Assessment of Nurses Knowledge about Therapeutic Communication in Psychiatric Teaching Hospitals at Baghdad City مييقتفراعم نيضرمملا لوح ا يف يجلاعلا لاصتلا يف ةيميلعتلا ةيسفنلا تايفشتسملا داذغب ةنيذم Mr

ةصلاخلا  فلخ ي ثحبلا ة : .تُعَروخلا تَاٌعلا عاىًأ عُوج ٍف نرخشه رىحهو ٍساسأ ءسج ىه طَرولا عه لاصحلاا و ظروولا ةذعب طَرولا عه لصاىخح ت ًلع بجَو ,ٍجلاعلا لاصحلاا ىه اهوهأو قرغ ظروولا ىأ ت  .هلر يمخح  فذهلا ثاظروولا فراعه نُُمح ًلإ تسارذلا فذهح :  لىح  ,ٍجلاعلا لاصحلاا و خسه ذَذحح ٍف ثلاهاعلا ثاظروولل ٍجلاعلا لاصحلاا ثاَى جلاعلا لاصحلاا يُباه ثاللاعلا تفرعه اعَأو تُسفٌلا ثاُفشخسولا .ضروولل لوعلا ةذهو ٍفامثلا يىخسولاو روعلاو ٍ  ةيجهنملا  يه ةرخفلل تُفصو تسارد جَرجأ : 1 / 11 / 5112  ًلإ 1 / 3 / 5112  ٍف جَرجأ تسارذلا , لا ثاُفشخسو لا تُسفٌ لا تُوُلعخ  )داشرلا ,ذشر يبا( ذغب ٍف .دا تٌُع جًىو  تسارذلا يه 84  ظروه نوص ىاُبخسلاا .تسارذلا تٌُع ثافصاىه ًلع اداوخعا اورُخخا تُسفٌلا ثاُفشخسولا ٍف ىىلوعَ ت ثحابلا تطساىب فلاخح يه 28  هظرع نح ىاُبخسلاا تُلاذصه شاُملو .ةرمف  ًلع 12  ابثو رُبخ ث  تًابخسلاا 43 %  رو شاُمه للاخ يه ًو ُ زافلا خا .  جئاتنلا : تبسً ىاب تسارذلا جئاخً ثراشا 25 تبسًو طَروخلا ثاَداذعا اىجَرخ نه % 82.4 فراعه جًاوو تُسفٌلا ثاُفشخسولا ٍف ةربخ نهَذل % تبسٌبو تطسىخه ٍجلاعلا لاصحلااب تملعخولا يُظروولا 28.3 % .  :جاتنتسلاا  سارذلا ججخٌخسا ت  ثاظروولا فراعه ىا جًاو يىخسوب ىخه ػس .ٍجلاعلا لاصحلاا صخَ اه ٍف  ا تايصوتل ,نُلعخلا بُلاسأو تُوُلعخلا جهاٌولا رَىطح ًلإ تسارذلا ٍصىح : و روخسولا نُلعخلا جهاًرب ًلإ فاعَ ٍبَرذحو ٍفُمثح جهاًرب رَىطح .ًفشخسولا ٍف ٌىٌسلا  Abstract: Background: Communication with the patient is an essential part and the common dimension among all nursing care. The nurse communicates with the patient in several ways and the most important one is the therapeutic communication and the nurse must learn to do it well. Objectives: study aims to assess knowledge of nurses concerning therapeutic communication, determine therapeutic communication levels for who works in psychiatric hospitals and find out the relations between the therapeutic communication and age of nurses, educational levels, and time working. Methodology: Descriptive study was carried out from 1-112015 to 1-3 2016, the study was conducted in psychiatric teaching hospitals (Ibn Rushed &Al-Rashad) in Baghdad city. The sample of the study consisted of 48 nurses working in psychiatric hospitals selected according to the criteria of the study sample. A questionnaire was constricted by the researcher. It consist of (64) items. The content validity of the questionnaire was established through penal of 15 experts. Reliability of the study was 83% percentage data was analyzed by Cronbach's alpha. Result: the highest percent 52.1% for educational level was graduated from secondary nursing school; the experiences of nurses in psychiatric hospital, 45.8% are working for five years, the highest present is moderate level in therapeutic communication 64.3%. Conclusion: the study concluded that there were poor levels in nurse’s knowledge about therapeutic communication. Recommendation: The study is recommended to developing the teaching programs and training courses.


