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The Development of Nurse-patient Relationship Scales in Chronic Care

Quality of life and well-being of patients living in chronic care (CC) are determined to a considerable extent by the relationships these patients have with nursing personnel caring for them. Given the importance of these relationships, there is an absence of empirical research and measurement tools to assess these relationships from a patient’s perspective. The purpose of this study was to develop and test valid and reliable instruments to determine what qualities of the humanistic relationships between cognitively competent patients and nursing personnel in CC settings were most important to patients and what they experience most. A conceptual framework based on the Humanistic Nursing Theory by Paterson and Zderad (1976) served as a foundation to develop two scales; the Humanistic Relationship Importance Scale (HRIS) assessed what attributes of the relationship are most important, and the Humanistic Relationship Experience Scale (HRES) assessed what attributes of the relationship are experienced. Sixty-nine content relevant items based on six dimensions of the Paterson and Zderad theory were developed and tested for content validity resulting in the deletion of 20 items. Forty patients completed the now 49-item scales to establish their initial internal consistency reliability, test-retest reliability and construct validity. Another 25 items were deleted in the process. The 24-item scales were completed by 249 patients in five CC facilities and the results subjected to a
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principal axis analysis (PAA). An oblique rotation resulted in a five factor solution labeled: relational availability, promoting quality of daily life, recognizing and supporting choice, forming connections, and supporting human uniqueness. This was a simplification of the original six dimensions of the Paterson and Zderad theory. A PAA of the 24-item HRES resulted in a one factor solution labeled humanistic connection. Reliability testing of the factors resulted in the deletion of one more item and an HRIS with a Cronbach′s alpha of .87 indicating strong internal reliability and an HRES with a Cronbach′s alpha of .98 suggesting some redundancy of items. Relational availability was rated as the most important factor in the nurse-patient relationship although all factors were important to patients. The mean score of the HRES indicated that patients experience a moderate level of humanistic connection in terms of frequency and intensity with nurses who generally care for them. Findings of this study have contributed to a better understanding of the nurse-patient relationship, and support the care, research, and theoretical knowledge of nurses and patients in these environments.

Identiferoai:union.ndltd.org:TORONTO/oai:tspace.library.utoronto.ca:1807/24691
Date05 August 2010
CreatorsBoscart, Veronique
ContributorsPringle, Dorothy, McGilton, Katherine Simone
Source SetsUniversity of Toronto
Languageen_ca
Detected LanguageEnglish
TypeThesis

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