# Changes in Nurse-Patient Communication Through Health Technologies and Nursing Practices to Recognize and Support Limited Digital Health Literacy: Qualitative Study

## TL;DR

This study explores how health technologies have changed communication between nurses and patients, and how nurses support patients with limited digital health literacy.

## Contribution

The study identifies specific communication changes and nursing practices related to digital health literacy in a hospital setting.

## Key findings

- Health technologies impacted all six functions of nurse-patient communication, improving some areas but challenging others.
- Nurses use intuition, observation, and questioning to identify limited digital health literacy.
- Barriers to supporting patients include high workload and limited knowledge.

## Abstract

In the past decade, the use of health technologies, such as telemonitoring, video consultations, and patient portals, has increased. However, it remains unclear how these technologies have influenced nurse-patient communication. Additionally, little is known about the role nurses play in recognizing and supporting limited (digital) health literacy patients.

This study aimed to explore which health technologies are currently being used in a hospital context and how nurse-patient communication has changed as a result. Furthermore, we sought to identify the practices nurses use and the barriers they experience in recognizing and supporting patients with limited digital health literacy.

This is a qualitative descriptive study that used semistructured interviews with nurses working in a hospital (n=21). The interview guide was partly based on the 6-function model of medical communication by de Haes and Bensing. All interview transcripts were analyzed by 2 independent coders using a combination of deductive and inductive approaches.

According to the nurses, health technologies have impacted all 6 functions of nurse-patient communication. They noted improvements in gathering information, providing information, enabling disease and treatment management, and responding to patients’ emotions. In contrast, technology made fostering the relationship more difficult, and technologies were seldom used in shared decision-making. Nurses identified limited digital health literacy through intuition, observation of verbal and nonverbal cues, and direct questioning. To support patients with limited digital health literacy, nurses relied on building trust, involving the social network, tailoring communication, and offering additional support. High workload and limited knowledge were the main barriers to applying these practices.

Our findings show that health technologies have significantly influenced nurse-patient communication in the hospital setting. The results highlight the need for tailored training programs to strengthen nurses’ competencies in identifying and supporting patients with limited digital health literacy. This is essential to ensure more comprehensible and accessible care and promote equitable patient engagement with health technologies.