Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 4 uppsatser.

M.Cur. (Psychiatric Nursing) / The psychiatric nurse, as a member of the multiprofessional mental health team, utilises a goal directed approach to assist the psychiatric patient to mobilise resources to promote, restore and maintain his mental health as an integral part of his quest for wholeness. This goal directed approach is the nursing process which comprises assessment, planning, implementing and evaluation. All four steps of the nursing process and the nurse's interaction wi th the patient are dependent upon therapeutic communication between the nurse and the patient to elicit the necessary information so as to be able to formulate the nursing diagnosis, nursing actions and the patients' outcomes. Therapeutic communication remains important as the core of all nurse-patient interactions. Lack of therapeutic communication with the patient can cause conflict in the patient's internal and external environments since he will be unable to communicate his needs and problems and this will delay the mental health promotion, restoration and maintenance phases. Currently much attention is paid to the pharmacological treatment of the patient as more and more sophisticated psychotropic drugs are produced, and yet the other aspect of the patient's treatment which is equally important is neglected, namely his communication during hospitalisation, especially with the psychiatric nurse as she is the person in direct contact with him and should spend most of her time interacting with him.

M.Cur. / Please refer to full text to view abstract

Indiana University-Purdue University Indianapolis (IUPUI) / Technology dependent children such as those who require a feeding tube, tracheotomy or ventilator are a special group of chronically ill children who require complex care on a daily basis. When these children are hospitalized, the accompanying parent and the nurse caring for the child on the inpatient unit must communicate together about the care of the child. Care for the technology dependent child is optimized when parents and nurses both understand the plan of care for the child. To discover the process of parent-nurse communication that results in mutual understanding of the child’s plan of care, a grounded theory study to explore the perspectives of the parents of previously hospitalized technology dependent children was undertaken. The Theory of Shared Communication emerged from the data and illuminates the parent-nurse communication process. The antecedents of the process are respect for own and others expertise. The communication process consists of six communication behaviors; ask, listen, explain, advocate, verify understanding and negotiate roles. The behaviors are nested within each other and all are not necessarily required for the non-linear process to result in the relational outcome of mutual understanding of the child’s plan of care. An integrative review of the literature regarding the process of communication between parents of hospitalized chronically ill children and their nurses shed light on the components of the process, but no study was found that explicated the entire communication process. A subsequent grounded theory study added the perspectives of the nurses to the original theory. No new components of the process were uncovered, but the nurse’s narratives added significantly to our understanding of the communication process. Additionally, parents of currently hospitalized technology dependent children confirmed the propositions of the Theory of Shared Communication.

The purpose of this study was to develop and test a measuring instrument based on the Gibb’s Defensive Communication Climate Paradigm (1961) to assess the communication climate focus of professional nurses in selected public hospitals in the Gauteng province. This focus involves the communication behaviour orientation of the professional nurses and their perceptions of the communication behaviour orientation of their operational managers. The Gibb’s model comprises six bipolar conceptual continuums, namely Evaluation-Description, Control-Problem orientation, Strategy-Spontaneity, Neutrality-Empathy, Superiority-Equality and Certainty-Provisionalism Continuums. The study consisted of a non-experimental design, including a developmental phase and a testing phase. During the developmental phase the researcher developed a measuring instrument (a Semantic Differential Scale questionnaire); used a simple, random sample method to pre-test the instrument; analysed the data by applying Cronbach’s Alpha reliability analysis and refined the instrument. Further refinement of this new instrument by future researchers is recommended. During the testing phase the researcher also used a simple, random sample, consisting of professional nurses (N = 270) from three selected public hospitals in Gauteng; tested the items against the biographical data and the three research questions and analysed the obtained data by utilising both descriptive and inferential statistics. A Delphi panel of experts were involved in both phases of the study. The results of the study indicated that although the respondents had a predominantly supportive communication behaviour orientation, they were more focused on the communication behaviour of their operational managers than on their own. Furthermore, the results indicated no significant differences in the influencing factors: age, tenure (periods in hospital), gender, language and institution (public hospital), in terms of the six conceptual continuums. Significant differences were found only in the factor: unit/ward, indicating that the supportiveness of the communication behaviour of professional nurses could be dependent on their specific work environment. Guidelines aimed at the development of a supportive climate were drawn up for the National Department of Health, Gauteng Department of Health, public hospitals, operational managers and professional nurses. It is recommended that implementation of the newly developed guidelines be pivotal for public hospitals, to refocus their communication climates towards supportive communication. / Health Studies / D. Litt. et Phil. (Health Studies)