022 , 20 , 28. [ Google Scholar ] [ CrossRef ] [ PubMed ]
Zhang, X. Analysing Issues of Medical Communication during the COVID-19 Outbreak. Cult. Sci. 2022 , 5 , 79–87. [ Google Scholar ] [ CrossRef ]
Street, R.L., Jr.; Finset, A. Two Years with COVID-19: New and Old-Challenges for Health Communication Research. Patient Educ. Couns. 2022 , 105 , 261–264. [ Google Scholar ] [ CrossRef ] [ PubMed ]

Participants Characteristics	Total Sample (n = 691)	Physicians (n = 311)	Nurses (n = 257)	Students (n = 39)	Allied Health Professionals (n = 84)	p-Value
Country of current employment (n (%))
Cyprus	26 (3.8)	6 (1.7)	20 (7.6)	0 (0.0)	1 (1.3)	<0.001
Germany	99 (14.3)	55 (17.8)	12 (4.8)	23 (58.3)	15 (17.5)
Greece	146 (21.2)	90 (28.9)	34 (13.2)	3 (8.3)	18 (21.3)
Italy	106 (15.3)	60 (19.5)	14 (5.6)	0 (0.0)	29 (35.0)
Poland	92 (13.3)	60 (19.5)	26 (10)	0 (0.0)	4 (5.0)
Portugal	64 (9.2)	0 (0.0)	61 (23.6)	0 (0.0)	1 (1.3)
Spain	105 (15.2)	16 (5.0)	74 (28.8)	11 (29.2)	5 (6.3)
Other	53 (7.7)	24 (7.7)	16 (6.4)	2 (4.2)	11 (12.5)
Sex (n (%); Male)	250 (36.2)	153 (49.2)	67 (26.1)	11 (28.2)	19 (22.6)	<0.001
Age category (n (%))
18–24 years old	59 (8.5)	11 (3.5)	16 (6.1)	29 (74.4)	3 (3.6)	<0.001
25–34 years old	127 (18.4)	44 (14.1)	59 (23.0)	9 (23.1)	15 (17.9)
35–44 years old	166 (24.0)	78 (25.1)	67 (26.1)	0 (0.0)	21 (25.0)
45–54 years old	187 (27.1)	84 (27.0)	78 (30.4)	1 (2.5)	24 (28.6)
55–64 years old	135 (19.5)	81 (26.0)	35 (13.6)	0 (0.0)	19 (22.6)
>65 years old	17 (2.5)	13 (4.3)	2 (0.8)	0 (0.0)	2 (2.5)
Highest educational degree attained (n (%))
Secondary school	49 (7.1)	13 (4.2)	10 (3.8)	23 (59.0)	2 (2.4)	<0.001
Vocational training	41 (5.9)	2 (0.3)	21 (8.1)	10 (25.6)	9 (10.7)
Undergraduate degree (BSc)	165 (23.9)	44 (14.3)	89 (34.6)	5 (12.8)	29 (34.5)
Graduate degree (MSc)	255 (36.9)	119 (38.4)	111 (43.2)	1 (2.6)	25 (29.8)
Doctoral training (PhD)	181 (26.2)	133 (42.8)	26 (10.3)	0 (0.0)	19 (22.6)
Years of professional experience (n (%))
<5 years	150 (21.6)	57 (18.1)	43 (16.9)	36 (91.2)	17 (20.2)	<0.001
6–10 years	104 (15.0)	49 (15.9)	38 (14.6)	3 (8.8)	13 (15.5)
11–20 years	165 (23.9)	81 (26.2)	62 (24.0)	0 (0.0)	21 (25.0)
21–30 years	155 (22.5)	71 (22.7)	72 (28.0)	0 (0.0)	12 (14.3)
>30 years	117 (17.0)	53 (17.1)	42 (16.5)	0 (0.0)	21 (25.0)

	Total Sample (n = 691)	Physicians (n = 311)	Nurses (n = 257)	Students (n = 39)	Allied Health Professionals (n = 84)	p-Value
Necessity of specialized HCT for:
Physicians (n (%))
Necessary	618 (89.4)	278 (89.4)	228 (88.6)	38 (97.4)	74 (88.1)	0.799
Good to have but not necessary	68 (9.9)	31 (10.0)	27 (10.6)	1 (2.6)	9 (10.7)
Unnecessary	5 (0.7)	2 (0.6)	2 (0.8)	0 (0.0)	1 (1.2)
Nurses (n (%))
Necessary	616 (89.2)	274 (88.2)	236 (91.8)	37 (94.9)	69 (81.9)	0.154
Good to have but not necessary	72 (10.4)	35 (11.1)	21 (8.2)	2 (5.1)	14 (16.9)
Unnecessary	3 (0.4)	2 (0.7)	0 (0.0)	0 (0.0)	1 (1.2)
HC is considered more important in (n (%))
Primary healthcare	61 (8.8)	26 (8.4)	27 (10.5)	2 (5.1)	6 (7.2)	0.193
Hospital	28 (4.1)	14 (4.5)	11 (4.3)	1 (2.6)	2 (2.4)
Private practice	6 (0.9)	4 (1.3)	0 (0.0)	2 (5.1)	0 (0.0)
All of the above settings	593 (85.8)	266 (85.5)	218 (84.8)	34 (87.2)	75 (89.2)
Other setting	3 (0.4)	1 (0.3)	1 (0.4)	0 (0.0)	1 (1.2)
Receipt of HCT in the past (n (%); Yes)	394 (57.0)	152 (48.9)	168 (65.4)	27 (69.2)	47 (55.4)	<0.001
Educational level at which HCT was received (n (% of those who have received HCT))
Graduate level	202 (51.3)	93 (61.2)	91 (59.9)	16 (10.5)	2 (1.3)	<0.001
Postgraduate level	274 (69.5)	106 (69.7)	106 (69.7)	35 (23)	27 (17.8)
Residency training	339 (86.0)	120 (78.9)	151 (99.3)	41 (27)	27 (17.8)
Continuous education training	230 (58.4)	101 (66.4)	75 (49.3)	28 (18.4)	26 (17.1)
Other	361 (91.6)	143 (94.1)	156 (102.6)	36 (23.7)	26 (17.1)
Willingness to participate in HCT (n (%); Yes)	609 (88.1)	266 (85.6)	233 (90.6)	33 (84.6)	77 (91.1)	0.218

