Nurses\u27 Perceptions of Diagnosis and Prognosis-Related Communication: An Integrative Review

Background: Disclosure of diagnostic and prognostic information has become the standard in the United States and increasingly around the world. Disclosure is generally identified as the responsibility of the physician. However, nurses are active participants in the process both intentionally and inadvertently. If not included in initial discussions regarding diagnosis and prognosis, the nurse may find it challenging to openly support the patient and family. Objective: The aim of this study is to synthesize published literature regarding nurses’ perceptions and experiences with diagnosis and prognosis-related communication. Methods: The Whittemore and Knafl method guided the integrative review process. Electronic databases including Cumulative Index to Nursing and Allied Health Literature, Health Sciences in ProQuest, PubMed, and Web of Science were used to review the literature from 2000 to 2015. Constant comparison methods were used to analyze the data and develop themes. Results: Thirty articles met all of the inclusion criteria and were included in this review. Several themes emerged from the data, including the nurse’s role in the process of diagnosis and prognosis-related communication, barriers and difficulties related to communication, and positive and negative outcomes. Conclusions: Nurses play an integral role in the process of diagnostic and prognostic disclosure. Further exploration of both physician and patient perceptions of the nurse’s role are needed. Interprofessional training regarding diagnosis and prognosis-related communication is essential to promote collaboration and better empower nurses in this process. Implications for Practice: Nurses should aim to purposefully partner with physician colleagues to plan and participate in diagnostic and prognostic discussions. Nurses should identify opportunities to improve their knowledge, understanding, and comfort with challenging conversations