INTRODUCTION
Nursing is the corner stone in the health care system, and the nurse is the most important part in it.One hundred and fifty years ago, nurses were unpaid, untrained, and unpopular, but then Florence Nightingale made nursing into a profession.The methods she introduced in the 1850s were copied all over the world, and nowadays, nursing is a career with three -or four -years training, qualifications, grades, unions, and pensions (1,2) .
And more, nurses provide nursing care services for patients and deal with them for 24 hours, seven days a week, so that they are very precious part in this system (1,2) .
Communication with the patient is an essential part and the common dimension among all nursing care.The nurse communicates with the patient in several ways and the most important one is the therapeutic communication .Therapeutic communication is the foundation of professional practice, and the nurse must learn to do it well.It involves the use of carefully selected communication intervention to help patients and families overcome stress and adjust to the unalterable.Therapeutic communication in many aspects of nursing used to giving information's, obtaining information and control the mental state of the patient, it is the biggest part of the nursing care in the psychiatric hospitals, the nurse must be characterized by tactful and the ability to conversation in Psychiatric departments because of unique characteristics of the psychiatric clients or patients those who have a lack of thinking and mental processes, and also reactions (1,3).
According to Model of Shannon he split the communication into several parts includes; the sender, the encoding message or the information, and then send this message by a specific channel, and then received by the recipient, who is analyzing or decoding the message and reacting as a feedback to the sender (2,3,4) .Nurses working in the psychiatric ward their rules when they communicate with the psychiatric clients or patients are encoding the message, and the message should be elaborately, thin sending this message via an appropriate channel in a clear environment as possible (2,4,5) .
Psychiatric hospitals are a unique type of hospitals because the type of patients.Patients and clients are suffering from a mantel illness effecting on them behavioral and reaction with others.This uniquely situation need for a uniquely nurse.Western countries focusing on communication problems and mention it as a care health problem (2,6) .
All in all, therapeutic communication between nurses and clients or patients on the psychiatric hospitals lead to elevate the trust between them, based on this basic of principle, the nurse should have a continuous educational programs to raise the level of knowledge, and the therapeutic communication interaction to develop the nursing care and elevate the health level for thepsychiatric patients and society (3,7) .

OBJECTIVE:
The study aimed to: 1. assess knowledge of nurses concerning therapeutic communication 2. Determine therapeutic communication levels for nurses working in psychiatric hospitals 3. Find out the relations between the therapeutic communication and such variables (age, educational levels, and years of experiences in psychiatric hospital.