	Total Sample (n = 691)	Physicians (n = 311)	Nurses (n = 257)	Students (n = 39)	Allied Health Professionals (n = 84)	p-Value
Effective health communication contributes to (% Agree/Strongly agree):
	97.5	97.4	97.6	97.5	97.6	0.267
	97.4	97.1	98.1	94.8	97.5	0.014
	96.6	95.1	98.4	94.9	97.5	0.029
	94.6	94.2	94.5	97.4	95.2	0.506
	94.3	92.8	95.3	94.9	96.4	0.019
	93.9	93.8	95.2	94.8	89.9	0.255
	81.3	77.0	85.1	81.6	85.3	0.442
	78.5	72.3	85.6	71.8	83.1	<0.001
	74.8	72.0	79.8	56.4	78.5	0.038
Importance of communication skills (% Very important):
	78.6	84.8	75.8	69.2	68.3	<0.001
	80.6	78.7	87.2	61.5	76.5	0.003
	78.8	77.2	84.2	73.7	70.4	0.117
	78.4	77.0	81.6	74.4	75.6	0.623
	75.6	72.0	83.8	69.2	66.7	0.031
	73.2	70.1	80.6	69.2	64.2	0.023
	72.6	71.2	79.4	51.3	67.1	0.008
	70.2	67.5	77.3	56.4	64.6	0.145
	69.6	65.4	76.7	66.7	65.4	0.154
	68.1	66.2	76.5	55.3	55.6	0.005
	66.5	64.0	73.0	51.3	63.4	0.018
	66.0	60.3	76.7	51.3	61.3	0.004

