Report (Ed. D.)--Teachers College. / Issued also on microfilm. Includes bibliographical references.

In nursing literature, power is conceptualized as an object transferred, distributed, controlled or conquered by empowerment. In this management care paradigm, the service of care provides power to achieve the product of health. The socio-philosophical framework proposes power as intra-interpersonal set of relationships. Interdisciplinary collaboration allowed discovering power-and-relationships as inseparable mind-body subunits constituting micro and macro health interactions, through a mixed methods instrumental case study. Control and power mechanisms were revealed analyzing body movements and conversations in Case A-15min- and Case B-16.10min- nurse practitioner-patient videotaped encounters. Catalyzed by a hermeneutical music metaphor this thesis proposes relational healing care. Despite interruptions and disruptive postures, nurse practitioners-patients reverse differentials by sharing potentials in simultaneous connections. Power balance is developed by equitable-inequitable communication. Like diverse related tones, nurse practitioner-patient is an Intermelody solving tension continuum in concordance. Health struggles in that way are nothing to be fixed, but healing cycles to be played. / xiv, 436 leaves : ill. ; 29 cm

Communicating With Difficult Patients: Nurses' Perceptions Effective communication is paramount in any nurse-patient relationship. Nurses must develop good interpersonal skills with which to evaluate patient needs, provide therapeutic interaction and obtain mutual goals. The purpose of this study was to describe the variables present in nurses self reported communication with difficult patients.Imogene King provides the theoretical framework for this study using the concept of goal attainment as the basis. The Difficult Patient Assessment Tool (Podrasky & Sexton, 1988) was used to measure communication with difficult patients, along with the addition of an open-ended question. A convenience sample of 25 (40%) R.N.'s and L.P.N.'s from a community hospital in the Midwest was used. The procedures for the protection of human subjects were followed. Descriptive statistics were used to analyze the data.Findings of the study included that nurses perceive difficult patients as demanding, never satisfied, confused, frustrating, female, noncompliant, manipulative and uncooperative. Nurses reacted to the communication that takes place with the difficult patient, with feelings of frustration, incompetence, anger, disgust, anxiety, and at times, "O.K.". Nurses most frequently interact with difficult patients in informative, pragmatic, supportive, prescriptive and catalytic manners. The resulting transaction between the nurse and the difficult patient included feelings of frustration, fright, confusion and hurt.Conclusions were that difficult patients are perceived as making unrealistic demands on the nurses' time, and impair nursing interactions. Nurses' transactions resulted in both positive and negative reactions, depending on the situation, and the reactive patterns of the nurse. Nurses tend to take a more authoritative, rather than a facilitative role in interactions with difficult patients.Implications include the need for learned communication patterns which may or may not be effective in dealing with difficult patients. Effective communication skills involve not only acquired knowledge, but also knowledge of self and one's perceptions and values. Self knowledge of communication patterns, and how to improve on those patterns, might be helpful. / School of Nursing

Job-communication satisfaction and its importance to nursing staff and first-line supervisors is important because people in complex health care delivery systems tend to dehumanize communication (Duldt, 1989, 1990b). The purpose of the study is to determine the level of satisfaction first-line supervisors and staff nurses have of job-communication and interpersonal relationships, and the degree of importance staff members and first-line supervisors place on job-communication and interpersonal relationships within a mid-sized acute care facility in an urban area. The theoretical framework is Duldt's Humanistic Nursing Communication Theory (Hersey & Duldt, 1989).The population was all staff nurses and first-line supervisors employed in inpatient services at a midwest hospital. The sample was comprised of about 231 registered nurses and 61% first-line supervisors who volunteered to answer the Job-Communication Satisfaction Importance Questionnaire (JCSI). The JCSI was developed by B. W. Duldt (1990) based on the work of Downs, Hazen, and Thiry as cited in Duldt (1990a). The procedures for the protection of human subjects were followed.Findings revealed that supervisors and staff nurses were satisfied with aspects of job-communication. Supervisors and staff nurses rated six of the eight topics on the JCSI as important aspects of job-communication. Aspects of job-communication and interpersonal relationships were important to supervisors and staff nurses in the facility studied.The conclusions from the study were: (a) satisfaction with job-communication and interpersonal relationships can be improved, (b) aspects of job-communication and interpersonal relationships identified in the study were important to supervisors and staff nurses. Nursing supervisors are in key positions to influence job -communication satisfaction. Organizations undergoing rapid changes need to develop and maintain communication which is satisfactory to human beings working in the organization. / School of Nursing

Report (Ed. D.)--Teachers College. / Issued also on microfilm. Includes bibliographical references.

Thesis (Ed. D.)--Illinois State University, 1993. / Title from title page screen, viewed February 20, 2006. Dissertation Committee: Dent M. Rhodes (chair), Ray Davidson, Donald Kachur, Rebecca Shaw. Includes bibliographical references (leaves 237-246) and abstract. Also available in print.

M. Curr. / Mental health challenges are a worldwide phenomenon, and more people are experiencing these challenges which are related to the life style and psychological stressors facing them. Addressing this burden is a challenge to health care providers, as some are influenced by their perceptions about mental illness in facing the demands made be society. Registered nurses who are not trained in psychiatric nursing do not have the appropriate background information or skill of how to cope with patients with mental health challenges even if they have undergone an introduction into nursing psychology at college. This increases their fears and anxieties when having to interact with these patients. The aim of this study is thus to explore the experiences of registered nurses in interaction with patients with mental health challenges so as to be able to formulate and describe guidelines to facilitate the registered nurses mental health.

