Rev Esc Enferm USP. Apr;17(1) [Nurse-patient therapeutic relationship]. [Article in Portuguese]. Stefanelli MC. PMID: ; [Indexed for . The nurse-patient relationship is conceptualised as a professional, therapeutic relationship, established to meet the needs and health outcomes of the patient. Reprinted January as Therapeutic Nurse-Client Relationship Updated May following amendments to the Protecting Patients Act, (Bill 87).
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". The "bright" relationship involved nurses who validated clients and their feelings.
[Nurse-patient therapeutic relationship].
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. 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". 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. 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.
Developing effective and caring nurse-patient relationships
Letters were chosen from 13 chronically ill clients from Finland. The clients were also interviewed in addition to their letters. The interviews reported that humour played an important role in health. A paralyzed woman said, "Well you have to have a sense of humour if you want to live and survive. You have to keep it up no matter how much it hurts". One participant stated, " A participant said, "For male patients humour is also a way of concealing their feelings.
It's extremely hard for them to admit they're afraid". Patient-centered care also known as person-centered or patient- and family-centered care describes a standard of care that ensures the patient and their family are at the center of care delivery.
Therefore, the aim of this review is to identify strategies to enhance therapeutic interpersonal relationships between patients and health care professionals in the acute care setting.
Methods Integrative review process An integrative review is a research strategy involving the review, synthesis, and critique of extant literature. In addition, the reference lists of potential papers retrieved were examined to identify any further material that met the inclusion criteria. Both versions of British and American spellings were used to construct the search strategy as to reflect a systematic and comprehensive approach.
The concept of therapeutic interpersonal relationships is not confined to any specific time period or type of peer-reviewed publication, and so no limitations were placed on these parameters to ensure a broad and diverse scope of knowledge.
Papers that focused on pediatrics and adolescence were also excluded as this review focused on adult patient—staff interaction.
Developing effective and caring nurse-patient relationships
In addition, papers involving student cohorts were also excluded as were papers that reported solely on satisfaction surveys. Data evaluation The search strategy initially identified papers after removal of duplicates Figure 1. The authors RK and KW independently identified 37 potential papers for inclusion based on titles and abstracts.
The authors RK, KW, and JD independently appraised the 37 identified papers based on the inclusion and exclusion criteria.