Introduction
In families where interaction among student nurses and patients depends on family
backgrounds, it mainly presents specific challenges in the delivery of healthcare services,
especially where family support is an integral part of service provision. More so, outcomes in
health are always driven by family dynamics, and effective communication makes nursing
interventions even more complicated. In the article "Silent Struggles of Non-Communicative
Family Background of Nurse-Patient Interactions Among Student Nurses, "it emphasizes such
issues and particularly in the Philippines, where family-centered care is considerably valued and
most interactions with patients are identified with cultural expectations.
Non-communicative family background is the result of various causes, which may involve
emotional or psychological barriers, cultural differences, limited health literacy, and sometimes
unwillingness due to previous experiences within the healthcare system. In many cases, such
dynamics lead to miscommunication, mistranslation, or shyness, which delay the effective
communication between patients, families, and healthcare providers. The family cannot be
ignored in the nursing process because it is a primary source of emotional support and a bridge
to cultural and social context. However, this may inadvertently allow families with inept
communication and freely create stress for both patients and health providers that will
undermine the quality as well as effectiveness of care.
Accordingly, patient-centered care is based on effective family-patient-provider communication.
More recent research indicates that such family involvement could greatly influence a patient's
compliance with the suggested treatment and more rewarding outcomes of care. On the
contrary, difficulties in communication with the family may lead to misinterpretation of the care
plan, non-compliance, and less desirable results. This is particularly critical for student nurses,
as the learning process traverses significant areas in the development of clinical skills. The non-
communicative family backgrounds have posed major hindrances to learning and facilitating
care around the patient for the progression of the student nurse to experience practice in
handling complex patient interactions.
The families are highly involved in patient care in the Philippines and become
representatives/advocates and a moral support system for the patients. Delos Reyes et al.
(2021) discovered that patients whose families poorly communicate to them portray more
anxiety and perceive less support during treatment. For instance, if these patients poorly
communicate with health care providers, they may feel isolated or confused. This may
complicate the environment for students' required therapeutic environment to facilitate healing
and comfort to patients.
Park and Kim (2020) investigated how non-communicative family backgrounds impact the
perceptions and interaction of healthcare providers with patients. Frustration and stress for
nurses and student nurses would be quite common in dealing with the complexity of family
dynamics without effective communication. Low family involvement in care consultations has
been associated with heightened emotional tension, especially among less experienced student
nurses who significantly rely on feedback from families to provide full care. The communication
barrier can prove to be very stressful for the patient and reduce confidence and competency
while providing care to a patient by the student nurse.
Other researchers further explain that family communication is a fundamental factor in
healthcare outcomes. For example, Tanaka and Espiritu (2023) recommend open flows of
communication among the individuals in the family care network can help increase patient
compliance with the medication prescribed, lower instances of hospital readmission, and
contribute to faster recovery times. On the other hand, non-communicative families also limit
their support and assurance towards the patients, which can gradually deteriorate into
healthcare disaster circumstances and foster abusive relationships with healthcare
professionals.
Effective communication relationships between the nurses, patients, and families can facilitate
the growing clinical skills of the student nurses at their early entry into professional practice. As
mentioned by Chua and Ferrer (2021), effective family engagement is important in nursing
education because a nurse student exposed to communicative families would be more confident
and competent in her practice compared to the situation of a non-communicative family for a
student nurse.
Chen et al. (2022) also researched the influence of cultural and socio-economic factors on
family communication patterns in healthcare settings. According to them, socio-economic and
cultural constraints tend to limit active family involvement in healthcare discussions. Such
constraints usually provoke reluctance or intimidation, and ultimately prevent families from
asking questions or openly discussing their treatment with a healthcare provider. Apart from
these communication barriers, the researcher feels that it makes their job tough and indirectly
influences the performance of the student nurse who relies on family feedback for patient-
centered care.
Based on these studies, the current research work, "Silent Struggles of Non-Communicative
Family Background of Nurse-Patient Interactions Among Student Nurses," is designed to
enhance understanding toward how non-communicative family dynamics influence nursing
education and practice. This study focuses on the challenges student nurses experience and
recommends where students might improve in handling complex family interactions properly.
Findings could also be used to inform nursing educators as they design curriculum content
geared toward preparing student nurses in handling different family dynamics, including those
with little communication, thus improving healthcare delivery and outcomes.
