Terveysneuvonta, oppimaan oppimista : videotallenteet hoitajien terveysneuvonnan ilmentäjinä ja vuorovaikutustaitojen kehittämismenetelmänä

Abstract

The purpose of this research was to describe health education and communication in counselling situations with nurses and patients as an analyse of educational needs to improve nurses' communication skills. Another research question was to explain the nurses' learning, professional development and process of development in interaction by self-reflection and education intervention. The opinions of health, learning and self-reflection were the theoretical frames which applied to nurses' orientation to profession and patients' self-care in health counselling. Nineteen nurses participated in the research on a voluntary basis and evaluated their interaction with patients on video on two occasions half a year apart. Nurses and patients gave verbal feedback in the interview. Besides nurse read education materials and watched their videotapes and wrote an evaluation of their communication skills. The health counselling was dominated by nurses. The view of health was often negative and also dynamic. The behaviouristic learning view was emphasized but sometimes could be seen features of cognitive and action theoretical learning views especially in the second video. Some patients were eager to individualistic learning to learn process together nurses. Nurses said that they were able to use familiar language, to listen and to encourage the patients to express their feelings and ask questions. Nurses gave little feedback on nonverbal communication. They wanted to develop their listening skills and their ability to encourage patients to ask and express their feelings. They also wanted to improve their preparations for counselling sessions. Written and second evaluations gave more information than first verbal answers in the interviews. Nurses were conscious of their skills and needs of development but it was very difficult to transfer them in action. The research gives information about nurses' opinions about communication skills and needs of improving them. The results indicate a need for training programs dealing with communication skills and self-reflection. The professional growth is an individual process of development. Using the videotape was found to be a good method to enhance the quality of health counselling.