Nurses' Quality of Communication and its Relationship with Psychological Strain and Perceived work Difficulty among Nurses Working in Hospitals of Malayer

Hadi Salimi, Sepideh Bashirgonbadi, Mousa Javdan, Kobra Haji Alizadeh, Marzieh Sadeghian



Background and Aim: Researches have described nurses as poor communicators; therefore, it is essential to examine nurses' communication in different situations. Hence this study was done aimed to compare nurses' quality of communication with spouse, colleague and patient and its relationship with psychological strain and perceived work difficulty among nurses working in hospitals of Malayer.

Materials and Methods: The present research was cross-sectional (descriptive- analytical). The statistical population included all married nurses working in hospitals of Malayer in 2016 year that (115 subjects) were selected using simple random sampling method. Nurses' Quality of Communication Questionnaire, Psychological Strain Questionnaire (PSQ) and Work Difficultly Scale were used for gathering data. The one-way analysis of variance (ANOVA), Bonferroni and Pearson correlation and software SPSS 22 were used for analyzing the data.

Findings: The results showed that there was a significant different between nurses' quality of communication with spouse with quality of communication with colleague and patient, respectively with average of 91.08±12.42, 83.45±12.39 and 81.45±13.01 (F=18.36, p=0.001), but there wasn't significant different between quality of communication with colleague and with patient (p=0.690). The correlation results showed that there was a negative and significant correlation between psychological strain with nurses' quality of communication with colleague (r=-0.19, p=0.049) and patient (r=-0.30, p=0.002). Also there was a negative and significant correlation between perceived work difficulty with nurses' quality of communication with patient (r=-0.21, p=0.030).

Ethical Considerations: At first, a permissions was obtained from the Malayer Health Network and then, after referring to hospitals the voluntary participation in the research and hide personal information was explained to participants to participate satisfaction.

Conclusion: According to findings of this study, nurses aren't poor communicators and they behave according to their audience and another factors and can suggested training and intervention on improving psychological strain and perceived work difficulty of nurses as an effective way on creasing their quality of communication.


Cite this article as: Salimi H, Bashirgonbadi S, Javdan M, Haji Alizadeh K, Sadeghian M. Nurses' Quality of Communication and its Relationship with Psychological Strain and Perceived work Difficulty among Nurses Working in Hospitals of Malayer. Med Ethics J 2019; 13(44): e2.


Quality of Communication; Psychological Strain; Work Difficulty; Nurses

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Sadeghi T, Dehghan-Nayeri N, Karimi R. Comparison of nurses and hospitalized adolescents` perceptions about importance and observance of hospitalized adolescents` decision making. IJN 2011; 23(68): 31-38. [Persian]

Wigham C, Chanier T. A study of verbal and nonverbal communication in second life–the ARCHI21 experience. ReCALL 2013; 25(01): 63-84.

Bonnice B. Nurses’ Communication Skills and Response to Conflict: Impact of "New Directions" Relational Skills Training [Doctoral Thesis]. Doctor of Nursing Practice: Oregon Health and Science University School of Nursing; 2015.

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

Mahmoudi H, Ebadi A, Salimi SH, Najafi Mehri S, Mokhtari Noori J, Shokrollahi F. Effect of nurse communication with patients on anxiety, depression and stress level of emergency ward patients. IJCCN 2010; 3(1): 7-12. [Persian]

Seaward BL. Managing stress in emergency medical services. Massachusetts: Jones & Bartlett Learning; 2000.

Mahon MM, Nicotera AM. Nursing and conflict communication: avoidance as preferred strategy. Nurs Adm Q 2011; 35(2): 152-163.

Padgett SM. Professional collegiality and peer monitoring among nursing staff: an ethnographic study. Int J Nurs Stud 2013; 50(10): 1407-1415.

Twigg D, McCullough K. Nurse retention: A review of strategies to create and enhance positive practice environments in clinical settings. Int J Nurs Stud 2014; 51(1): 85-92.

Fathi Ashtiani A, Pirzadi H, Shokoohi-Yekta M, Tavallai S. The influence of teaching program of stress management and communication skills on improvement of mental health of nurses and hospital staff: An experimental study. IJN 2014; 27(91): 1-13. [Persian]

Leal-Costa C, Diaz-Agea JL, Tirado-Gonzalez S, Rodriguez-Marin J, van-der Hofstadt CJ. Communication skills: A preventive factor in Burnout syndrome in health professionals. A Sist Sanit Navar 2015; 38(2): 213-223.

Mahmoodi H, Soori-Laki A, Boulhasani M, Sepahvand M. The relationship between use of communication skills and job satisfaction of nurses. Sci Res J Shahed Univ 2012; 20(101): 77-82. [Persian]

Kruijver IP, Kerkstra A, Bensing JM, Van de Wiel HB. Nurse-patient communication in cancer care: A review of the literature. Cancer Nursing 2000; 23(1): 20-31.

McCabe C. Nurse-patient communication: an exploration of patients' experiences. J Clin Nurs 2004; 13(1): 41-49.

