The Relationship Between Intercultural Communication Apprehension and Therapeutic Communication of Nurses in Regional Public Hospital Ward

Cultural differences can influence the communication process in the implementation of nursing care. Nurses must adapt to client cultural differences so that intercultural communication anxiety does not hinder effective therapeutic communication. This research was conducted to determine the relationship between intercultural communication apprehension and therapeutic communication in hospital ward nurses. A correlational quantitative research design with a cross-sectional survey comprising 98 nurse respondents was selected through the total sampling technique. Personal Report of Intercultural Communication Appreciation (PRICA) questionnaire and the therapeutic communication questionnaire showed that intercultural communication apprehension level among nurses was mainly at a moderate level with a total of 69 nurses (70.4%), while nurse therapeutic communication mainly was at good group with a total of 82 nurses (83.7%). The Kendall's Tau-B test showed no significant relationship with a p-value of 0.698. Therapeutic communication may be influenced by other factors such as age, gender, culture and language, education level and length of work described as the respondents' characteristics. Nurses must consider factors influencing therapeutic communication so that services can run well.


INTRODUCTION
Nursing services are implemented holistically, which views the patient as an interrelated biological, psychological, sociocultural, and spiritual unit (Jasemi et al., 2017).Cultural differences between nurses and patients often influence the implementation of nursing care.Research by Fite et al. (2019) found that cultural differences in communication affect therapeutic communication between health workers and patients.
In practice, patients who face intercultural communication barriers with nurses from different cultural backgrounds will need help to receive the information nurses convey in the treatment process (Abdullah et al., 2022).In the process of providing nursing care, some people find it very difficult to communicate with people from other cultures due to barriers in the form of Indonesia is a country with different cultures and languages.This diversity also affects health factors.Ethnic and cultural diversity in society is often encountered by nurses in healthcare settings, especially in hospitals.Long-term care services are also influenced by the ethnic and cultural diversity found in hospitals (Abdullah et al., 2022).This can be seen in nurses who The questionnaire consists of 14 questions, measured using a 5-point Likert scale from 1 "strongly disagree" to 5 "strongly agree".
The total score is from 14 to 70.The longer the time worked, the more experience one gets.The more one's experience, the more one's ability to communicate will also be affected Gender can affect how one thinks, acts, feels, and communicates.
Cultural and language factors can be obstacles that can affect therapeutic communication.Dada differences in language, culture, and religion or beliefs can directly affect patient communication (Alshammari et al., 2019).Besides that, cultural differences are the key barriers to effective therapeutic communication (Amoah et al., 2019).These language differences can affect communication.The researcher believes that implementing good therapeutic communication in the wardroom of the regional public hospital cannot be separated from the respondents' cultural background and language skills (Arumsari et al., 2016).This can be seen from the background of the respondents, who are mostly Javanese and Maduranese, with the majority of the cultural background of the Lumajang people.The same thing also happened to the use of language used by respondents while interacting with clients.Apart from using Indonesian as the national language, some respondents also use other languages, especially Javanese and Maduranese.
Problems can occur when nurses face clients with limited Indonesian language skills, and this can also be exacerbated if the language used between the client and the nurse is different, for example, the client uses Maduranese while the nurse can use Javanese but not Maduranese.
nurses consciously influence their clients and help them better understand themselves through verbal or non-verbal communication (Sherko et al., 2013).Therapeutic communication aims to develop a trusting relationship between nurse and patient to become the foundation to improve the quality of life, maintain health, or treat patient health problems (Zivanovic & Ciric, 2017).
and have a good outlook when interacting with people with different cultural backgrounds.On the other hand, participants with high levels of intercultural communication anxiety tend to have negative feelings about the situation, such as fear, anxiety, and low self-confidence.Based on these results, it can be concluded that the description of intercultural communication apprehension of nurses in the regional public hospital ward room is moderate.The researchers argue that this can be influenced by several factors, namely gender and ethnocentrism, which are influenced by the research location.The research was conducted in the Pandhalungan cultural area, which allowed for cultural assimilation to occur, and the characteristics of the respondents were primarily women.

