The nurse–client relationship is an interaction aimed to enhance the well-being of a "client," It assists nurses to establish a unique perspective regarding the meaning of the patient's . explains that a nurse should apply communication and interpersonal skills to create, maintain, and terminate a nurse-client relationship. Interpersonal relations in nursing. BASIC ELEMENTS: the patient the nurse the interaction between them DEFINITIONS: nursing since every nurse-client relationship is an interpersonal situation in which recurring. INTERPERSONAL RELATIONSHIPS AMONG HOSPITAL NURSES AND clearly defining the activities of each professional role and developing the necessary.
In turn, the scarcity of instruments measuring interpersonal relationship in nursing care makes it difficult to evaluate specific elements of the nursing work that make the interpersonal relationship effective. Therefore, the measurement of interpersonal relationship in nursing care remains an open field for research. The development of an instrument in this area would not only identify the current stage of this interpersonal relationship in nursing care, but it would also provide parameters to improve it, favoring a humanitarian praxis, based on general health promotion, prevention of suffering and improvement of care by allowing a system to monitor the quality of interpersonal relationships.
Thus, the objective of this study was to elaborate an instrument for the measurement of the interpersonal relationship in nursing care through the Item Response Theory IRTand the validation thereof. Method It is a methodological study, with a quantitative approach, delineated from the theoretical, empirical and analytical poles of Psychometrics 9 - In the theoretical pole, the theoretical dimensionality was defined and the constitutive and operational definitions were established.
The items were elaborated and content validation was carried out. These elements were carefully analyzed and the constitutive definitions emerged from them. After elucidating the constitutive definitions, the operational definitions and the items were elaborated, based on an integrative revision 11 and on six focus groups, considering the variety of nursing actions and their contexts, which occurred in the three levels of health care.
The Secondary Care groups were carried out at the Integrated Center for Hypertension and Diabetes ICHDa reference unit for research and care on these diseases, where all its users go through a nursing consultation and health education sections with the nurse. The WCUH is a reference center for high-complex care, human resources training and research development.
The inclusion criteria for the participants were: Those who did not communicate verbally and those who were in isolation for some contagious infectious disease that prevented interaction with the researcher were excluded. The elaboration of the items followed the twelve criteria of psychometry amplitude, balance, behavior, simplicity, clarity, relevance, precision, modality, typicity, objectivity, variety and credibility 9 - The content analysis was performed by nine nurses that are experts in interpersonal relationship.
These were five academics and four clinicians with clinical experience, research and publications on the subject, from four Brazilian states. In order to perform the semantic analysis, the NCIRQ was applied in a pilot test to 66 people in the same locations of the focus groups and considering the same inclusion and exclusion criteria, with 28 people from primary care, 23 from secondary care and 15 from tertiary care. These people were distinct from focus group participants.
The difficulties in understanding the words and expressions present in the items were observed, participants were asked about the need for adjustments, and the adequacy of the response categories of each item was reviewed. Participants in studies for the development of instruments via TRI should have a sample size enough to preserve heterogeneity and achieve respondents covering the entire latent trait, but there is no consensus on the ideal number.
Simulations for the decision of sample size in TRI concluded that subjects in relation to 40, bring results very close to those estimated in larger samples There were 18 participants lost due to incompleteness in the answers to the items, but this was within the expected range. The training was carried out in a private room, in which the objectives of the research were presented, as well as the NCIRQ. On another day, the researchers were accompanied by the research coordinator at one of the data collection sites, where they observed and applied the NCIRQ.
This is an important therapeutic nurse behaviour essential to convey support, understanding and share experiences. Patients are expecting a nurse who will show interest, sympathy, and an understanding of their difficulties. When receiving care patients tend to be looking for more than the treatment of their disease or disability, they want to receive psychological consideration. During hard times, clients are looking for a therapeutic relationship that will make their treatment as less challenging as possible.Communication Skills in Nursing
Many patients are aware that a solution to their problems may not be available but expect to have support through them and that this is what defines a positive or negative experience. Past experiences can help the clinician can better understand issues in order to provide better intervention and treatment. The goal of the nurse is to develop a body of knowledge that allows them to provide cultural specific care. This begins with an open mind and accepting attitude.
