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Coupé C, Ollagnier-Beldame M. Toward a phenomenology of taking care. Int J Qual Stud Health Well-being 2022; 17:2045671. [PMID: 35291910 PMCID: PMC8933010 DOI: 10.1080/17482631.2022.2045671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Christophe Coupé
- Department of Linguistics, The University of Hong Kong, Hong Kong, China
- Laboratoire DDL, CNRS – University of Lyon, Lyon, France
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Cope JM, Precht MC, Hannah MC, Bennett CC. Naming the Dead: What information do Physical Therapy and Physician Assistant Anatomy Faculty Share With Students? ANATOMICAL SCIENCES EDUCATION 2019; 12:636-644. [PMID: 30661289 DOI: 10.1002/ase.1862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 01/15/2019] [Accepted: 01/16/2019] [Indexed: 06/09/2023]
Abstract
In this novel study, the researchers quantify cadaver information provided to Physical Therapy (PT) and Physician Assistant (PA) anatomy faculty and ask what portion of that information is then shared with students. Descriptive statistics were used to the describe demographics of the study respondents and to report survey responses. The majority (60% or greater) of faculty who teach anatomy to PT and PA students have clinical degrees matching the student groups they teach. Chi-square analysis showed no appreciable difference (P < 0.001) between PT and PA anatomy faculty in the amount of cadaver information they receive or then share with students. There was a difference in the type of cadaver information (identifying vs. non-identifying) that is received and then shared by these faculty. Faculty are more likely to receive non-identifying cadaver information (93%) than identifying information (40%) (P < 0.0001) and share non-identifying information (83%) than identifying information (26%) with students (P < 0.0003). Interestingly, there is no consensus as to whether sharing cadaver information is respectful or disrespectful to those who donate their bodies for anatomy education and research. Further research is warranted into the reasons anatomy faculty withhold cadaver information from students and in the value, if any, for students knowing more about the cadavers they are learning from.
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Affiliation(s)
- Janet M Cope
- Department of Physical Therapy Education, School of Health Sciences, Elon University, Elon, North Carolina
| | | | - Mary C Hannah
- Department of Physical Therapy Education, School of Health Sciences, Elon University, Elon, North Carolina
| | - Cynthia C Bennett
- Department of Physician Assistant Studies, School of Health Sciences, Elon University, Elon, North Carolina
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McAllister S, Robert G, Tsianakas V, McCrae N. Conceptualising nurse-patient therapeutic engagement on acute mental health wards: An integrative review. Int J Nurs Stud 2019; 93:106-118. [PMID: 30908958 DOI: 10.1016/j.ijnurstu.2019.02.013] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 01/18/2019] [Accepted: 02/23/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The review aimed to 1) explore the constituents of nurse-patient therapeutic engagement on acute mental health wards; 2) map factors that influence engagement to the Theoretical Domains Framework and 3) integrate results into a conceptual model of engagement to inform the development of interventions to improve engagement. DESIGN A systematic integrative review using an established framework specific to the integrative review methodology. DATA SOURCES Database searches (CINAHL, PsycINFO, BNI and Cochrane Library) and hand searching identified 3414 articles. After screening, applying eligibility criteria, and quality appraisal, 37 articles were included: n = 27 empirical research studies, n = 10 expert opinion pieces, n = 1 case study and n = 1 theoretical report. REVIEW METHODS Peer-reviewed empirical studies, theoretical reports or expert opinion pieces that explored therapeutic engagement as a stated aim and were conducted in acute mental health inpatient settings from the patient or nurse perspective were included. Data were extracted from the introduction, results and discussion sections of empirical research, and the complete article of theoretical and expert opinion pieces. Data were coded then grouped into subthemes and themes. Data relating to influencing factors were further categorised according to the Theoretical Domains Framework. Results were synthesised into a conceptual model of engagement. RESULTS Five conceptually distinct, but closely related constructs of engagement - called the "Principles of Engagement" - emerged: 1) Understanding the person and their experiences; 2) Facilitating growth; 3) Therapeutic use of self; 4) Choosing the right approach and 5) Authoritative vs. emotional containment. Influences on engagement ranged across all 14 theoretical domains of the Theoretical Domains Framework. CONCLUSION A holistic understanding of the essential components of engagement may make it easier for nurses to recognise what they do, and to do it well. The model can be used to generate testable hypotheses about how and where to target behavioural change interventions. The Principles of Engagement must be reflected in the development of interventions to improve engagement.
