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2002, Number 2

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Salud Mental 2002; 25 (2)

Well-being and medical recovery in the critical care unit: The role of the nurse-patient interaction

Ríos CJL, Sánchez-Sosa JJ

Language: English
References: 36
Page: 21-31
PDF size: 107.11 Kb.


ABSTRACT

In order to examine the effects of a nurse-patient interaction-training program on the perceived well-being and medical recovery of patients in the Critical Care Unit of a second level care hospital, 18 nurses and 120 patients were randomly assigned to either an experimental or a waiting-list group. Training consisted of an intensive eight-week nurse training program which included reading materials, verbal instruction, modeling, role playing, and descriptive feedback (verbal and videotaped). The program sought to establish specific nurse behaviors such as visual contact, greeting the patient, offering help, physical proximity, praising, smiling, verbal requests, comforting touch, and avoiding criticizing, yelling/ scolding and ignoring the patient. The effects of the program were measured in terms of patients’ perceived well-being, pain, level of satisfaction with nurse care, and length of stay in the hospital, as well as instruction following, and approving or thanking nurse behavior. Behavioral recording involved videotaping nurse-patient interaction through a video camera and recorder controlled by an automatic motion detection device which could get activated at any time within the corresponding area. Medical recovery measures included the scales of the Acute Physiology Age Chronic Health Evaluation II (APACHE-II) assessment system, the Glasgow Coma Scale and caregiver estimates of apparent emotional state, independence from life-support equipment, reflexes, wound healing and general clinical stability. In order to assess inter-observer reliability, independent raters examined a random sample of at least one-hour of videotaped nurse-patient interaction in each eighthour hospital shift. Reliability levels exceeded 80% for any given behavioral category or scale estimate. Results consistently indicated both clinical and statistically significant higher scores for the appropriate interaction and recovery measures of experimental participants as compared to those in the waiting-list condition. In view of several measures adopted to mitigate, against some alternative explanations of the results, and the practicality, low cost and effectiveness of the nurse-patient program, its use is recommended in the context of health care facilities and conditions in developing nations.


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