The Developing Nurse-Client Relationship: Nurses' Perspectives

Abstract

This descriptive qualitative study of the nurse-client relationship used an interpersonal focus and Leininger's (1985) method of qualitative analysis. The setting was a tertiary care psychiatric hospital in southern Ontario, Canada. Nurses within 10 newly formed dyads participated in interviews. The research questions focused on the nature and progression of the relationship and the identification of helping and hampering influences. Helping influences identified included consistency, pacing, listening, positive initial impressions, and attention to comfort and control. Relationships were hampered by inconsistency, unavailability, client factors related to trust, nurses' feelings about the client, confronta tion of delusions, and unrealistic expectations. Phases consistent with those described by Peplau (1952, 1991) were identified within dyads that progressed well. However, a different set of phases was identi fied in nontherapeutic relationships. (J Am Psychiatr Nurses Assoc [2000]. 6, 3-10.)

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References

Beeber, L.S. , & Bourbonniere, M. (1998). The concept of interpersonal pattern in Peplau's theory of nursing. Journal of Psychiatric and Mental Health Nursing, 5(3), 187-192.

Burd, S. F. , & Marshall, M. A. (Eds.). (1971). Some clinical approaches to psychiatric nursing. London: Macmillan.

Forchuk, C. (1992). The orientation phase: How long does it take? Perspectives in Psychiatric Care, 28(4),7-10.

Forchuk, C. (1993). Hildegard E. Peplau: Interpersonal nursing theory. Newbury Park, CA: Sage.

Forchuk, C. (1994). The orientation phase of the nurse-client relationship : Testing Peplau's theory. Journal of Advanced Nursing Practice , 20, 532-537.

Forchuk, C. , Chan, L. , Schofield, R. , Martin, M.L. , Sircelj, M. , Woodcox, V. , Valledor, T. , Jewell, J. , & Overby, B. (1998a). Bridging the discharge process. Canadian Nurse, 94(3), 22-26.

Forchuk, C. , & Voorberg, N. (1991). Evaluating a community mental health program. Canadian Journal of Nursing Administration, 4(6), 16-20.

Forchuk, C. , Westwell, J. , Martin, M.L. , Bamber-Azzapardi, W. , Kosterewa-Tolman, D. , Hux, M. ( 1998b). Factors influencing movement of chronic psychiatric patients from the orientation to the working phase of the nurse-client relationship on an inpatient unit. Perspectives in Psychiatric Care, 34(1), 36-44.

Hays, J. , & Larson, K. (1963). Interacting with patients. New York: Macmillan.

10.

Hirschmann, M.J. (1989). Psychiatric and mental health nurses' beliefs about therapeutic paradox. Journal of Child Psychiatric Nursing , 2(1), 7-13.

11.

Leininger, M.M. (1985). Ethnography and ethnonursing: Models and modes of qualitative data analysis. In M. M. Leininger (Ed.), Qualitative research methods in nursing. (pp. 33-72). Orlando, FL: Grune & Stratton.

12.

Lemmer, B. (1988). Care plan for a man receiving domiciliary care, Using Peplau's model of nursing. In B. Collister (Ed.), Psychiatric nursing: Person to person (pp. 25-37). London : Edward Arnold.

13.

Martin, M.L. , & Kirkpatrick, H. (1987). Nursing theories used by staff nurses. Hamilton, Ontario, Canada: Hamilton Psychiatric Hospital.

14.

Martin, M.L. , & Kirkpatrick, H. (1989). Nursing theories used by staff nurses: A two year reevaluation. Hamilton, Ontario , Canada: Hamilton Psychiatric Hospital.

15.

Peplau, H.E. (1952). Interpersonal relations in nursing: A conceptual framework of reference for psychodynamic nursing. New York : G. P. Putnam & Sons.

16.

Peplau, H.E. (1991). Interpersonal relations in nursing: A conceptual framework of reference for psychodynamic nursing. New York : Springer.

17.

Peden, A.R. (1993). Recovering in depressed women: research with Peplau's theory. Nursing Science Quarterly, 6(3), 140-6.

18.

Peden, A.R. (1996). Recovering from depression: A one-year follow-up . Journal of Psychiatric and Mental Health Nursing, 3, 289-295.

19.

Peden, A.R. (1998). Evolution of an intervention-The use of Peplau's process of practice-based theory development. Journal of Psychiatric and Mental Health Nursing, 5(3), 173-178.

20.

Price, B. (1998). Explorations in body image: Peplau and practice knowledge. Journal of Psychiatric and Mental Health Nursing , 5(3), 179-186.

21.

Silva, M.C. (1986). Research testing nursing theory: State of the art. Advances in Nursing Science, 9(1), 1-11.

22.

Thompson, L. (1986). Peplau's theory: An application to short-term individual therapy. Journal of Psychosocial Nursing, 24(8), 26-31.

23.

Tudor, G.E. (1952). A sociopsychiatric nursing approach to intervention in a problem of mutual withdrawal on a mental hospital ward. Psychiatry: Journal for the Study of Interpersonal Processes, 15(2). (Reprinted in Perspectives in Psychiatric Care, 8(1), 11-35, 1970.)