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An observational study of the nurse-patient relationship in an oncology setting Lotzkar, Michelle

Abstract

The purpose of this study was to describe the development of a nurse-patient relationship (NPR) in an oncology setting. Although theorists and researchers have attempted to explain the nature of the NPR, and have recognized its potential benefits, further exploration is necessary to increase our understanding of the complexities inherent in NPRs. Using qualitative ethological research methods, videotaped recordings (VTRs) of the interactions between a nurse and patient on an active cancer treatment ward were used to investigate and delineate important features of nurse-patient interactions (NPIs) that reflect the development of a NPR. A sample of sixty videotaped NPIs that represented all the interactions between one patient and one nurse over a three-day period was selected for this study. The data analysis of the VTRs was completed by reviewing all the interactions, identifying behavioral clusters, identifying constituents of behavioral clusters and constructing an ethogram. The findings of this study were validated and extended by using a focus group meeting with clinical nurse experts. Several behavioral clusters were found on each day of this three-day relationship which reflected a dynamic and complex interplay between the nurse and patient. Some patterns of interaction were observed in all three days of the relationship, while others changed as the relationship developed. A dominant theme observed in most of the interaction patterns was the one of humor. The findings of this study suggested active participation of both the nurse and patient in relationship development. The development of this NPR was reflected in the changes observed i n the behaviors of both the nurse and patient over the course of three days. The NPR is complex. Awareness of nurse and patient behaviors that contribute to the development of effective NPRs may challenge oncology nurses to reflect on their own practice and to consciously incorporate behaviors that contribute to effective NPRs into their patient care.

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