Table I.
Example of the structural analysis
| What the text says | What the text speaks about | Theme |
|---|---|---|
| “It makes good sense to have this pocket guide to consider whether I have included all aspects and possibilities.” | Having a communication strategy that contains an algorithm and the BASIS frame meant that the nurse communication guides had tools supporting them in getting an overview. | The communication intervention components provided overview, a conceptual framework, awareness and room for reflection |
| “You just become so happy when you succeed [laughs], and there are a lot of times when I don’t succeed, but when I do, it gives me energy that I ‘cracked the code’. And the strategy has definitely supported me in this, so that more often I’m able to interpret what the patient is trying to say.” | ||
| “I think that what I was most surprised about and that I hadn’t given so much thought was the importance of how we document and describe how the patient communicates, what the different signals mean. I think that I have become more aware of this.” | Nurses described that they became more focused on documenting their communication in detail, thereby allowing their colleagues to draw on their observations and experiences | |
| “And to describe in detail, that communication with this patients works best this way, I think that I have become more focused on that.” | ||
| “I have become very aware of how to have a systematic approach when I ask questions.” | Others experienced that the project allowed them to develop new insights and techniques especially concerning systematism. | |
| “I am more conscious about some things for example, how to have a systematic approach with the conscious patient” | ||
| “I have become more attentive towards the fundamental principles that you need to consider. Does the patient have his hearing aid and glasses? Are we sure that we have a clear yes/no response? You know, all those things.” | The nurses also described how the basic principles of communication had become more evident to them; e.g., giving the patients time to respond, providing them with glasses or hearing aids, securing a clear yes/no response and asking short and precise questions. | |
| “I have become better at observing when others interact with the patients, especially giving the patient time to respond because they have latency” | ||
| “Communication is an area that is hard to put into words, how I sense different things. And I actually thing that the algorithm helps me to do that” | The nurses found that communication was a phenomenon that was difficult to put into words, and they did not possess as extensive a vocabulary as for other more instrumental or technical parts of nursing care, e.g., ventilator treatment. Being a nurse communication guide increased their vocabulary and ability to discuss nurse-patient communication with students and colleagues | |
| “I’ve become more focused about the subject and I’ve been able to have conversations with my colleagues and bring it into play in our group.” | ||
| “It will be much easier for me to bring it up, because I can base my guidance on this [the algorithm and low-tech communication book]. I can show them that we have these categories to work with” | Furthermore, the intervention provided tangible tools to apply when supervising newly employed nurses or students. | |
| “We have to remember that many experienced nurses supervise younger nurses, and then it is nice to have something to show them and make them reflect upon. | ||
| “I have become more conscious about the importance of communication and that I actually have many options to draw on. I have also become more reflective about others’ communication and can distinguish between what was a good approach and what wasn’t quite as good [laughs]. So more awareness” | The nurse communication guides described that they were able to reflect upon communication at a deeper level |