	Barriers of Effective Health Communication in: (Mean (SD))	Total Sample (n = 691)	Physicians (n = 311)	Nurses (n = 257)	Students (n = 39)	Allied Health Professionals (n = 84)	p-Value
Primary healthcare	Emotional state of patients	4.32 (0.78)	4.21 (0.81)	4.50 (0.62)	4.38 (0.75)	4.11 (0.98)	<0.001
	Time restrictions	4.34 (0.81)	4.38 (0.83)	4.40 (0.73)	4.31 (0.86)	3.99 (0.88)	<0.001
	Low health literacy of patients	3.98 (0.89)	3.91 (0.88)	4.10 (0.85)	3.74 (0.97)	4.00 (1.01)	0.022
	Language issues (e.g., patients from migrant backgrounds)	4.27 (0.91)	4.17 (1.02)	4.39 (0.79)	4.13 (0.84)	4.30 (0.80)	0.026
	Large number of patients/heavy workload/exhaustion	4.43 (0.73)	4.47 (0.72)	4.43 (0.72)	4.44 (0.68)	4.28 (0.83)	0.196
	Lack of professionals’ training in health communication skills	4.23 (0.87)	4.07 (0.91)	4.41 (0.73)	3.97 (1.05)	4.35 (0.90)	<0.001
	Lack of interest on the physicians’/nurses’ part	4.19 (0.94)	4.04 (0.99)	4.36 (0.85)	4.23 (0.96)	4.27 (0.93)	0.001
	Lack of interest from administration	4.09 (1.02)	3.99 (1.08)	4.24 (0.93)	3.87 (1.22)	4.16 (0.88)	0.015
	Physicians’ older age	2.96 (1.33)	2.84 (1.35)	3.07 (1.27)	2.85 (1.42)	3.18 (1.34)	0.073
	Physicians’ younger age	2.82 (1.22)	2.62 (1.21)	3.01 (1.16)	2.54 (1.23)	3.09 (1.28)	<0.001
	Physicians’ sex	2.23 (1.28)	2.00 (1.21)	2.41 (1.26)	1.92 (1.18)	2.65 (1.42)	<0.001
	Problems with salaries of the physician or nurse	3.20 (1.31)	3.15 (1.33)	3.32 (1.27)	3.05 (1.19)	3.06 (1.36)	0.253
Hospitals	Emotional state of patients	4.40 (0.75)	4.35 (0.76)	4.50 (0.69)	4.42 (0.68)	4.29 (0.89)	0.056
	Time restrictions	4.37 (0.85)	4.31 (0.91)	4.50 (0.75)	4.39 (0.79)	4.16 (0.88)	0.008
	Low health literacy of patients	3.96 (0.95)	3.85 (0.97)	4.11 (0.90)	3.84 (0.95)	3.99 (0.95)	0.013
	Language issues (e.g., patients from migrant backgrounds)	4.23 (0.90)	4.15 (0.98)	4.31 (0.86)	4.21 (0.81)	4.33 (0.76)	0.159
	Large number of patients/heavy workload/exhaustion	4.43 (0.77)	4.39 (0.85)	4.52 (0.66)	4.38 (0.76)	4.36 (0.73)	0.155
	Lack of professionals’ training in health communication skills	4.18 (0.91)	3.99 (1.02)	4.38 (0.73)	4.08 (1.05)	4.33 (0.75)	<0.001
	Lack of interest on the physicians’/nurses’ part	4.08 (1.02)	3.89 (1.09)	4.26 (0.92)	4.13 (1.02)	4.23 (0.90)	<0.001
	Lack of interest from administration	3.96 (1.11)	3.87 (1.18)	4.07 (1.03)	3.76 (1.16)	4.06 (0.97)	0.100
	Physicians’ older age	2.83 (1.32)	2.72 (1.32)	2.91 (1.30)	2.61 (1.33)	3.05 (1.35)	0.102
	Physicians’ younger age	2.63 (1.24)	2.41 (1.20)	2.79 (1.22)	2.47 (1.27)	3.03 (1.30)	<0.001
	Physicians’ sex	2.19 (1.28)	2.00 (1.23)	2.35 (1.29)	1.76 (1.13)	2.63 (1.34)	<0.001
	Problems with salaries of the physician or nurse	3.26 (1.32)	3.15 (1.38)	3.44 (1.24)	3.08 (1.28)	3.22 (1.29)	0.053
Private practice	Emotional state of patients	4.29 (0.87)	4.25 (0.92)	4.36 (0.81)	4.36 (0.71)	4.22 (0.92)	0.369
	Time restrictions	3.74 (1.21)	3.54 (1.27)	3.94 (1.13)	3.89 (1.10)	3.76 (1.15)	0.002
	Low health literacy of patients	3.86 (1.05)	3.73 (1.10)	3.96 (1.02)	3.75 (1.13)	4.05 (0.86)	0.028
	Language issues (e.g., patients from migrant backgrounds)	4.03 (1.03)	3.96 (1.09)	4.08 (1.00)	3.95 (1.00)	4.18 (0.91)	0.284
	Large number of patients/heavy workload/exhaustion	3.69 (1.23)	3.43 (1.28)	3.86 (1.20)	3.92 (0.98)	3.97 (1.06)	<0.001
	Lack of professionals’ training in health communication skills	4.06 (0.97)	3.88 (1.03)	4.22 (0.85)	4.14 (0.92)	4.22 (1.02)	<0.001
	Lack of interest on the physicians’/nurses’ part	3.81 (1.18)	3.57 (1.25)	4.00 (1.09)	3.94 (1.01)	4.04 (1.11)	<0.001
	Lack of interest from administration	3.43 (1.40)	3.16 (1.45)	3.68 (1.30)	3.17 (1.44)	3.78 (1.27)	<0.001
	Physicians’ older age	2.68 (1.32)	2.51 (1.32)	2.82 (1.26)	2.54 (1.41)	2.97 (1.36)	0.009
	Physicians’ younger age	2.64 (1.25)	2.45 (1.23)	2.78 (1.19)	2.41 (1.28)	3.00 (1.36)	0.001
	Physicians’ sex	2.17 (1.29)	1.94 (1.22)	2.35 (1.27)	1.81 (1.22)	2.62 (1.42)	<0.001
	Problems with salaries of the physician or nurse	3.01 (1.38)	2.87 (1.39)	3.23 (1.37)	2.68 (1.27)	3.00 (1.37)	0.013