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Affiliation(s)
- Sarah McAllister
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, United Kingdom.
| | - Glenn Robert
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, United Kingdom
| | - Vicki Tsianakas
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, United Kingdom
| | - Niall McCrae
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, United Kingdom
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Roberts LC, Burrow FA. Interruption and rapport disruption: measuring the prevalence and nature of verbal interruptions during back pain consultations. ACTA ACUST UNITED AC 2018. [DOI: 10.1080/17538068.2018.1449289] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Lisa C. Roberts
- Faculty of Health Sciences, University of Southampton, Southampton, Hampshire
- Therapy Services Department, University Hospital Southampton (NHS) Foundation Trust, Southampton, Hampshire
| | - Faye A. Burrow
- Faculty of Health Sciences, University of Southampton, Southampton, Hampshire
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Kennedy AB, Patil N, Trilk JL. 'Recover quicker, train harder, and increase flexibility': massage therapy for elite paracyclists, a mixed-methods study. BMJ Open Sport Exerc Med 2018; 4:e000319. [PMID: 29387449 PMCID: PMC5786918 DOI: 10.1136/bmjsem-2017-000319] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2017] [Indexed: 11/04/2022] Open
Abstract
Objectives Massage therapy (MT) enhances recovery by reducing pain and fatigue in able-bodied endurance athletes. In athletes with disabilities, no studies have examined similar MT outcomes, yet participation in sport has increased by >1000 athletes from 1996 to 2016 Olympic games. We examined the effect of MT on pain, sleep, stress, function and performance goals on the bike, as well as quality of life off the bike, in elite paracycling athletes. Methods This is a quasi-experimental, convergent, parallel, mixed-methods design study of one team, with nine paracycling participants, in years 2015 and 2016. One-hour MT sessions were scheduled one time per week for 4 weeks, and then every other week for the duration of the time the athlete was on the team and/or in the study. Closed and open-ended survey questions investigating athlete goals, stress, sleep, pain and muscle tightness were gathered pre and post each MT session, and every 6 months for health-related quality of life. Quantitative analysis timepoints include baseline, 4-6 months of intervention and final visit. Additional qualitative data were derived from therapists' treatment notes, exit surveys, and follow-up emails from the athletes and therapists. Results Significant improvement was found for sleep and muscle tightness; quantitative results were reinforced by athlete comments indicating MT assisted in their recovery while in training. There were no improvements in dimensions measuring quality of life; qualitative comments from athletes suggest reasons for lack of improvement. Conclusion This real-world study provides new information to support MT for recovery in elite paracyclists.
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Affiliation(s)
- Ann Blair Kennedy
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, South Carolina, USA
| | - Nirav Patil
- Department of Quality Management, Greenville Health System, Greenville, South Carolina, USA
| | - Jennifer L Trilk
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, South Carolina, USA
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Delaney KR, Shattell M, Johnson ME. Capturing the Interpersonal Process of Psychiatric Nurses: A Model for Engagement. Arch Psychiatr Nurs 2017; 31:634-640. [PMID: 29179832 DOI: 10.1016/j.apnu.2017.08.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 08/04/2017] [Accepted: 08/06/2017] [Indexed: 12/30/2022]
Abstract
Staff members' engagement with patients is a critical element of inpatient psychiatric care, essential to safety, the hospitalization experience and the development of a culture of care. Currently broad concerns exist around the amount of time inpatient psychiatric nurses expend in patient engagement and the quality of these interactions. In this paper we present a model of engagement that clarifies necessary skills to support the engagement process. The model is based on Peplau's theory of interpersonal relations, patients' ideas on healing elements of psychiatric hospitalization and research on inpatient therapeutic relationships. We are currently using this model for a web-based teaching/learning course to cultivate interpersonal engagement, and to explicate how through operationalizing their inpatient role, nurses support patients in the development of their mental health and well-being.