METHODOLOGY
Descriptive design is correlation study used to assess the nurses knowledge about therapeutic communication used with psychiatric patients.
The sample of the study consisted of (48) nurses who works in psychiatric hospital in Baghdad city, the main hospitals at Al Rusaffa sector are Ebn-Rushd Psychiatric teaching and Al-Rashad Psychiatric Teaching Hospitals,during the period of 1 st to 12 th November2015 A questionnaire was constructed by the researcher for the purpose of the study it consist of three parts: Part 1. Socio-demographic Data sheet The first part contains information regarding; Gender, age, level of education, total working time in nursing, total time working in the psychiatric hospitals.
Part 11.Nonverbal communication components: This part consisted of 21 items that measure the level of knowledge of nonverbal therapeutic communication nurses as yes or no for answer.
Part III: verbal communication components: This part consisted of 43 items or questions that measure the level of knowledge of verbal therapeutic communication among nurses as yes or no for answer.
The total items was (64), levels are divided to five stages the first level for points in 22 and less and the result is weak; second level take points from 23 to 32 and the result is excepted; third level take points from 33 to 42 and the result is moderate; fourth level take points from 43 to 52 and the result is good; fifth level take points from 53 to 62 and the result is very good.
The Reliability of the study was determined through the use of Cronbach's Alpha by Alpha correlation coefficient.The result revealed that the reliability was 0.83.
An interview technique was used for data collection through the period from 1 to 12 th November2015 after receiving the instructions from the researcher the nurses filling the questionnaire.
Data were analysed through the application of a descriptive statistic is used descriptively by frequency, percentage, summation, and standard deviation (2,6,8) .(1) shows that the highest percent were male in 52.1% and the same results for educational level whom graduated from secondary nursing school; the total period of the participants of nurses working in the psychiatric hospital at 45.8% are working for five years or less in F (22); the highest number for age are 16 at 33.3% they are in age between 41-50 from the study participants.4 show that the highest percent (62.5 %.) were in third level at score from 33 to 42 in moderate level.Table 5 is to compare between the levels of therapeutic communication by using t-test with the age, educational levels, and years of experiences in psychiatric hospital in (P=0.005) and in the all comprises were showed there is no relations between them.

DISCUSSION:
The finding of the present study showed that the majority of participants gander were (52.1%) male.( table 1)and the same results for educational level were graduated from secondary nursing school, this findings are supported by Al Rusaffa directory monthly reports and statistic for nurses (unpublished reports) show that the high number of nurses are male and graduated from the secondary nursing school.According to the total time spend working in psychiatric hospital (45.8%) are working for five years or less ;( 33.3%) are in age between (41-50) years (9).
Table 2 shows the levels of verbal and non verbal therapeutic communication for the nurses revealed that the verbal therapeutic communication is percentage 42.9 at moderate level and the non verbal communication percentage is 57.1 at moderate level, and more the total score result is moderate level and the percentage is 21. 4  Table4 show that the highest percent (62.5 %.) were in third level at score from 33 to 42 In moderate level for all nurses in the sample The Tai report (2006) supports the findings observed in this study.The vast majority of students had a background in the scientific methodology and the practical lessons on communication, but their self evaluation did not support their ability to communicate well (10) .
Table 5 is reveals that there is no relation between the level of education and the level of therapeutic communication in contras the communication skills training for both student and working nurses is an important goal of professional development and training within the nursing profession (8) .andsupported by Cinar (2011) the study showed that the structured

Table 2
shows the test for nurses, the highest score of verbal test was 21-27 degree (moderate) in Ibn Rushed Hospital while 21-27 degree in (moderate) Al Rashad hospital.describe the therapeutic communication levels for the first hospital (Ibn Rushed) and the highest score in nonverbal therapeutic communication is 6 participants and the percentage is 42.9 at moderate level, and 6 participants get the same result at good level; the verbal communication score is 8 participants and the percentage is 57.1 at moderate level; the total score result is 3participants and the percentage is 21.4 at moderate level.The result of therapeutic communication for the second hospital (Al Rashad) are shown the highest score in nonverbal therapeutic communication is 19 participants and the percentage is 55.9 at moderate level; the result of verbal communication is 18 participants and the percentage is 52.9 at moderate level; the total score result is 5 participants and the percentage is 14.7 at moderate level.

Table 3 is
show that the highest level were in third level at score from 33 to 42, moderate were 64.3%.In Ibn Rushed hospital and 61.8 % in score 33 to 42 at Al Rashad hospital

Table
at Ibn Rushed The same results are appeared in Al Rashad at moderate levels.The finding above was supported by a similar previous Asian research by Park, E. & Song (2011) that focused on communication skills of Japanese nurses in hospitals.Table 3 is reveals that most of nurses 61.8 % and 64.3% were in third level (moderate) at score from 33 to 42, from Ibn Rushed and Al Rashad hospital.This finding was reflected in another similar previous Chinese research by LiLi and Lambert (2006) that focused on communication skills in Chinese nurses in Chinese hospitals.