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Fulltext Nurse-patient communication barriers as perceived by adult in-patients and nurses in a private hospital in Malaysia

Maniam, Radha, Mbambe, Ikome Otto

The Malaysian Journal of Nursing, 2018;10(1):71-76.
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Effective and skilful communication is crucial and an important element in the quality of nursing care. This enables nurses to assess patients' needs and provide them with the appropriate physical care, emotional support, knowledge transfer and exchange of information. However, nurses find it difficult to communicate effectively and therapeutically with their patients. Aim: To identify the nurses' and adult inpatients' perceptions of barriers to effective nurse-patient communication. Methodology: A descriptive study was used to collect data from nurses (n=40) and adult inpatient (n=63) in multidisciplinary wards in a private hospital in Malaysia. Two sets of self-administered questionnaire for the two different groups of participants, the patients and nurses were used. Data were analysed using the SPSS version 20.0. Results: Nurses and adult in patient perceived heavy workload, dialect and negative attitudes towards nurses as main barriers that hinders effective communication among nurses and patients. Conclusion: Communication places an important part in patients' satisfaction of care and the ability of the nurse to provided patient centred care. Nurses should take in to account those communication barriers that affect the patients and be confident enough to take the first step to initiate communication and be able to handle patients' dynamic emotions.
End of life care preference among hemodialysis population: Revisit Q methodology

Maniam R, Tan MP, Chong MC

Patient Educ Couns, 2021 Sep 29.
PMID: 34625322 DOI: 10.1016/j.pec.2021.09.026

OBJECTIVE: End-of-life care is often overlooked in the dialysis unit despite high mortality rates. This study aimed to understand the diverse subjectivity of opinions on end-of-life care preferences, feelings, needs, value and goals in life among a haemodialysis population.
METHODS: The Q methodology was used where 37 opinion statements were ranked in order of importance in a unimodal shaped grid. Results were explored using the Centroids factor extraction and Varimax rotation.
RESULTS: Four-three persons living with haemodialysis, mean age± SD= 56.58 ± 10.22 years, participated in the study. Five-factors were identified: living in the present, family preference, self preservation, power vs. control and autonomy in decision making, loaded by eleven, four, four, three and three participants with 16 individuals not loading significantly and two were confounded. Preferences for remaining positive in the face of illness through a healthy lifestyle and preserving relationships and autonomy were demonstrated.
CONCLUSIONS: End-of-life discussions are potentially inhibited by preferences to live for the present which should be explored in future studies.
PRACTICE IMPLICATION: Statement sets may be used to help facilitate end-of-life discussions through identification of opinion groups. Establishing preferences may guide identification of those willing to initiate discussions.
Fulltext Advanced care planning among persons living with haemodialysis: a qualitative study

Maniam R, Tan MP, Chong MC, Subramanian P

Singapore Med J, 2024 Apr 01.
PMID: 38567793 DOI: 10.4103/singaporemedj.SMJ-2021-463
Fulltext Preliminary study of an exercise programme for reducing fatigue and improving sleep among long-term haemodialysis patients

Maniam R, Subramanian P, Singh SK, Lim SK, Chinna K, Rosli R

Singapore Med J, 2014 Sep;55(9):476-82.
PMID: 25273932

INTRODUCTION: Fatigue and quality of sleep are the main factors that contribute to a poor quality of life among patients on long-term haemodialysis. Studies have also emphasised the importance of exercise for improving the wellbeing of dialysis patients. This study aimed to determine the effectiveness of a predialysis low-to-moderate-intensity exercise programme for reducing fatigue and improving sleep disorders among long-term haemodialysis patients.

METHODS: In this quasi-experimental study, an exercise programme was conducted three times a week for 12 weeks before long-term haemodialysis patients underwent dialysis at two centres. The patients were categorised into either the exercise group (n = 28) or control group (n = 27). The latter was asked to maintain their current lifestyles. Assessments of fatigue and sleep disorder levels were performed for both groups using self-reported questionnaires at baseline and after intervention. The patients' perception of the exercise programme was also determined using self-reported questionnaires.

RESULTS: Paired sample t-test indicated improvements in fatigue level in the exercise group (mean fatigue score: post-treatment 40.5 ± 7.9 vs. pre-treatment 30.0 ± 10.9). Improvements in sleep disorders were also observed in the exercise group (mean score: post-treatment 7.6 ± 3.3 vs. pre-treatment 10.1 ± 3.8). However, sleep quality deteriorated in the control group (mean score: post-treatment 10.7 ± 2.9 vs. pre-treatment 9.3 ± 2.9).

CONCLUSION: Simple low-to-moderate-intensity exercise is effective for improving fatigue, sleep disorders and the overall quality of life among haemodialysis patients.