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Affiliation(s)
- Kathleen R Delaney
- Department of Community, Systems and Mental Health Nursing, Rush University, College of Nursing, 600 S. Paulina St, Chicago, IL 60612, United States.
| | - Mona Shattell
- Department of Community, Systems and Mental Health Nursing, Rush University, College of Nursing, 600 S. Paulina St, Chicago, IL 60612, United States.
| | - Mary E Johnson
- Department of Community, Systems and Mental Health Nursing, Rush University, College of Nursing, 600 S. Paulina St, Chicago, IL 60612, United States.
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Kennedy AB, Munk N. Experienced Practitioners' Beliefs Utilized to Create a Successful Massage Therapist Conceptual Model: a Qualitative Investigation. Int J Ther Massage Bodywork 2017; 10:9-19. [PMID: 28690704 PMCID: PMC5495388 DOI: 10.3822/ijtmb.v10i2.367] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background The massage therapy profession in the United States has grown exponentially, with 35% of the profession’s practitioners in practice for three years or less. Investigating personal and social factors with regard to the massage therapy profession could help to identify constructs needed to be successful in the field. Purpose This data-gathering exercise explores massage therapists’ perceptions on what makes a successful massage therapist that will provide guidance for future research. Success is defined as supporting oneself and practice solely through massage therapy and related, revenue-generating field activity. Participants and Setting Ten successful massage therapy practitioners from around the United States who have a minimum of five years of experience. Research Design Semistructured qualitative interviews were used in an analytic induction framework; index cards with preidentified concepts printed on them were utilized to enhance conversation. An iterative process of interview coding and analysis was used to determine themes and subthemes. Results Based on the participants input, the categories in which therapists needed to be successful were organized into four main themes: effectively establish therapeutic relationships, develop massage therapy business acumen, seek valuable learning environments and opportunities, and cultivate strong social ties and networks. The four themes operate within specific contexts (e.g., regulation and licensing requirements in the therapists’ state), which may also influence the success of the massage therapist. Conclusions The model needs to be tested to explore which constructs explain variability in success and attrition rate. Limitations and future research implications are discussed.
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Affiliation(s)
- Anne B Kennedy
- Department of Biomedical Sciences, Division of Behavioral, Social, and Population Health, University of South Carolina School of Medicine Greenville, Greenville, SC, USA
| | - Niki Munk
- Department of Health Sciences, School of Health and Rehabilitation Sciences, Indiana University, Indianapolis, IN, USA
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Kennedy AB, Cambron JA, Sharpe PA, Travillian RS, Saunders RP. Clarifying Definitions for the Massage Therapy Profession: the Results of the Best Practices Symposium. Int J Ther Massage Bodywork 2016; 9:15-26. [PMID: 27648109 PMCID: PMC5017817 DOI: 10.3822/ijtmb.v9i3.312] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Massage therapists are at times unclear about the definition of massage therapy, which creates challenges for the profession. It is important to investigate the current definitions and to consider the field as a whole in order to move toward clarity on what constitutes the constructs within the profession. PURPOSE To determine how a sample of experts understand and describe the field of massage therapy as a step toward clarifying definitions for massage and massage therapy, and framing the process of massage therapy practice. SETTING A two-day symposium held in 2010 with the purpose of gathering knowledge to inform and aid in the creation of massage therapy best practice guidelines for stress and low back pain. PARTICIPANTS Thirty-two experts in the field of massage therapy from the United States, Europe, and Canada. DESIGN Qualitative analysis of secondary cross-sectional data using a grounded theory approach. RESULTS Three over-arching themes were identified: 1) What is massage?; 2) The multidimensional nature of massage therapy; and 3) The influencing factors on massage therapy practice. DISCUSSION The data offered clarifying definitions for massage and massage therapy, as well as a framework for the context for massage therapy practice. These clarifications can serve as initial steps toward the ultimate goal of creating new theory for the field of massage therapy, which can then be applied in practice, education, research, and policy. CONCLUSIONS Foundational research into how experts in the profession understand and describe the field of massage therapy is limited. Understanding the potential differences between the terms massage and massage therapy could contribute to a transformation in the profession in the areas of education, practice, research, policy and/or regulation. Additionally, framing the context for massage therapy practice invites future discussions to further clarify practice issues.
