PATIENT–NURSE COMMUNICATION: A CRITICAL BRIDGE FOR QUALITY HEALTHCARE DELIVERY

Abstract

Although good communication between the nurse and patient is a cornerstone of good health care, there is limited quantitative evidence that links to the quality of communication with patients to satisfaction for secondary-level public hospitals. This cross sectional and correlational study investigated the correlation between nurse-patient communication and patient satisfaction among 408 adult inpatients and 138 nurses in two secondary care public hospitals and the research instruments were Nurse-Patient Communication Scale (NPSC) and Patient Satisfaction with Nursing Care Scale (PSNC). Hierarchical regression and structural equation modeling showed that communication quality was the unique determinant of almost half of the variance in satisfaction and was the most important predictor when the other variables were entered. The model fit was excellent with the comparative fit index higher than 0.99 which shows that this model is well-fitting.The model fit was excellent with the comparative fit index being higher than 0.99, which shows that the model is a good fit. Ensemble machine learning approaches showed over a 90% predictive accuracy ( near perfect discrimination between the patients that were satisfied and those that were unsatisfied). The Working phase of therapeutic communication had the greatest effect size and accounted for almost a quarter of the variance in satisfaction, and emotional fatigue was the most harmful barrier, with the heaviest negative relationship with patient outcomes. Shared decision making had the highest odds ratio and number needed to treat (2.5 patients). The difference in satisfaction scores was very pronounced between the highest quartile (above eighty-five) and the lowest quartile (below sixty). Longitudinal reliability was excellent, implying that 24 h measurement stability was excellent. The results validate that therapeutic communication, particularly through empathic engagement, and collaborative decision making is the most important modifiable factor affecting overall satisfaction among hospitalized patients, and has the ability to buffer them from emotional fatigue, providing targets for therapeutic communication in secondary-level public healthcare for nurse education and hospital quality improvement and health policy.