Development and psychometric properties of the Therapeutic Relationship Assessment Scale‐Nurse

Abstract

Accessible Summary What is known on the subject? The literature shows a clear relationship between a good therapeutic relationship (TR) and the efficacy of nursing interventions. For the implementation of nursing psychotherapeutic interventions, the initial establishment of a good TR is essential. Several instruments assess the relationship established between the therapist and the patient in psychotherapy. However, no tool has been found to assess the quality of the TR established between the nurse and the patient. What this paper adds to existing knowledge? This study allowed the development and evaluation of the psychometric properties of a scale to assess the TR between the nurse and the patient in a sample of mental health nurses. The developed scale (Therapeutic Relationship Assessment Scale‐Nurse) has psychometric properties that attest its reliability (internal consistency and test–retest) and construct validity as an instrument to assess the quality of the TR established between the nurse and the patient from the nurse's perspective. What are the implications for practice? As the TR is crucial for providing nursing care and, in particular, for implementing nursing psychotherapeutic interventions, the scale developed is a valid tool to assess the quality of the TR established between the nurse and the patient in the perspective of the mental health nurse. The use of instruments to assess the quality of the nurse–patient TR facilitates the identification of the relationship's gaps, which can serve as a basis for improving the relationship itself and the nursing care provision. Abstract IntroductionThe therapeutic relationship (TR) is essential to providing psychiatric and mental health nursing care. Nevertheless, no assessment tools exclusive for assessing nursing TR were found in the literature. AimTo describe and evaluate the psychometric properties (reliability and construct validity) of a scale that allows assessing the quality of TR established between the nurse and the patient. MethodA survey method was adopted, using a convenience sample of 356 mental health nurses. Internal consistency was assessed by Cronbach's alpha and Omega index. ResultsA total of 221 mental health nurses participated in the study (response rate = 62.08%). The scale's final structure has 25 items. Cronbach's alpha was 0.93, ranging from 0.78 to 0.88 for each of the factors. The cumulative variance explained in a four‐factor structure was 71.12%. DiscussionThe Therapeutic Relationship Assessment Scale (TRAS)‐Nurse presents good psychometric properties. In the light of Benner's theory, it can be an useful tool for novice nurses to better understand what aspects they should pay attention to for establishing a successful TR. Implications for PracticeMental health nurses can use the TRAS‐Nurse, thus having a scale available that allows them to self‐assess the quality of TR they establish with their patients.

Psychometric properties of the Turkish version of the therapeutic relationship assessment scale for nurses

“…As a result of EFA, it was seen that the Turkish version of the scale preserved its original structure and had a strong factor structure for the Turkish sample. In the study of Coelho et al (2021), all 25 items had a factor load of at least 0.30 in the sub-dimension.…”

“…The original TRAS-Nurse consists of 25 items (Coelho et al, 2021). It has been reported that the scale can be used in one dimension as well as in four sub-dimensions (Empathy, Self-knowledge, Involvement, Orientation).…”

“…TRAS-Nurse form. The scale, originally developed by Coelho et al (2021), is a valid tool for evaluating the quality of therapeutic rehabilitation established between nurses and patients in terms of mental health nurses. The scale is a five-point Likert-type and consists of 25 items.…”

“…In addition, these scales include therapy-oriented questions, and it was stated that the scales were completed by the patients. Therefore, this study has an effective and important place in determining the therapeutic relationship between patient and nurse (Coelho et al, 2021). Bringing this scale into our language will eliminate an important deficiency.…”

Forensic mental health nurses' experiences of rebuilding the therapeutic relationship after an episode of physical restraint in forensic services in Ireland: A qualitative study

“…Participants' demographic information was obtained through a questionnaire. The quality of the nurse–patient therapeutic relationship from the nurse's perspective was also obtained through The Therapeutic Relationship Assessment Scale–Nurse (TRAS‐Nurse; Coelho et al, 2021). This scale was administered to all participants prior to the interview.…”