	Facilitators of Health Communication in (mean (SD)):	Total Sample (n = 691)	Physicians (n = 311)	Nurses (n = 257)	Students (n = 39)	Allied Health Professionals (n = 84)	p-Value
Primary healthcare	Training of physicians/nurses in health communication skills	4.56 (0.70)	4.44 (0.81)	4.71 (0.51)	4.54 (0.68)	4.52 (0.74)	<0.001
	Interest in health communication from higher administration	4.35 (0.83)	4.28 (0.91)	4.50 (0.67)	4.10 (1.05)	4.28 (0.83)	0.002
	Longer consultation hours/fewer patients	4.49 (0.72)	4.50 (0.74)	4.55 (0.66)	4.41 (0.82)	4.33 (0.73)	0.088
	Informed patients	4.22 (0.90)	4.11 (0.95)	4.38 (0.84)	4.03 (0.96)	4.17 (0.83)	0.002
	Presence of cultural/language mediators	4.23 (0.90)	4.16 (0.98)	4.27 (0.84)	4.36 (0.71)	4.26 (0.86)	0.385
	Satisfactory remuneration of the physician or nurse	3.92 (1.13)	3.94 (1.16)	3.98 (1.08)	3.77 (1.22)	3.70 (1.12)	0.190
Hospitals	Training of physicians/nurses in health communication skills	4.60 (0.68)	4.50 (0.78)	4.73 (0.49)	4.64 (0.63)	4.53 (0.75)	0.001
	Interest in health communication from higher administration	4.39 (0.82)	4.37 (0.89)	4.50 (0.70)	4.10 (0.97)	4.28 (0.91)	0.011
	Longer consultation hours/fewer patients	4.47 (0.73)	4.46 (0.76)	4.59 (0.62)	4.44 (0.75)	4.19 (0.87)	<0.001
	Informed patients	4.20 (0.89)	4.04 (0.97)	4.43 (0.74)	4.08 (0.93)	4.12 (0.87)	<0.001
	Presence of cultural/language mediators	4.29 (0.88)	4.21 (0.94)	4.33 (0.83)	4.36 (0.78)	4.29 (0.81)	0.420
	Satisfactory remuneration of the physician or nurse	3.95 (1.12)	3.95 (1.14)	4.04 (1.07)	3.82 (1.12)	3.73 (1.20)	0.170
Private practice	Training of physicians/nurses in health communication skills	4.50 (0.77)	4.41 (0.86)	4.64 (0.61)	4.53 (0.73)	4.44 (0.88)	0.007
	Interest in health communication from higher administration	4.03 (1.19)	3.88 (1.31)	4.29 (0.97)	3.71 (1.39)	3.95 (1.13)	<0.001
	Longer consultation hours/fewer patients	4.15 (0.95)	4.06 (1.00)	4.28 (0.88)	4.13 (1.02)	4.10 (0.89)	0.073
	Informed patients	4.14 (0.92)	4.06 (0.95)	4.28 (0.85)	4.08 (1.00)	4.05 (0.91)	0.035
	Presence of cultural/language mediators	4.09 (1.00)	3.98 (1.10)	4.18 (0.92)	4.13 (0.96)	4.16 (0.86)	0.125
	Satisfactory remuneration of the physician or nurse	3.82 (1.21)	3.75 (1.29)	4.00 (1.08)	3.54 (1.22)	3.65 (1.21)	0.017

Healthcare Professionals’ Characteristics	Univariate Analysis (Unadjusted Models) OR (95% CI)	Multi-Adjusted Model OR (95% CI)
Sex (ref: female)
Male	0.79 (0.58, 1.08)	0.89 (0.62, 1.28)
Professional status (ref: physicians)
Nurses	1.98 (1.40, 2.77) ***	1.84 (1.16, 2.91) **
Students	2.35 (1.15, 4.81) **	1.98 (0.59, 6.63)
Other	1.30 (0.80, 2.12)	1.19 (0.69, 2.04)
Country of current employment (ref: Greece)
Germany	3.21 (1.85, 5.57) ***	3.12 (1.73, 5.62) ***
Cyprus	4.12 (1.61, 10.54) **	3.18 (1.16, 8.68) **
Italy	1.74 (1.03, 2.93) **	1.63 (0.92, 2.86) *
Poland	1.72 (0.99, 2.96) *	1.70 (0.96, 3.02) *
Portugal	2.77 (1.48, 5.19) **	1.70 (0.83, 3.46)
Spain	3.16 (1.84, 5.43) ***	2.08 (1.14, 3.77) **
Other	3.11 (1.58, 6.13) **	3.09 (1.53, 6.24) **
Age category (ref: 18–24 years old)
25–34 years old	0.57 (0.29, 1.11) *	0.99 (0.34, 2.92)
35–44 years old	0.46 (0.24, 0.89) **	0.93 (0.28, 3.05)
45–54 years old	0.38 (0.20, 0.71) **	0.55 (0.16, 1.95)
55–64 years old	0.53 (0.27, 10.2) *	0.62 (0.16, 2.44)
>65 years old	0.42 (0.14, 1.27)	0.38 (0.07, 2.23)
Highest educational degree attained (ref: secondary school)
Vocational training	0.45 (0.18, 1.08) *	0.45 (0.13, 1.74)
Undergraduate degree (BSc)	0.51 (0.26, 1.03) *	1.12 (0.32, 3.92)
Graduate degree (MSc)	0.54 (0.28, 1.07) *	1.57 (0.46, 5.42)
Doctoral training (PhD)	0.52 (0.26, 1.04) *	2.19 (0.61, 7.80)
Years of professional experience (ref: ≤5 years)
6–10 years	0.41 (0.25, 0.70) **	0.52 (0.27, 0.99) **
11–20 years	0.59 (0.37, 0.93) **	0.87 (0.43, 1.78)
21–30 years	0.63 (0.39, 1.00) *	1.13 (0.48, 1.64)
>30 years	0.84 (0.51, 1.40)	1.70 (0.64, 4.52)

The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.

Share and Cite

Zota, D.; Diamantis, D.V.; Katsas, K.; Karnaki, P.; Tsiampalis, T.; Sakowski, P.; Christophi, C.A.; Ioannidou, E.; Darias-Curvo, S.; Batury, V.-L.; et al. Essential Skills for Health Communication, Barriers, Facilitators and the Need for Training: Perceptions of Healthcare Professionals from Seven European Countries. Healthcare 2023 , 11 , 2058. https://doi.org/10.3390/healthcare11142058

Zota D, Diamantis DV, Katsas K, Karnaki P, Tsiampalis T, Sakowski P, Christophi CA, Ioannidou E, Darias-Curvo S, Batury V-L, et al. Essential Skills for Health Communication, Barriers, Facilitators and the Need for Training: Perceptions of Healthcare Professionals from Seven European Countries. Healthcare . 2023; 11(14):2058. https://doi.org/10.3390/healthcare11142058

Zota, Dina, Dimitrios V. Diamantis, Konstantinos Katsas, Pania Karnaki, Thomas Tsiampalis, Piotr Sakowski, Costas A. Christophi, Eleni Ioannidou, Sara Darias-Curvo, Victoria-Luise Batury, and et al. 2023. "Essential Skills for Health Communication, Barriers, Facilitators and the Need for Training: Perceptions of Healthcare Professionals from Seven European Countries" Healthcare 11, no. 14: 2058. https://doi.org/10.3390/healthcare11142058

Article Metrics

Article access statistics, further information, mdpi initiatives, follow mdpi.