Gholami H, Sarhangi F, Mokhtari Nouri J, Javadi M. Nurses’ communication skills in military hospitals. J Nurs Midwife Sci 2015; 2(1): 40-45. [Persian]

Siamian H, Bagheri-Nesami M, Nia RD, Nezhad FR, Akbari H, Balaghafari A, et al. Assessment of interpersonal communication skills among sari health centers’ staff. Mater Sociomed 2014; 26(5): 324-328. [Persian]

Barati M, Afsar A, Ahmadpanah M. Assessment of communication skills level among healthcare practitioners. Sci J Hamadan Univ Med Sci 2013; 19(1): 62-69. [Persian]

Wloszczak-Szubzda A, Jarosz MJ. Professional communication competences of nurses: A review of current practice and educational problems. Ann Agric Environ Med 2013; 20(1): 183-188.

Norgaard B, Ammentorp J, Ohm Kyvik K, Kofoed PE. Communication skills training increases self-efficacy of health care professionals. J Contin Educ Health Prof 2012; 32(2): 90-97.

Rostami H, Golchin M, Mirzaei A. Evaluation of communication skills of nurses from hospitalized patients' perspective. J Urmia Nurs Midwife Faculty 2012; 10(1): 27-34. [Persian]

Moustaka E, Constantinidis TC. Sources and effects of Work-related stress in nursing. Health Science J 2010; 4(4): 210-216.

Baraz Pordanjani SH, Shariati A, Alijani H, Moein Mosavi BS. Assessing barriers of Nurse-patient’s effective communication in educational hospitals of Ahwaz. IJNR 2010; 5(16): 45-52. [Persian]

Asad Zandi M, Sayari R, Ebadi A, Sanainasab H. Abundance of depression, anxiety and stress in militant nurses. J Mil Med 2011; 13(2): 103-108. [Persian]

Khamse F, Rocha H, Ebaady A, Hajiamini Z, Salimi H, Radfar S. Survey Relationship between demographic factors and stress, anxiety and ‎depression in nurses working in selected hospitals in Tehran city‎. Holist Nurs Midwifery 2011; 21(1): 13-21. [Persian]

Mohammadi I, Mozafari M, Jamshid Beigi E, kaikhavani S. Barriers to Effective Nurse-Patient Communication from Perspective of Nurses Employed in Educational Hospitals of Ilam. J Neyshabur Univ Med Sci 2014; 2(3): 20-27. [Persian]

Mohammadi Z, Hosseinchari M. Influence of perceived work difficulty on nursing quality of life. J Women's Studies Sociological & Psychological 2009; 7(1): 117-131. [Persian]

Lake ET, Friese CR. Variations in nursing practice environments: relation to staffing and hospital characteristics. Nursing Research 2006; 55(1): 1-9.

Twigg D, Duffield C. A review of workload measures: A context for a new staffing methodology in Western Australia. International Journal of Nursing Studies 2009; 46(1): 132-140.

Van den Heever JM. Neonatal nursing workload-can it be measured? Curationis 1995; 18(3): 43-47.

Souder E, O'Sullivan P. Disruptive behaviors of older adults in an institutional setting. Staff time required to manage disruptions. Journal of Gerontological Nursing 2003; 29(8): 31-36.

Silén M, Tang PF, Wadensten B, Ahlstrom G. Workplace distress and ethical dilemmas in neuroscience nursing. Journal of Neuroscience Nursing 2008; 40(4): 222-231.

Malekpour F, Mohammadian Y, Mohamadpour Y, Fazli B, Hassanloei B. Assessment of relationship between quality of life and mental workload among nurses of Urmia medical Sciences university hospital. J Urmia Nurs Midwifery Fac 2014; 12(6): 499-505. [Persian]

Zakerian SA, Abbasinia M, Mohammadian F, Fathi A, Rahmani A, Ahmadnezhad I, et al. The Relationship between Workload and Quality of Life among Hospital Staffs. Journal of Ergonomics 2013; 1(1): 43-56. [Persian]

Anoosheh M, Zarkhah S, Faghihzadeh S, Vaismoradi M. Nurse-patient communication barriers in Iranian nursing. Int Nurs Rev 2009; 56(2): 243-249.

Osipow SH. Development of Strain Instruments for use in counseling. Journal of Counseling and Development 2003; 70: 322-326.

Mohammadi S, Roshanzadeh M. The relationship between psychological empowerment and psychological strain among clinical nurses in educational hospitals. J Nursing Management 2014; 3(3): 51-60. [Persian]

Safavi M, Ghasemi Panjah S, Fesharaki M, Esmaeilpour Bandboni M. Communication skills and its related factors in Guilans teaching hospitals' nurses 2015. Sci J Hamadan Nurs Midwifery Fac 2016; 24(1): 50-57. [Persian]

Matiti M, Sharman J. Dignity: A study of pre-operative patients. Nursing Standard 1999; 14(13): 32-35.

Lemonidou C, Merkouris A, Leino-Kilpi H, Välimäki M, Dassen T, Gasull M, et al. A comparison of surgical patients’ and nurses’ perceptions of patients’ autonomy, privacy and informed consent in nursing interventions. Clinical Effectiveness in Nursing 2003; 7(2): 73-83.

Farnia F, Abbaszadeh A, Borhani F. Barriers to developing the nurse-patient relationship in operation room: A qualitative content analysis. J Qual Res Health Sci 2013; 2(1): 76-90. [Persian]


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