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Affiliation(s)
- Ann B. Kennedy
- University of South Carolina School of Medicine Greenville, Human Performance Lab, Greenville, SC, USA
| | - Jerrilyn A. Cambron
- Department of Research at the National University of Health Sciences, Lombard, IL, USA
| | | | | | - Ruth P. Saunders
- University of South Carolina Department of Health Promotion, Education, and Behavior, Columbia, SC, USA
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Nygren Zotterman A, Skär L, Olsson M, Söderberg S. District nurses' views on quality of primary healthcare encounters. Scand J Caring Sci 2014; 29:418-25. [PMID: 24806952 DOI: 10.1111/scs.12146] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 04/08/2014] [Indexed: 11/30/2022]
Abstract
Good encounters are fundamental for good and professional nursing care, and can be described as treating patients with respect and protecting their integrity and autonomy. This study describes district nurses' views on quality of healthcare encounters in primary healthcare. A purposive sample of 27 district nurses participated in five focus group interviews. The focus groups interviews were digitally recorded and transcribed verbatim. The interview texts were analysed using a thematic content analysis. The analysis resulted in four themes, including being aware of the importance and difficulties during encounters, being the patient's advocate, being attentive to the unique person and being informed when a meeting turned out poorly. The results show that district nurses believed that encounters formed the basis of their work and it was vital for them to be aware of any difficulties. District nurses found that acting in a professional manner during encounters is the most significant factor, but this type of interaction was sometimes difficult because of stress and lack of time. The district nurses considered themselves to be the patients' advocate in the healthcare system; in addition, the acts of seeing, listening, believing and treating the patient seriously were important for providing good quality care. If a poor encounter occurred between the district nurse and the patient, the district nurses found that it was necessary to arrange a meeting to properly communicate what problems arose during the interaction. The district nurses highlighted that providing an apology and explanation could improve future encounters and establish a better nurse-patient relationship. In conclusion, this study shows the importance of confirming and respecting patients' dignity as the fundamental basis for a good quality encounter in primary healthcare.
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Affiliation(s)
- Anna Nygren Zotterman
- Division of Nursing, Department of Health Science, Luleå University of Technology, Luleå, Sweden
| | - Lisa Skär
- Division of Nursing, Department of Health Science, Luleå University of Technology, Luleå, Sweden
| | - Malin Olsson
- Division of Nursing, Department of Health Science, Luleå University of Technology, Luleå, Sweden
| | - Siv Söderberg
- Division of Nursing, Department of Health Science, Luleå University of Technology, Luleå, Sweden
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Nurjannah I, Mills J, Usher K, Park T. Discharge planning in mental health care: an integrative review of the literature. J Clin Nurs 2013; 23:1175-85. [PMID: 23844598 DOI: 10.1111/jocn.12297] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2013] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To identify the evidence base related to discharge planning in the context of acute and community mental healthcare service provision to ascertain the need for future research. BACKGROUND Discharge planning is an important activity when preparing consumers to transition from hospital to home. The efficiency of discharge planning for consumers living with a mental health issue can influence both the number of future readmissions to acute-care facilities and their quality of life at home. DESIGN An integrative review of the peer-reviewed literature. METHOD This review uses specific search terms and a 21-year time frame to search two key nursing databases CINAHL (Cinahl Information Systems, Glendale, CA, USA) and PSYCHINFO (American Psychological Association, Washington, DC, USA) for research reports investigating the substantive area of enquiry. Hand searches of reference lists and author searches were also conducted. Nineteen peer-reviewed journal articles met the inclusion criteria for this review. RESULTS Research findings about discharge planning for people living with a mental health issue identify the importance of communication between health professionals, consumers and their families to maximise the effectiveness of this process. The complexity of consumer's healthcare needs influences the discharge planning process and impacts on aftercare compliance and readmission rates. There is a limited amount of research findings relating to differences between health professionals and families' perceptions of the level of information required for effective discharge planning, and the appropriate level of involvement of individuals living with a mental health issue in their own discharge planning. Results from this integrative review will inform future research related to this topic. CONCLUSION Discharge planning for consumers living with a mental health issue involves many stakeholders who have different expectations regarding the type of information required and the necessary level of involvement of people living with a mental health issue in this process. RELEVANCE TO CLINICAL PRACTICE Comprehensive discharge planning can result in reduced readmissions to both acute and community mental health services. Understanding the impact of effective communication on the outcomes of discharge planning is an important step in promoting success.