Subscribe to receive issue release notifications and newsletters from MDPI journals

Learning Design
Video Production
Interactive Design
Graphic Design
Whiteboard Animation
Motion Graphic
Character Animation
Frame by frame Animation
Patient Education
Healthcare Professional Education
Staff Training
Medical Devices & Pharmaceutical Explainer
Research Communication
Social Media Campaign
Interactive Onboarding
Product Knowledge
Soft Skill Development
Process & Procedure Training
Social Media Communication
Curriculum Integration
Interactive learning modules
Technology Explainers
Financial Literacy
Our Process
Case Studies
Infographics

8 Types of Communication Barriers in Healthcare and How to Deal with Them

by Minh Anh - June 5, 2024 | Blog - For Medical

The communication gap in patient education is more than jargon barriers. It’s also about emotional barriers, perspective barriers, and other noises that affect patient education. Before jumping right into a new patient education campaign, we want you to slow down and go back to 8 types of communication barriers in healthcare . Though most of them are basic communication knowledge, it gives you more perspective on the “gap” and brings new ideas for your next campaign.

8. Channel flow barriers

An affordable partner, 8 types of communication barriers in healthcare, 1. physical and environmental barriers.

When you launch a healthcare event for patients, many physical and environmental factors limit patients from receiving the message.

Noise: The primary type that occurs during transmission level. Noise commonly happens when patients use telehealth services or watch healthcare shows on TV. Poor signal when talking via phone and watching TV may disrupt patients from consuming healthcare information.
Time and Distance : When our marketing lead shared her experience in one of her healthcare communication campaigns, she said: “The hardest part when conducting an offline healthcare event is to set location and time smartly because we need to ensure as many patients as possible join the event.” Also, we need to consider the time differences between the two countries.
Wrong choice of medium : Sometimes, healthcare knowledge is not the problem. The problem is how we approach and deliver this knowledge via the wrong channel. Not all patients have good imagination skills, so think how hard it can be when they read a full-text prescription without understanding how medicine impacts their bodies. In this situation, an animation with visualized information may help to solve communication barriers in healthcare.

In the below video, F.Learning uses visuals to explain different symptoms of migraines, so patients understand the root cause of their health issues. Also, we choose a viewpoint of patients’ daily lives so they can see the migraine from their social perspective.

Message design : The most challenging part of communicating with patients is controlling how patients think about your message. Thus, ensure your message is under a strict proofreading process and avoid wrong word choices, jargon, and complex words.

2. Physical or Biological Barriers

How do you talk to Alzheimer’s patients? Talk slowly. If needed, educate their family members. How do you talk to patients with HIV or disabilities? Share with them real-life stories. Emotional control is essential when educating patients with special physical health. There are a few nuances here. Sometimes you only need to change the communication format to fit the patient’s health issues.

For example, F.Learning changed text-based content into podcasts to serve the demands of audiences with poor eyesight. However, we must choose the proper perspective to show our sensitivity and empathy to audiences without offending them.

3. Language Barriers

What is a good start to educating patients effectively? The answer is choosing the right healthcare information. Removing language barriers is the priority before you want to remove communication barriers in healthcare. At F.Learning, we have worked with many healthcare clients to realize that we just capture a tiny nuance of language barriers – the healthcare jargon. The language barriers in patient communication have 3 angles:

Misinterpretation of words : Cholesterol is bad, eating before bed causes overweight, cold weather causes a cold, etc. These healthcare myths are the significant consequences of misinterpretation. Different people mean different understandings while using the same word. We can’t blame patients because they are confused by various information resources. Using channels, tools, content format, and communication methods, we must set a firm context for your healthcare message.
Medical jargon : Since most patients have a non-medical background, medical/ healthcare jargon will be a significant communication barrier. For example, patients don’t understand diagnosis results like what disease code G55.3 means. In this case, a short explainer video will help, like the below video explaining Heparin and Warfarin.

In 3/2021, F.Learning collaborated with Dr. Manish Chand to make a patient education video about colorectal cancer and rectal bleeding. This healthcare video is used in the “Colorectal Awareness Month” campaign so that his patients can understand their conditions’ treatment.

Multiple meanings of words in a different context: Have you ever searched for your symptom on Google? You are a healthcare communication manager, but sometimes a patient as well. We all share a common problem – Dr. Google, even a headache can turn into a brain tumor. A patient education campaign without a clear context causes different uses of different words per need/ message. That’s why you need a healthcare expert on your team to ensure accuracy.

