( ) - * :.. 45 90. : ). 1385 ) 4 (. ( 0/05. SPSS 12.0 ( ) 3/24 :. 2/80. - :.. - - : 87/7/16 : 88/9/25 : 1 09126104684 : ( ) Email:m_aghabarary@yahoo.com 2 3

... (4). Heaven... ( ) ( ) (5)!.. )... (1). (2 3). / /

...... ( 5) ( 14) ( 14) ICU ( 6) ) ( 12) ( 17) ( 10) CCU ( 12).. :. ) ( 15 1 15. ( ) ) 15 ) 15 ( 90. ( 30 45 (%86) 77. (... 0/82 ( ) 0/76. ( ) : 2 44 29 ( ) 5. : 4.. (1) (0) :.(4) (3) (2) 1/5 :1/4 0/6 :0/5 0 :. :4 3/5 :3/4 2/5 :2/4 / /

... - () (76/7)23 (23/3)7 (33/3)10 (66/7)20 (10)3 (6/7)2 (13/3)4 (40)12 (30)9 (26/7)8 (16/7)5 (46/7)14 (6/7)2 (3/3)1 93 1. 11/36 3/24 2/68 2/80 2.(3 ).. (%67) ( ). SPSS 12.0. 0/05 30/27 (1). 6 4/36 31/1.(2 ) - () (72/7)56 (27/3)21 (51/9)40 (48/1)37 (79/2)61 (15/6)12 (5/2)4 (22/1)17 (2/6)2 (22/1)17 (10/4)8 (42/9)33 (51/9)40 (48/1)37 (70/1)54 (29/9)23 (29/9)23 (70/1)54 / /

... ) (... 4 ).(5-3 - 4-5. : - 1-2 - 2/80 2/56 2/37 2 3/24 3/22 3/09 2/68 3/16 3/57 3/52 3/21 3/10 3/10 3/31 3/18 3/04-2/60 2/93 2/97 2/63 2/57 2/77 2/87 2/80 3/38 3/68 3/75 3/29 3/31 3/52 3/13 / /

... - 3/57 3/52 3/31 3/21 3/18 3/16 3/04 3/10 3/10 2/93 2/77 2/97 2/87 2/60 2/80 2/63 2/57 3/68 3/75 3/52 3/38 3/13 3/29 3/31 29 18.(6 ) - P 0/072 0 /107 *0/000 * 0/003 * 0/012 0 /253 0 /601 0 /885 0 /887 0 /834 0 /095 * 0/016 * 0/029 * 0/001 0 /104 * 0/001 * 0/009 * 0/002 1/53 2/20 2/13 1/53 2/60 2/97 3/10 3/11 2/93 3/11 2/80 2/30 2/30 2/93 2/73 2/40 2/03 1/95 2/69 3/05 2/35 3/38 3/23 3/03 2/97 3/12 3/23 2/97 2/97 3/75 3/68 3/61 3/34 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 / /

... - P * 0/000 * 0/000 * 0/023 * 0/021 * 0/009 * 0/009 * 0/001 * 0/004 0 /114 0 /210 0 / 002 2/11 2/03 2/53 2/43 2/57 2/63 2/33 2/11 2/87 2/80 2/77 3/47 3/31 3/18 3/05 3/31 3/29 2/90 3/13 3/52 ) ( ) (... ) ( 19 20 21 22 23 24 25 26 27 28 29. 0/05 * 71. (6)... 75 5 4 3 Park Song.. 62 57 / /

... (9). Deborah Tannen.. (8)... (6 4 )....... (8).. (8).. / /

.... ( ).. Park Song (6). Heaven Heaven... Heaven. (9)..(4 ) : / /

... ) ( ).(4..... (5) Catherin McCabe. -. - (10). / /

... (9 12) (8) - (9). ) (... (12). ( ) ) (... ( ) ( ) ).(4 ) ( (11) ( ).. (9) / /