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Affiliation(s)
- Intansari Nurjannah
- School of Nursing, Midwifery and Nutrition, James Cook University, Cairns, Qld, Australia
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Abstract
OBJECTIVE The objective of the study was to assess differences among perceptions of patients, nurses, nursing faculty, and nursing students regarding nurse caring, skill, and knowledge based on attire and level of visible body art. BACKGROUND People often make judgments (positive and negative) based on how a person appears. Given somewhat more flexible dress codes for nurses, we wondered what type of perceptions a variety of stakeholders would have of nurses in different levels of attire. METHOD A descriptive comparative design was used. A convenience sample of 240 patients, nurses, students, and faculty were surveyed regarding their perceptions of a nurse based on appearance. Multivariate analyses of variance were calculated to determine if participants' perception of nurse caring, skill, and knowledge differed by scrub type or level of body art. RESULTS For the entire sample, the nurse wearing the solid scrub was rated significantly more skilled and knowledgeable than a nurse wearing print or T-shirt attire. Students rated the nurse wearing the solid scrub and print scrub significantly more skilled and knowledgeable. They rated the print scrub higher, with faculty rating it lower. Nurses rated the T-shirt attire more caring than faculty. Patients rated the T-shirt attire more skilled than faculty and students. All subjects rated the nurse with the most body art (piercings and visible tattoo) the least caring, skilled, and knowledgeable. Nurses rated the most amount of body art more caring than patients and faculty. Students rated the most amount of body art more caring than patients and faculty. CONCLUSION The conflict between the right to self-expression and professional role expectations during nurse and patient interactions is a difficult one. However, because a nurse's appearance can impact perceptions during an encounter, dress codes in the acute care setting should take this into account. To be perceived as skilled and knowledgeable, nurses should wear a solid colored uniform with limited visible body art.
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Wright KM. Therapeutic relationship: developing a new understanding for nurses and care workers within an eating disorder unit. Int J Ment Health Nurs 2010; 19:154-61. [PMID: 20550638 DOI: 10.1111/j.1447-0349.2009.00657.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The establishment of a positive therapeutic relationship has been widely acknowledged internationally as an intrinsic part of therapy and caring services, even healing and restorative in its own right. In this paper, current understandings of the therapeutic relationship are presented and reconsidered within the context of caring for patients with anorexia in hospital in the UK. The relevance of interpersonal processes and the expectations of care and recovery are re-evaluated and the question posed as to whether these principles can be wholly employed in this setting. The service in which the therapeutic relationship exists (eating disorder services), current understandings of 'therapeutic relationship', responsibility, and tensions that exist in attaining a relationship are examined.
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Affiliation(s)
- Karen M Wright
- University of Central Lancashire, School of Nursing and Caring Sciences, Preston, UK.