4. Personal barriers

Differences in personal and psychological makeup may create barriers to communication in healthcare between patients and other healthcare providers. They arise from the judgments, emotions, and social values of people. According to Ms. Fasiha Haq, Senior Director of Global Medical Affairs Strategy & Execution at Eli Lilly Canada , doctors and patients have different perspectives about healthcare when they visit each other.

Doctors focus on long-term treatment and root causes, while patients focus on day-to-day healthcare treatment and symptoms. The insight brings a lot of suggestions on how to create a healthcare message from the patient’s perspective. To do that, we need to understand how patients think about the disease.

Communication barriers in healthcare: Personal barriers

5. Emotional barriers

If you handle a patient education campaign for a sensitive sexual and reproductive health topic, you will find emotional barriers familiar. Another situation is when patients fear, are anxious, or even sad because the pain prevents them from doing things. In healthcare communication, it’s hard to realize because these moments fester beneath the surface.

6. Socio-psychological barriers

There are 2 types of socio-psychological barriers in healthcare communication. To successfully break the socio-psychological barrier, It’s essential to define the patient persona with a complete description of behavior, characteristics, and background:

Selective perception : We often see selective perception in fitness or other preventative healthcare topics when patients hear based on their needs and motivations. For example, if you want to lose weight but hesitate to do a workout, you want to listen to a diet solution without exercising.
Halo effect : Halo effect is when people distrust someone based on their experience, fear, etc. For example, a mom with experience in child care will be more skeptical when consuming healthcare information.

Socio-psychological barriers: Communication barriers in healthcare

7. Cultural barriers

When talking about sexual health, people from Eastern countries will be more hesitant than Western countries. Patients from underdeveloped areas will be more skeptical about treatment than those from other areas. This is one of the communication barriers in healthcare that impact patients’ healthcare decision-making. Cultural barriers also mean different understandings among countries with the same symbol, color, etc. Therefore, communication managers need to research intensely locally to avoid controversial situations.

Here’s our patient education video F.Learning made for our client – iHeed. Since the target audience is patients from the Middle East, we use materials relevant to patients’ cultures to create a social context for them.

interested to know more?

Glad you like us! Book a consultation call with us to explore how to kick start your animation project.

Channel flow barriers relate to healthcare communication channel strategy because each channel has strengths and weaknesses. When launching a healthcare communication campaign, we can use more than one channel to promote your healthcare message. Using the wrong channel or using too many levels of media may cause misleading in delivering information. Therefore, we ensure that all supporting messages align with the main message to prevent patients from misunderstanding.

Partner with F. Learning Studio to Solve Your Communication Barrier Problems

Expert in visual solutions for patient education.

It seems overwhelming for you as there are a lot of barriers to effective communication in healthcare. At F. Learning Studio , we understand the unique challenges of communicating complex medical information. Therefore, we come up with a unique solution for you, animated videos or animations that are informative, accessible, and impactful. From simple whiteboard animations to stunning 2D productions, we can tailor it to solve your specific communication problems.

Trusted by Leading Companies

With 8 years of experience, F. Learning Studio has built a strong proven track record, working with top-of-mind companies in the field, such as Intelycare, Boehringer Ingelheim, and Simple Nursing. We have supported them in raising patients’ awareness, improving training, and simplifying medical knowledge. No matter what you’re struggling with in healthcare communication, we have something for you.

If you have a budget constraint, don’t worry. We offer a 30% lower solution compared to the UK or US-based studios. However, it doesn’t mean we compromise the price with the quality of the animation. Let’s check our portfolio and see it by yourself.

F. Learning offers solutions for communication barriers in healthcare

Addressin g communication barriers in healthcare is not just about removing common obstacles. It’s also about creating an environment where patients feel listened to, respected, and engaged in their treatment. With all of the potential solutions we’ve listed in the article, we hope you can find the key to your problem. To make communication a breeze, why not contact F.Learning ? With our crafted visual solutions, you can experience a remarkable boost in your patient education!

WhatsApp : (+84) 378 713 132
Email : [email protected]
Fanpage : https://www.facebook.com/f.learningstudio
LinkedIn : https://www.linkedin.com/company/f-learning-studio/
Patient Education Explainer Videos: How to Make a Mind-blowing Animation
Top Healthcare Video Production Companies to Work With [Update 2023]
Breaking Healthcare Communication Barriers: 8 Tips for MarCom Manager

Healthcare Animation: How to Use Animated Explainer Video in Health Industry

Animated explainer video 101 for healthcare business: benefits, best uses, best examples, real-life case studies, how to produce one.

Medical Animation: A Complete Guide with 10 Examples in 2024

Medical animation: More than just pretty pictures. With 10 outstanding examples, let's discover how it simplifies complex procedures, improves patient education, & drives results. Explore now!

Addressing Patients’ Unmet Needs: Enhancing Access to Healthcare

Discover the untold stories of patients’ unmet needs in our compelling blog. Join us on this journey to create a more patient-centered future.

Don’t know where to start? Get a quick quote!

Leave your contact information and we will be in touch within 24h!

FREE Animation Demo

Is heading your way.

Curious about how animation can bring your message to life?

We’ve got an awesome chance for you

Try a FREE

30-minute consultation.

Want Custom Animated Videos or Boosting Your Learning?

We’re Here for You!

