Mental health nurses are struggling to describe their nursing identity as professional discipline in a changing mental health care. Measuring nurse-sensitive patient outcomes and demonstrating nursing's effect(s) experienced by patients contribute to (re)discover the specific nursing identity. However, a valid and reliable scale is currently lacking. The aim of this study was the development and psychometric evaluation of the Mental Health Nurse-Sensitive Patient Outcome Scale (MH-NURSE-POS) for inpatient psychiatric hospital settings. This three-staged study resulted in a scale capturing how inpatients experience the contribution of nurses in their treatment in psychiatric hospitals. First, a draft questionnaire was developed based on a literature review, an independent expert's advice, and an experts panel. Second, the content validity was tested in a two-round Delphiprocedure and focus groups with patients. A pilot test, based on cognitive interviews, confirmed the feasibility of the questionnaire. Third, the psychometric properties of the mental health nurse-sensitive patient outcomes were determined in a sample of 353 patients. The cross-sectional study included a convenience sample of five psychiatric hospitals (Belgium). The factor structure (Kaiser-Meyer-Olkin measure of sampling adequacy 0.924; Bartlett's test of sphericity v 2 = 4162.537; df = 231; P < 0.001), convergent validity by the Individualized Care Scale (Pearson correlation 0.660; P < 0.001), and

Accessible Summary What is known on the subject? Psychiatric and/or mental health nurses are struggling to measure the outcomes of the nurse–patient relationship. Collecting nurse‐sensitive patient outcomes is a strategy to provide outcomes of a nurse–patient relationship from patients' perspectives. Because there was no validated scale, the Mental Health Nurse‐Sensitive Patient Outcome‐Scale (six‐point Likert‐scale) was recently developed and psychometrically evaluated. What the paper adds to existing knowledge? This is the first study using the Mental Health Nurse‐Sensitive Patient Outcome‐scale to measure nurse‐sensitive patient outcomes of the nurse–patient relationship in psychiatric hospitals. Moderate to good average scores for the MH‐NURSE‐POS total (4.42) and domains scores (≥4.09). are observed. Especially outcomes related to ‘motivation’ to follow and stay committed to the treatment received high average scores (≥4.60). Our results are consistent with the patient‐reported effect(s) of relation‐based nursing in qualitative research. The scores generate evidence to support the outcomes of the nurse–patient relationship and implicates that further investment in (re)defining and elaborating nurse–patient relationships in mental healthcare is meaningful and justified. More comparative patient‐reported data can determine how nurse‐sensitive patient outcomes are affected by the patient, nurse, and context. What are the implications for practice? Demonstrating patient‐reported outcomes of the nurse–patient relationship can be important to enhance the therapeutic alliance between nurses and patients, organize responsive nursing care, and create nursing visibility in mental healthcare. Further nursing staff training on interpersonal competencies, such as self‐awareness and cultural sensitivity, can be pivotal to achieving the patient‐reported outcomes for inpatients with mental health problems. Abstract Introduction Identifying patient‐reported outcomes of the nurse–patient relationship is a priority in inpatient mental healthcare to guide clinical decision‐making and quality improvement initiatives. Moreover, demonstrating nurse‐sensitive patient outcomes can be a strategy to avoid further erosion of the specialism of psychiatric and/or mental health nursing. Aim/Question To measure nurse‐sensitive patient outcomes of the nurse–patient relationship. Method In a multicentred cross‐sectional study, 296 inpatients admitted to five psychiatric hospitals completed the recently developed and validated Mental Health Nurse‐Sensitive Patient Outcome‐Scale (MH‐NURSE‐POS). The MH‐NURSE‐POS consists of 21 items (six‐point Likert‐scale) in four domains: ‘growth’, ‘expression’, ‘control’, and ‘motivation’. Results Participants displayed moderate to good average scores for the MH‐NURSE‐POS total (4.42) and domain scores (≥4.09). Especially outcomes related to ‘motivation’ to follow and stay committed to the treatment received high average scores (≥4.60). Discussion The results demonstrate that patients perceive the nurs...

Accessible SummaryWhat is already known? The nurse–patient relationship in mental health care is an important focus of mental health nursing theories and research. There is limited evidence about which factors influence nurse‐sensitive patient outcomes of the nurse–patient relationship. This hinders the development, planning, delivering, and quality assurance of the nurse–patient relationship in nursing practice and nursing education. What this paper adds to existing knowledge? To our best knowledge, this is the first study to examine associations between nurse‐sensitive patient outcomes of the nurse–patient relationship and a range of patient characteristics and relationship‐contextual factors. In this study, we found that gender, age, hospital characteristics, nurse availability when needed, nurse contact, and nurse stimulation were associated with the scores on the nurse‐sensitive patient outcome scale. What are the implications for practice? Having insight into the factors associated with nurse‐sensitive patient outcomes of the nurse–patient relationship can help nurses, nursing students, nursing management and also patients to enhance the nurse–patient relationship, trying to influence outcomes of nursing care. AbstractIntroductionThe lack of evidence on patient characteristics and relational‐contextual factors influencing nurse‐sensitive patient outcomes of a nurse–patient relationship is a possible threat to the quality and education of the nurse–patient relationship.AimTo measure nurse‐sensitive patient outcomes of the nurse–patient relationship and to explore the associations between nurse‐sensitive patient outcomes and a range of patient characteristics and relational‐contextual factors.MethodIn a multicenter cross‐sectional study, 340 inpatients from 30 units in five psychiatric hospitals completed the Mental Health Nurse‐Sensitive Patient Outcome Scale. Descriptive, univariate and Linear Mixed Model analyses were conducted.ResultsOverall, patient‐reported outcomes were moderate to good. Female participants, nurse availability when needed, more nurse contact and nurse stimulation were associated with higher outcomes. Age differences were observed for some of the outcomes. Outcomes also varied across hospitals but were not related to the number of times patients were hospitalized or to their current length of stay in the hospital.DiscussionThe results may help nurses to become more sensitive and responsive to factors associated with nurse‐sensitive patient outcomes of the nurse–patient relationship.ImplicationsThe nurse‐sensitive results can support nurses in designing future nurse–patient relationships.