An exploration of nurses' knowledge of right hemisphere stroke associated communication impairments

Abstract

<p>In the U. S. approximately 795,000 people experience a new or recurrent stroke yearly. Stroke survival has increased with advances in medical technology. The impact of stroke on a patient&rsquo;s neurological status poses critical challenges for nurses. Communication is one area impacted by stroke. Strokes affecting the brain&rsquo;s right hemisphere (RHS) have been described in the literature as negatively impacting communication behaviors of patients, often in a subtle manner. The purpose of this exploratory descriptive study was to examine the knowledge that RNs in North Carolina possess about communication impairments associated with RHS and how these nurses anticipate using knowledge gained about these impairments in the care of these patients. The study also explored perceived barriers and facilitators to participating in continuing education about RHS associated communication impairments. The RHS Communication Impairment Knowledge Assessment tool assessed demographic variables, knowledge of RHS associated communication impairments, perceived barriers and facilitators to participating in continuing education about communication clusters associated with RHS, as well as how nurses anticipate using education about these impairments in caring for patients following RHS. The study setting was North Carolina. A purposive sample of North Carolina RNs was contacted through email; and a sample size of 2495 was recruited. The study was guided conceptually by Ajzen&rsquo;s theory of planned behavior. Results indicated that a large percentage (78.2%) had received education about RHS associated communication impairments in their undergraduate nursing programs. The mean score on the 12-item knowledge assessment was 6.15 with less than 50% answering 3 specific application of knowledge questions correctly. The KR-20 for these 12 items was 0.532 which is an acceptable KR-20 for short tests (10&ndash;15 items). Cost of continuing education courses (23.5%), work responsibilities (32.9%), and family responsibilities (23.7%) were infrequently reported as barriers to participating in continuing education about these communication impairments while identified education need (87.1%), interest in learning (72.2%), providing better patient care (89.3%), improved decision making (87%), and increased competency (71.4%) were all frequently reported as facilitators to participating in RHS communication cluster continuing education. Three themes emerged regarding how RNs would use knowledge gained to change their patient care. These themes were: awareness of the need for education, improved nursing management of patients, including patient teaching and critical thinking, and better communication with survivors of RHS. The research contributed to the current body of nursing science by identifying knowledge gaps of NC RNs on RHS associated communication impairments, barriers and facilitators to participation in RHS continuing education, and intended changes in care based on continuing education.</p>