Pardon Our Interruption

As you were browsing something about your browser made us think you were a bot. There are a few reasons this might happen:

You've disabled JavaScript in your web browser.
You're a power user moving through this website with super-human speed.
You've disabled cookies in your web browser.
A third-party browser plugin, such as Ghostery or NoScript, is preventing JavaScript from running. Additional information is available in this support article .

To regain access, please make sure that cookies and JavaScript are enabled before reloading the page.

IMAGES

⇉Barriers to Effective Communication in Healthcare Essay Example
Communication Barriers in Healthcare
Communication Barriers in Healthcare
Addressing Barriers to Communication in Healthcare
Communication Barriers Free Essay Example
Barriers to Communication in Healthcare Settings Free Essay Example

VIDEO

Barriers To Healthcare
Barriers of Communication
Communication without barriers
Battling language barriers in healthcare
Promoting Inclusive Healthcare: Navigating Cultural & Language Barriers for Improved Patient Care
importance of communication, barriers of communication, essential quality of a nurse #shorts

COMMENTS

Communication Barriers in Healthcare
Get a custom essay on Communication Barriers in Healthcare. Effective communication in health care is the key to the successful functioning of a medical organization. Lack of communication channels and tools will lead to stagnation and increased losses in hospitals and clinics. Health care costs and adverse effects on patients will increase.
Addressing Barriers to Communication in Healthcare Essay
Conclusion. The barrier of power and authority can seriously affect the cooperation among healthcare professionals. The discussed example shows how physicians may contribute to ineffective communication by having personal biases, while nurses may do the same by failing to address arising issues.
Dissecting Communication Barriers in Healthcare: A Path to ...
Dissecting Communication Barriers in Healthcare: A Path to Enhancing Communication Resiliency, Reliability, and Patient Safety J Patient Saf. 2021 Dec 1;17(8):e1465-e1471. doi: 10.1097/PTS.0000000000000541. Authors Oren T Guttman ...
PDF Communication Barriers in Nursing and their Influence on ...
e communication. The quality of communication has a significant impact on patient safety. Barriers to communication reduc. the quality of communication and increase the risk of negative outcomes in pati. nt care. The current study focused on communication barriers between nurses and patients. The overall aim was to produce evidence-based ...
3.7: Barriers to Effective Communication
Internal Noise, Mental/Emotional Distress. Internal noise has an impact on the communication process. Fear and anxiety can affect the person's ability to listen to what the nurse is saying. People with feelings of fear and anger can find it difficult to hear. Illness and distress can alter a person's thought processes.
Strategies for overcoming language barriers in healthcare
A closer look at medical interpreters. Aside from facilitating communication between patients and healthcare providers, medical interpreters can also serve as cultural brokers. 27-30 The medical interpreter helps bridge the cultural divide between patients and clinicians. The translation process ensures that what a nurse says is delivered not only with technical accuracy, but also with ...
A literature-based study of patient-centered care and communication in
Providing healthcare services that respect and meet patients' and caregivers' needs are essential in promoting positive care outcomes and perceptions of quality of care, thereby fulfilling a significant aspect of patient-centered care requirement. Effective communication between patients and healthcare providers is crucial for the provision of patient care and recovery. Hence, patient ...
Effective Communication among Healthcare Providers
Executive Summary. The ability to effectively collaborate and transmit information among healthcare providers—as well as between providers and patients—is central to the provision of safe, quality medical care. However, the increasingly complex healthcare environment can complicate the communication process and hinder the information ...
Challenges for healthcare communication during the COVID-19 pandemic
In the present issue of PEC, we publish three articles on challenges for healthcare communication during the COVID-19. One of these papers is a Position Paper written by Sarah J. White and colleagues on behalf of the research committee (rEACH) of the International Association for Communication in Healthcare (EACH) [4].
Effective communication between nurses and patients: an evolutionary
Nonetheless, communication remains a complicated phenomenon in nursing, and most patient-reported complaints in healthcare are around failed communication (Reader et al, 2014). The aim of the present concept analysis is to explore and clarify the complexity of establishing effective communication between nurses and patients in practice.
Communication skills 2: overcoming the barriers to effective
Citation: Ali M (2017) Communication skills 2: overcoming barriers to effective communication Nursing Times; 114: 1, 40-42. Author: Moi Ali is a communications consultant, a board member of the Scottish Ambulance Service and of the Professional Standards Authority for Health and Care, and a former vice-president of the Nursing and Midwifery ...
Addressing Barriers to Effective Communication Essay
Introduction. Effective communication is an integral aspect of nursing because nurses constantly interact with patients, families, colleagues, supervisors, and managers in the course of their duties. Rosenblatt and Davis (2009) argue that the nature of communication determines the quality of care that patients receive.
Exploring the role of communication barriers in healthcare
The communication barriers in the health sector have been identified in three major domains, namely lack of communication between doctors and nurses, problematic communication between the healthcare team, patients, and their families, and cultural challenges. 4,6,7 Both physician (poor communication skills, no special training during under ...
Communication Barriers Perceived by Nurses and Patients
The first step in eradicating the problems related to nurse-patient communication is two-sided (nurse and patient) awareness of communication barriers. It is of no doubt that building an effective relationship is dependent on the understanding of both sides of the interaction (Park & Song, 2005). In this study, we aimed to determine the ...
Comparison of barriers to effective nurse-patient communication in
Background Communication is a basic need of humans. Identifying factors that prevent effective nurse-patient communication allows for the better implementation of necessary measures to modify barriers. This study aims to compare the barriers to effective nurse-patient communication from the perspectives of nurses and patients in COVID-19 and non-COVID-19 wards. Materials and methods This cross ...
Effective Communication in Health Care
Health administrators and other healthcare professionals should know the different types of communication, the barriers to effective communication, and evidence-based strategies for improvement. To help develop these skills and become a better healthcare leader, consider an advanced education in healthcare administration .
7 Barriers to Effective Communication in Healthcare
7 communication barriers. Many providers find it challenging to communicate well with patients. Here are seven common barriers: Medical words. Language differences. Cultural differences. Disabilities and other challenges. Low health literacy. Complexity of health topics.
Culturally sensitive communication in healthcare: A concept analysis
The defining attributes of culturally sensitive communication explored and explained in this paper, aid in establishing and maintaining a trusting therapeutic relationship. •. This concept analysis enhances understanding of culturally sensitive communication and the benefits and challenges to its use in healthcare. 1.
Implications of Language Barriers for Healthcare: A Systematic Review
The first impact of language barriers is miscommunication between medical providers (physicians and nurses) and patients [Table 2]. This miscommunication contributes to a reduction in the satisfaction of both medical providers and patients, the quality of healthcare delivery, and patient safety. The second impact is an increase in indirect ...
Essential Skills for Health Communication, Barriers, Facilitators and
Many healthcare professionals are unaware of the necessary skills and barriers hindering interpersonal health communication. This study aimed to evaluate the healthcare professional's perception regarding health communication training's necessity, barriers, facilitators and critical skills in health communication. Data from a cross-sectional online survey in the framework of the H-Com ...
8 Types of Communication Barriers in Healthcare in 2024
Though most of them are basic communication knowledge, it gives you more perspective on the "gap" and brings new ideas for your next campaign. Table Of Contents. 8 Types of Communication Barriers in Healthcare. 1. Physical and Environmental Barriers. 2.
Communication in healthcare: a narrative review of the literature and
Review criteria. A search was carried out on the different databases by means of the (Me SH)terms 'communication', 'primary health care', 'correspondence', 'patient safety', 'patient handoff' and 'continuity of patient care'.Reviewers screened 4609 records and 462 full texts were checked according following inclusion criteria: (1) publication between January 1985 and ...
Communication Barriers in Healthcare: Strategies for Effective
Common Barriers to Communication in Health Care Jargon: Avoid using medical terminology, complicated, or unfamiliar words. When communicating with patients, explain information in plain language that is easy to understand by those without a medical or nursing background. Lack of attention: Nurses are typically very busy with several tasks to complete for multiple patients.
Poor communication by health care professionals may lead to life
We report two cases which highlight the fact how poor communication leads to dangerously poor health outcome. We present the case of a 50-year-old woman recently diagnosed with rheumatoid arthritis from Southern Nepal presented to Patan hospital with multiple episodes of vomiting and oral ulcers following the intake of methotrexate every day for 11 days, who was managed in the intensive care unit.

