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Nurses' perception of time availability in patient communication in Hong Kong.

AIMS
To explore nurses' perceptions of their patient communication in practice and to identify their ways of communicating.


BACKGROUND
Nurse theorists and clinicians are aware of the importance of nurse-patient communication in providing patient-centred care. However, barriers remain that prevent nurses from implementing quality/effective communication, and time is often viewed as a critical variable. Continuous emphasis on efficiency contravenes patient-centred care, warranting a re-examination of nurses' perception of time in nurse-patient communication.


DESIGN
Focus group interviews were adopted. Thirty-nine registered nurses participated. Interviews were tape-recorded, transcribed and translated, and data were analysed using thematic analysis to identify codes, categories and themes/patterns.


RESULTS
Three themes were identified regarding nurses' perception of communication with time: (1) Patterns of communication. (2) Routine scheduled communication vs. meeting individuals' needs. (3) Saving time through communication. Patterns of communication, based on participants' criteria such as the purpose, who initiated it, the nature of communication, expectation to perform, therapeutic value and relation with time were explicated. By integrating communication into routines as intended actions, nurses demonstrate that communication and relationship building with patients take no extra time. Good communication and good relationships help nurses save time.


CONCLUSIONS
Nurses' communication behaviour is closely related to their perception of communication. This study suggests the need for a paradigm shift in thinking about communication as requiring time. Additionally, nurses should recognise the value of short, iterative interaction and chit-chat as quality communication for knowing their patients and providing patient-centred care.


RELEVANCE TO CLINICAL PRACTICE
Nurses should think beyond time in the discourse of effective nurse-patient communication, as it often relates to manpower. An understanding of how nurses perceive their time availability for nurse-patient communication and their use of time for this aspect contribute to the discourse regarding how to improve patient-centred care.