... ( ) (9). ) (.. (6). Park Song. (12). 1- Farmahini M, Kashaninia Z. Hosiani MA. Biglarian A. Impact of Training Communication Skills to Nurses on Patients Satisfaction with Nurse-Patient Relationship. Iranian J Nurs Rese, 2006; 1(3): 47-54. 2- Crow M. The Nurse - Patient Relationship: A Consideration of Its Discursive Content. J Adv Nurs, 2000; 31: 926-967. 3- Zrinyi M, Horvath T. Impact of Satisfaction, Nurse Patient Interactions and Perceived Benefits on Health Behaviors Following A Cardiac Event. Eur J Cardiovasc Nurs, 2003; 2: 159-166. 4- Bonnie P, Hagerty K. Reconceptualizing the nurse-patient relationship, J Nurs Scholarsh, 2003; 35(2): 145-150. 5- Heaven C, Clegg J, Maguire P. Transfer of Communication Skills Training from Workshop to Workplace: The Impact of Clinical Supervision. Patient Education and Counselling, 2006; 60: 313 325. 6- Park EK, Song M. Communication Barriers Perceived By Older Patients and Nurses. Int J Nurs Stud, 2005; 42: 159 166. 7- Lahoti V. Evaluation of Communication Barriers in Nurse-Patient Interactions; Nurses perspective. A Thesis Presented for the Degree of M.Sc in Nursing Education. Shahid Beheshti University. Faculty of Medical Science. Department of Nursing Education. 1996. 8- Harkreader H. Fundamental of Nurse Caring and Clinical Judgement. Philadelphia Pensilvania: W.B. Saunders Publishing, 2000; 316. 9- Kozier B, Erb G, Berman A, Snyder S, Fundamentals of Nurse Concept Process and Practice. 7 th ed. Prentice Hall Publishing. Newjersy, 2004: 420 440. 10- McCabe C. Nurse Patient Communication: An Exploration of Patients, Experiences. J Clinical Nurs, 2004; 13(1): 41 49. 11- Schofield NG, Green C, Creed F. Communication skills of health-care professionals working in oncology--can they be improved? Eur J Oncolo Nurs, 2008; 12(1): 4-13. 12- Potter PA, Perry AG. Basic Nurse Essential for Practice. 5 th ed. Mosby, 2003: 115 130. / /

Iran Journal of Nursing (IJN) 2009, 22(61):19-31 Barriers to Application of Communicative Skills by Nurses in Nurse- Patient Interaction: Nurses and Patients Perspective *M. Aghabarary 1 MSc E. Mohammadi 2 PhD A. Varvani-Farahani 3 MSc ABSTRACT Background and Aim: The main role of a nurse is caring. To take care of patients is achievable only through communicating them, but, the results of previous studies have revealed that due to lack of communicative skills, nurses are unable to communicate properly, a problem about which patients keep complaining very often. The present study is an attempt to determine the barriers to application of communicative skills by nurses from the perspectives of nurses and patients. Material and Method: This study is descriptive analytical study and adopts a problem solving perspective. The research samples (90 nurses and 45 patients) were selected through simple sampling method from two academic hospitals affiliated to Tehran University of Medical Sciences and Health services (Imam Khomeini and Valiy-e ASR). Two survey instruments within Lickert scale format were designed separately for two groups of nurses and patients. The instruments contained the barriers to application of communicative skills by nurses. These barriers were classified into four categories: barriers related to nurses, patients, nurses and patients and environment. Data were analyzed using descriptive and analytical statistics. Results: The results showed that from the nurses perspective the most and the least important barriers were patient related communication barriers, and nurse patient-related communication barriers, respectively; Whereas from the patients perspective, the most and the least important barriers were nurse related communication barriers, and nurse- patient related communication barriers, respectively. Conclusion: Nurses consider factors specific to patient as the most important barriers for nurses to use their communicative skills; yet for patients those specific to nurses were selected as the most important barriers. A strategy entitled Establishing a Committee for Ensuring Quality of Nursing Services with an Emphasis on Nurses Communicative Skills" was proposed to increase use of communicative skills by nurses when interacting with patients. Keywords: Nurse patient interaction - Communicative skills - Communication barriers - Suitable communication Received: 7 Oct, 2008 Accepted: 16 Dec, 2009 1 Master of Science in Nursing Education, Tarbiat Modarres University, Tehran, Iran (*Corresponding Author) Tel: 09126104684 E mail address: m_aghabarary@yahoo.com 2 Assistant Professor in Nursing, Tarbiat Modarres University, Tehran, Iran 3 Master of Science Candidate (Nursing Education), Tehran University of Medical Sciences, Tehran, Iran Page 31