Cultural competence is a viewpoint that increases respect and awareness for patients from cultures different from the nurse's own.
Cultural sensitivity is putting aside our own perspective to understand another person's perceptive. Caring and culture are described as being intricately linked. It is important to assess language needs and request for a translation service if needed and provide written material in the patient's language. As well as, trying to mimic the patient's style of communication e. Another obstacle is stereotyping, a patient's background is often multifaceted encompassing many ethic and cultural traditions.
In order to individualize communication and provide culturally sensitive care it is important to understand the complexity of social, ethnic, cultural and economic. This involves overcoming certain attitudes and offering consistent, non-judgemental care to all patients. Accepting the person for who they are regardless of diverse backgrounds and circumstances or differences in morals or beliefs.
By exhibiting these attributes trust can grow between patient and nurse. It includes nurses working with the client to create goals directed at improving their health status.
A partnership is formed between nurse and client. The nurse empowers patient and families to get involved in their health.
To make this process successful the nurse must value, respect and listen to clients as individuals. Focus should be on the feelings, priorities, challenges, and ideas of the patient, with progressive aim of enhancing optimum physical, spiritual, and mental health.
It is stated that it is the nurse's job to report abuse of their client to ensure that their client is safe from harm. Nurses must intervene and report any abusive situations observed that might be seen as violent, threatening, or intended to inflict harm. Nurses must also report any health care provider's behaviors or remarks towards clients that are perceived as romantic, or sexually abusive.
Interviews were done with participants from Southern Ontario, ten had been hospitalized for a psychiatric illness and four had experiences with nurses from community-based organizations, but were never hospitalized.
The participants were asked about experiences at different stages of the relationship. The research described two relationships that formed the "bright side" and the "dark side".
Nurse–client relationship - Wikipedia
The "bright" relationship involved nurses who validated clients and their feelings. For example, one client tested his trust of the nurse by becoming angry with her and revealing his negative thoughts related to the hospitalization. The client stated, "she's trying to be quite nice to me For example, one client stated, "The nurses' general feeling was when someone asks for help, they're being manipulative and attention seeking ". One patient reported, "the nurses all stayed in their central station.
They didn't mix with the patients The only interaction you have with them is medication time". One participant stated, "no one cares. It's just, they don't want to hear it. They don't want to know it; they don't want to listen".
These findings bring awareness about the importance of the nurse—client relationship. Building trust[ edit ] Building trust is beneficial to how the relationship progresses. Wiesman used interviews with 15 participants who spent at least three days in intensive care to investigate the factors that helped develop trust in the nurse—client relationship. Patients said nurses promoted trust through attentiveness, competence, comfort measures, personality traits, and provision of information.
Every participant stated the attentiveness of the nurse was important to develop trust. One said the nurses "are with you all the time.
- Nurse–client relationship
Whenever anything comes up, they're in there caring for you". They took time to do little things and made sure they were done right and proper," stated one participant. One client stated, "they were there for the smallest need. I remember one time where they repositioned me maybe five or six times in a matter of an hour".
The meaning of caring interpersonal relationships in nursing
One said, "they were all friendly, and they make you feel like they've known you for a long time" Receiving adequate information was important to four participants. One participant said, "they explained things.
They followed it through, step by step". Emotional support[ edit ] Emotional Support is giving and receiving reassurance and encouragement done through understanding.
Yamashita, Forchuk, and Mound conducted a study to examine the process of nurse case management involving clients with mental illness. Nurses in inpatient, transitional, and community settings in four cities in Ontario Canada were interviewed. The interviews show the importance of providing emotional support to the patients. One nurse stated that if the client knows "Somebody really cares enough to see how they are doing once a week To them it means the world".
A nurse stated that "We're with the families. We can be with them as oppositional and overly involved and somewhere else in between, and we're in contact with them as much as they want". The study reaffirmed the importance of emotional support in the relationship.
Nursing Care Interpersonal Relationship Questionnaire: elaboration and validation
Humour[ edit ] Humour is important in developing a lasting relationship. Astedt-Kurki, Isola, Tammentie, and Kervinen asked readers to write about experiences with humour while in the hospital through a patient organization newsletter. Letters were chosen from 13 chronically ill clients from Finland. The clients were also interviewed in addition to their letters.