Save citation to file

Add to My Bibliography

Dissecting Communication Barriers in Healthcare: A Path to Enhancing Communication Resiliency, Reliability, and Patient Safety

Conflict of interest statement

Similar articles

Related information

LinkOut - more resources

Areas of Focus

Featured Memberships & Services

Effective Communication among Healthcare Providers

​Action Recommendations

Who Should Read This

Leadership Support for Culture of Safety

The Issue in Focus​

Patient Safety

Claims and Lawsuits

Regulations and Standards

The Centers for Medicare and Medicaid Services (CMS)

The Joint Commission​

DNV GL Healthcare

Actio​​​n PLAN​

Teambuilding and Training

Chain of Command​

Disruptive Behaviors

Test Results Repor​​ting

Bibliography

Resource List

Guidance, Assessments, a​nd Training

Communicating with Patients and Caregivers

Related Resources

Your email address

Share on Social Media

Search menu

Effective communication between nurses and patients: an evolutionary concept analysis

Register now to continue reading

What's included

Communication skills 2: overcoming the barriers to effective communication

Introduction

Time constraints

Environmental factors

Pain and fatigue

Embarrassment and anxiety

Values, beliefs and assumptions

Information overload

Also in this series

Related files

Performing a cranial nerve examination and interpreting the findings

How to assess and examine a patient with abdominal symptoms

How to conduct a cardiovascular assessment in advanced practice

How to interpret chest radiographs (X-rays): a systematic approach

Have your say

Addressing Barriers to Effective Communication Essay

Introduction

Comparison of barriers to effective nurse-patient communication in COVID-19 and non-COVID-19 wards

Materials and methods

Study design

Measurements

Communication barrier questionnaire

Ethical considerations

Statistical analysis

Limitations

Implications

Data availability

Acknowledgements

Author information

Contributions

Corresponding author

Ethics declarations

Consent for publication

Competing interests

Additional information

Rights and permissions

About this article

Share this article

BMC Nursing

Adobe Fonts

What’s the downside of poor healthcare communication?

7 communication barriers

Barrier 1: Medical words

Barrier 2: Language differences

Action Recommendations

The Issue in Focus

The Joint Commission

Action PLAN

Chain of Command

Test Results Reporting

Guidance, Assessments, and Training