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Perspectives of mental health professionals and patients on self-injury in psychiatry: a literature review. Arch Psychiatr Nurs 2008; 22:180-9. [PMID: 18640537 DOI: 10.1016/j.apnu.2007.07.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2007] [Revised: 07/18/2007] [Accepted: 07/20/2007] [Indexed: 11/23/2022]
Abstract
Professionals in psychiatry often encounter patients who injure themselves. To explore the perspectives of mental health professionals and patients on self-injurious behavior and treatment, the authors carried out a literature review. The reviewers found little documented data that elucidated or discussed any shared understanding about self-injurious behavior between patients and professionals or between professionals themselves. Many of the problems experienced in relation to self-injury may be due to this lack of a common view. There were few evidence-based strategies for managing self-injury that received any attention in the literature. Future studies should focus on the development and testing of preventative interventions, putting particular emphasis on effective communication between professionals and patients.
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Speers J. Service user involvement in the assessment of a practice competency in mental health nursing – Stakeholders’ views and recommendations. Nurse Educ Pract 2008; 8:112-9. [DOI: 10.1016/j.nepr.2007.04.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2006] [Revised: 03/13/2007] [Accepted: 04/04/2007] [Indexed: 10/23/2022]
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Abstract
BACKGROUND AND PURPOSE Communication is the most important aspect of practice that health care professionals have to master. The purpose of this study was to measure the content and prevalence of verbal and nonverbal communications between physical therapists and patients with back pain. SUBJECTS Seven physical therapists and 21 patients with back pain participated in this study. METHODS The first interaction following the initial assessment was recorded with a video camera. The outcome measures were the Medical Communications Behavior System (verbal communication) and frequencies of nonverbal behaviors (affirmative head nodding, smiling, eye gaze, forward leaning, and touch). Semistructured interviews were undertaken with the physical therapists to determine the perceived influence of the video camera. RESULTS A total of 2,055 verbal statements were made. Physical therapists spent approximately twice as much time talking as patients, with content behaviors (such as taking history and giving advice) comprising 52% of verbal communications. The most prevalent nonverbal behaviors were touch by physical therapists (54%) and eye gaze by patients (84%). DISCUSSION AND CONCLUSION The prevalence and content of communication can be measured with video analysis and validated tools. Communication is an extremely important but underexplored dimension of the patient-therapist relationship, and the methods described here could provide a useful model for further research and reflective practice.
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Affiliation(s)
- Lisa Roberts
- Physiotherapy Department, Southampton University Hospitals NHS Trust, Southampton, Hampshire, United Kingdom
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Abstract
This paper describes the procedures undertaken in a qualitative study that used nurses' stories to examine the influence of Gestalt therapy training on the professional practice of psychiatric nurses. The paper places narrative research methodologies within a nursing context before introducing narrative inquiry, specifically narrative analysis methodology. Procedures used in the study are subsequently described in sufficient detail to serve as a guide for novice researchers interested in undertaking a narrative analysis study. An exemplar of a storied outcome is provided to evidence the product of the narrative analysis research process. The paper concludes with reflections on the importance of articulating the process of narrative analysis as a means of developing interest and competence in narrative research, and using nurses' stories as a means of exploring, understanding, and communicating nursing practice.
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Affiliation(s)
- Teresa Kelly
- School of Public Health, Faculty of Health Sciences, La Trobe University, Melbourne, Victoria, Australia.
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Abstract
The therapeutic relationship has been considered foundational to psychiatric nursing practice since at least the mid-20th century. However, this does not, in itself, guarantee either its continuity or relevance to current practice. Concepts such as the therapeutic relationship require sustained attention, both in theory and in practice, to illustrate ongoing relevance to the discipline. This paper addresses the therapeutic relationship in psychiatric nursing via aspects of psychoanalytic theory, particularly the notion of transference, as theorized by both Freud and Lacan. Two case fragments provide practice material, through which transference in the nurse-patient relationship is explored. The nurse, in the context of his/her relationship with the patient, a sick stranger, offers both a listening and the potential development of transference. This transference can be experienced, in part, as a form of attachment to the nurse, one that is not regarded pejoratively as dependency. There is the potential, within the nurse-patient relationship, for a psychical holding to develop, one from within which both the patient can speak and transference might arise. It is argued that listening to the patient has the potential to assist the patient and, with the development of transference, can provide the context for important work.
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Affiliation(s)
- A M Evans
- School of Nursing, Deakin University, Burwood, Melbourne, Vic., Australia.
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