Adult Patient Perceptions of Nurse Listening Behaviors in an Acute Care Setting

Abstract

Good listening is fundamental to effective nursing practice, critical to a healthcare professional’s competence, and essential for patient satisfaction and experience. Because nurse listening has been linked to an enhanced patient experience and improved patient outcomes, it has been considered important enough that the U.S. Centers for Medicare or Medicaid Services have solicited patient perception as part of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey (CMS, n.d.). However, little can be found in the literature that describes which nursing behaviors are perceived by patients as listening behaviors. Via face-to-face interviews, this study sought to discover, describe, and interpret the perceptions of recently hospitalized adult patients on their nurses’ listening behaviors in an acute care setting, and to identify which behaviors caused them to believe listening had occurred. Perceptions of the reverse experience (the experience of not being listened to and its associated behaviors) was also elicited, as were related outcomes for both. This qualitative study used as a framework King’s Theory of Goal Attainment (KTGA), a middle range theory that is grounded on the transaction processes of mutual goal setting between patient and nurse in achieving positive patient outcomes. The theory focuses on perception, stresses the need for listening, and elucidates the interaction of humans with their environment, of which the nurse is an integral part. Interpretive phenomenological analysis, or IPA, is an approach to qualitative, experiential, and psychological research, having been informed by concepts and debates from phenomenology, hermeneutics, and idiography. As such, it was the method used to conduct this study, exploring through semi-structured interview questions the essence of what it means to be or experience something. Data analysis produced 13 super-ordinate themes reflecting listening behaviors, non-listening behaviors, and outcomes related to each. Participants agreed that the perception of nurse listening has produced improved outcomes for patients with whom they interact and that non-listening nurse behaviors had detrimental effects. Questions within the HCAHPS “Communication with Nurses” domain measure patient perceptions of nurse listening because when nurses are perceived to be listening, the patient experience is improved. Evidence that the improved experience has been linked to improved health behaviors has aligned with the results of this study. For inpatient nurses to reflect on and improve their interactions with patients, ultimately improving patient outcomes, they need to know how their behaviors are perceived and work to adopt those that support the patient while discarding those that are untherapeutic.