No description available.

Thesis (MCur)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: Disruptive behaviour among health care providers in high stress areas such as the perioperative setting has been linked to negative patient safety. Conflicts of power, role and personality lead to communication failure, which are identified as the leading root cause of medication errors and wrong site surgery. The aim of the study was to explore and describe the factors underlying registered nurse (RN) interactions in a tertiary healthcare perioperative area. A non-experimental, descriptive, exploratory study with self-administered survey using a quantitative approach was used. The total population of N=52 participants working in the perioperative area of a Middle Eastern tertiary healthcare centre were invited to participate in the study and the response rate was n=44, 85%. A structured self-administered questionnaire was used to collect the data. Reliability and validity was assured by means of a pilot study and consultation with nursing experts and a statistician. The Health Research Ethics Committee of the University of Stellenbosch approved the study. Permission for the study to be done in the tertiary care centre was obtained from the Internal Ethical Review Board and the Nursing Executive. Informed written consent was obtained from the participants. Anonymity and confidentiality was respected. The data was analysed with the assistance of a statistician and presented in frequencies, tables and histograms. The responses were compared using Mann-Whitney U test, Kruskal- Wallis ANOVA and Spearman’s Rank correlation, on a 95% confidence level. Only one factor showed a significant result, following Spearman’s Rank correlation that an association exists between work experience and lateral violence (p≤0.045239). The open-ended questions were categorized into themes and respect and communication emerged as factors necessary in teamwork and task management The level of respect and open communication between RNs were seen as important factors for interacting with colleagues in the workplace and if poor, affects team work. An area of concern was the high number of neutral responses to the statements on morale and conflict. Underpinned by the literature and the outcomes of this study, it is recommended that strong leadership is required to implement regular team building activities. Furthermore, perioperative staff should be monitored for emotional fatigue which results from conflict situations in order to avert adverse patient care events. / AFRIKAANSE OPSOMMING: Steurende gedrag onder gesondheidsorgwerkers in hoë gespanne areas soos in die perioperatiewe omgewing, word gekoppel aan negatiewe pasiënt veiligheid. Konflikte van mag, rol en persoonlikheid lei tot mislukking van kommunikasie wat geïdentifiseer word as die hoofoorsaak van foute by die toediening van medikasie en verkeerde plek vir chirurgie. Die doel van die studie was om die faktore te ondersoek en te beskryf wat onderliggend is aan geregistreerde verpleeg (GV) interaksies in ’n tersiêre gesondheidsorg perioperatiewe area. ’n Nie-eksperimentele, beskrywende, ondersoekende studie met ’n self-administrerende opname deur ’n kwantitatiewe benadering, was gebruik. Die totale populasie van N=52 deelnemers wat in die perioperatiewe area van ’n Midde-Oosterse tersiêre gesondheidsorgsentrum werk, was uitgenooi om deel te neem aan hierdie studie en die responskoers was n=44, 85%. ’n Gestruktureerde self-administrerende vraelys was gebruik om die data te kollekteer. Betroubaarheid en geldigheid was verseker deur die gebruik van ’n loodsprojek en konsultasie met verpleegdeskundiges, asook ’n statistikus. Die Gesondheidsnavorsingsetiekkomitee aan die Universiteit van Stellenbosch het die studie goedgekeur. Toestemming vir die uitvoer van die studie by die tersiêre gesondheidssentrum was verkry van die Interne Etiese Oorsigraad en die Uitvoerende Verplegingsbestuur. Ingeligte geskrewe toestemming was verkry van die deelnemers. Anonimiteit en vertroulikheid was gerespekteer. Die data was geanaliseer met die hulp van ’n statistikus en aangebied in frekwensies, tafels en histogramme. Die response was vergelyk deur van Mann-Whitney U-toets, Kruskal-Wallis ANOVA of Spearman se Rangkorrelasie op ’n 95% vertroulikheidsvlak gebruik te maak. Slegs een faktor het ’n beduidende resultaat getoon, dat daar ’n assosiasie bestaan tussen werkservaring en laterale geweld (p≤0.045239), deur Spearman se Rangkorrelasie te volg. Die ope-vrae was gekategoriseer in temas. Respek en kommunikasie het as noodsaaklike faktore vir spanwerk en taakbestuur na vore gekom. Die vlak van respek en ope kommunikasie tussen geregistreerde verpleegsters was gesien as belangrike faktore vir interaksie met kollegas in die werkplek en indien dit swak is, affekteer dit spanwerk. ’n Area van besorgdheid was die hoë aantal neutrale response op die stellings oor moraal en konflik. Ondersteun deur die literatuur en die uitkomste van die studie, word dit aanbeveel dat sterk leierskap vereis word om gereelde spanbou aktiwiteite te implementeer. Verder behoort perioperatiewe personeel gemonitor te word vir emosionele moegheid wat spruit uit konfliksituasies, ten einde nadelige pasiëntsorg af te weer.

The purpose of this study was to determine the various values that influence nurses within the hospital, and ascertain, through comparison, any significant differences between the values of the floor nurse and the values of the emergency room nurse, The value systems (Tribalistic, Egocentric, Conformist, Manipulative, Sociocentric, and Existential) were developed by Clare W. Graves as the "Levels of Psychological Existence." A values test was utilized in order to collect data. The "Values for Nursing" test was administered to 161 nurses in a large metropolitan city in Texas. Specific hypotheses regarding value differences in nursing groups were tested.