In Peplau’s () concept, medical means an interpersonal, therapeutic procedure that takes place when advantages, specifically educated become nurses, practice therapeutic dating with folks who need health functions.
When you look at the short term positioning phase, hospitalized clients understand they require assist and then try to adjust to its newest (and often the latest) knowledge. One of many opportunities that nurses guess within their relations which have customers, the original character from inside the positioning stage would be the fact regarding complete stranger. Very first, nurses are required in order to acceptance people on “regard and you can positive notice accorded a stranger” (Peplau, , p. 44). People and you can nurses rapidly transit this stage and you will nurses have to still display compliment of and you may admiration regarding three phases. As qualities of the direction stage are proceeded regarding the most other several levels; in today’s studies, the fresh new positioning stage was not initially hypothesized to-be a hidden factor.
The next step is the working stage, which makes up more nurses’ date having patients. Contained in this stage, nurses generate assessments regarding people to use through the practise of course adding to the interdisciplinary bundle out-of proper care (Peplau, ). Inside doing work stage, brand new roles off nurses be much more common so you can clients; they start to accept nurses as health educators, financing people, advisors, and care organization. Nurses routine “nondirective hearing” so you’re able to assists patients’ enhanced focus on its emotions about their changing fitness (Peplau, , p. 43). With this particular healing type of interaction, nurses provide reflective and you can nonjudgmental feedback to help you customers on the purpose off helping her or him clarify its view. Within data, the working phase was operationalized because of the computing brand new studies with the HCAHPS Issues step 1, 2, step three, 4, 8, nine, 11, thirteen, fourteen, 16, and you can 17 (get a hold of Profile step one ).
The past phase ‘s the cancellation stage, that’s commonly thought of as release think (Peplau, 1992). The prosperity of the fresh new termination dil mil log in phase is dependant on how good people and you may nurses navigated new direction and dealing stages. A major a portion of the termination stage is when nurses illustrate customers on the danger signal government and you will data recovery at home. Inside data, the latest cancellation stage are operationalized of the measuring the newest feedback into the HCAHPS Activities 19, 20, 23, 24, and you will twenty-five (select Profile 1 ).
Relevant Literary works
Nurses contribute enormously to patients’ experiences. The first published, nation-wide evaluation of the HCAHPS, which included data collected over 1 year (2006-2007) from 2,429 hospitals (with a 36% response rate), found that patients who rated their overall experiences as most positive were significantly more likely to have had higher numbers of nurses per patient days (Jha, Orav, Zheng, & Epstein, 2008). Hospital characteristics and HCAHPS ratings were examined using multivariate regression models that adjusted for potential confounding variables such as numbers of beds in hospitals or percentages of patients receiving Medicaid health benefits. The sample was divided into quartiles, and among the quartile reflecting the lowest ratio of nurses to patients, only 60.5% of patients reported the highest global ratings. However, among the quartile reflecting the highest ratio of nurses to patients, 66.7% reported the highest global ratings category (p < .001; the exact value of ? 2 is not reported for this chi-square test).
Peplau theorized you to definitely nurse-patient relationships need certainly to pass through three phases in order to be successful: (a) direction, (b) functioning, and (c) termination
Likewise, the HCAHPS items reflecting the communication with nurses’ factor have been found to correspond strongly with patients’ perceptions about their hospital experiences. Investigating the relations between putative factors on the HCAHPS survey with overall patient experience scores, Wolosin, Ayala, and Fulton (2012) found that higher nurse communication factor scores were significantly related to achieving the highest possible overall HCAHPS scores (OR = 1.05; 95% CI not provided; p < .001). This study used binary logistic regression and controlled for age, gender, race, education, preferred language, and self-reported health status of randomly sampled subjects (N = 136,546) and had an overall average response rate of 34%. More recently, a Canadian study that utilized the HCAHPS survey items with 27,492 discharged, English-speaking patients over a 3-year period found that of all the HCAHPS factors, the nurse communication factor had the strongest Pearson correlation with overall experience ratings (r = .45, p < .001) (Kemp, McCormack, Chan, Santana, & Quan, 2015). Additionally, it was found that the factors of pain management, room cleanliness, and room quietness were also significantly related to overall experience ratings (r = .31 to .42, p <.001). These factors largely reflect practices under the influence of nursing.