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was found that there was one male respondent who was considered to have insufficient therapeutic communication.At the same time, no female respondents had insufficient therapeutic communication.Researchers argue this can happen because men tend to communicate less verbally but are more likely to initiate communication and talk about problems directly.In contrast, women tend to share personal information, actively listen and help others express their thoughts.This is in line with the research by (Handayani & Armina, 2018), which explains that gender can influence therapeutic communication.
of a minimum score of 77 and a maximum score of 119.This value was close to the minimum and showed that the cultural competence of ward nurses at the Regional public hospital of the research was low.Based on the results of this study, the low cultural competence of nurses can be a factor affecting the anxiety level of intercultural communication of nurses(Abdullah et al., 2022).In addition, Lumajang Regency, where the research was done, with its geographical factors, gave birth to the Pandhalungan culture, which comes from the assimilation of Javanese, Maduranese and Tengger ethnic cultures.Inter-ethnic interactions lead to the emergence of cultural assimilation in the form of languages and dialects, namely the transition areas of the East Madura dialect with the West Madura dialect, the transition areas of the Maduranese to Javanese languages, the contact areas between the Javanese and the Maduranese languages, the Maduranese language outliers and the Tengger dialect outliers, and areas using the East Javanese dialect(Savitri & Indrawati, 2018).This shows that there is a possibility that the condition every country and even every region within one country.These language differences can affect communication(Arumsari et al., 2016).The existence of Indonesian as the national language can facilitate communication.Even though a small number of people cannot speak Indonesian and can only use regional languages, this can be overcome with the help of nurses or other family members who can use Indonesian and the regional languages used by patients.However, it cannot be denied that the existence of Indonesian as the national or unifying language can affect communication effectiveness.This can be a factor that P.P.F.Za`im, R. Purwandari, K.R.M. Nur.The Relationship Between Intercultural Communication Apprehension and Therapeutic Communication of Nurses in Regional Public levels, can occur due to factors such as gender and the geographical conditions of the research location that influence ethnocentrism, which can affect the level of intercultural anxiety.At the same time, the value of therapeutic communication, which is mainly a reasonable level, can occur due to factors such as age, gender, culture and language, as well as the level of education, which can influence the implementation of therapeutic communication.The results related to the relationship between the two variables can occur due to knowledge factors and research locations that affect ethnocentrism and the language used, which can affect the relationship between the two variables.From this research, it is hoped that it can be used as knowledge for nurses to maintain and improve the implementation of nurse therapeutic communication, improving the quality of health services to clients.ACKNOWLEDGEMENT Researchers would like to thank all parties involved in this research, the Nursing Faculty of the University of Jember, all respondents who are willing to participate and the hospital that allows the implementation of research for the success of this research.

RESULTS AND DISCUSSION Table 1. Average of Numerical Data of Age and Length of Work of Nurses in Regional public hospital Ward General Data Mean (SD) Median (min-max)
Haryono Lumajang ward rooms class I, II and III.This study's exclusion criteria P.P.F.Za`im, R. Purwandari, K.R.M. Nur.The Relationship Between Intercultural Communication Apprehension and Therapeutic Communication of Nurses in Regional Public Hospital Ward 68 DOI: 10.32668/jitek.v11i1.1096

Table 2 .
Average of Numerical Data of Age and Length of Work of Nurses in Regional public hospital Ward

the language that the nurse used in talking to the patient
by nurses who came from the Javanese ethnic group, as much as 48.39%.The respondents of his research show characteristics in which Javanese dominate their cultural or ethnic background, with 100 respondents (92.6%).Researchers assume that the chosen research location influences this study's dominant ethnicity or cultural background (Abdullah et al., 2022).The research was located in the Lumajang district, where geographical factors resulted in the Pandhalungan culture, which was formed from the P.P.F.Za`im, R. Purwandari, K.R.M. Nur.The Relationship Between Intercultural Communication Apprehension and Therapeutic Communication of Nurses in Regional Public Hospital Ward 70 DOI: 10.32668/jitek.v11i1.1096assimilation of Javanese, Maduranese and

Table 3 .
Frequency distribution Of Intercultural Communication Apprehension in RSUD Haryoto Lumajang Ward

Table 4 .
Frequency Distribution of Therapeutic Communication in RSUD Haryoto Lumajang