Development of the Nursing Relationships Scale: a measure of interpersonal approaches in nursing care

Abstract

Background: There is no comprehensive measure of dimensions describing the nursing relationship that is suitable for use with survey samples and that is focused on nursing particular types of patients. The objective of this study was to develop a measure to investigate significant dimensions of the nurse-patient relationship, the Nursing Relationship Scale (NRS).Methods: Hypothetical cases (diabetes or mental illness) in vignette format were presented to 132 psychiatric and 76 general nurses. Thirty-four questions about the nurse-patient interaction were asked. Principal component analyses (with oblique rotation) were used to identify underlying dimensionality in the correlations of items, combining ratings from the two case vignettes. Scales were constructed from the final solution and Cronbach's alpha coefficients calculated. Subscale score variations were analysed across nurse type and patient type to examine the discriminant validity of the subscales.Results: Principal components analysis revealed five dimensions accounting for 52 percent of the variation within items. Four 'conceptual' factors were derived. These were labeled Caring/Supportive Approach, Nursing Satisfaction, Authoritarian Stance, and Negativity. Developed as subscales, reliability analysis indicated high internal consistency with respective alpha coefficients for the diabetes case 0.91, 0.75, 0.65, and 0.78 and for the mental illness case of 0.91, 0.75, 0.73, and 0.85. There was significant variation in scale scores according to nurse type (psychiatric versus general) and patient type (diabetes versus mental illness). Nurses endorsed more highly items from the subscales Caring/ Supportive Approach and Nursing Satisfaction than items from Authoritarian Stance (with intermediate endorsement) and Negativity (lowest endorsement) subscales.Conclusions: Psychometric evaluation of the NRS suggests it is a reliable instrument for measuring four key dimensions of the nurse-patient relationship and enables the study of this relationship in large samples.

Adult Patients’ Satisfaction with Inpatient Nursing Care and Associated Factors in an Ethiopian Referral Hospital, Northeast, Ethiopia

“…Nursing staff are the most numerous professional group and have the greatest contact with patients in comparison with physicians and other healthcare professionals. Therefore, they have significant chance to manipulate patients' attitudes and behaviors' in relation to their treatment, rehabilitation, and recovery process [5,12].…”

Culture and Stigma of Mental Illness: Path Analysis Conducted with Amos in Transcultural Psychiatry in Australia

“…However, apart from Brinn's [11] and Ellsworth's [12] studies, this assumption had not been widely tested. In the present study the Nursing Relationship Scale (NRS) [13] was specifically developed to compare relative nursing care approaches endorsed for a case with mental illness versus a case with diabetes. The former case did attract more negative and less positive practice approach ratings [13].…”

The Application of Problem Based Learning in Undergraduate Nursing Education: A Strategy for Curriculum Reform

“…Critical thinking skill is the fundamental tool required of a nurse besides integrating theory and clinical procedures. In the course of graduating as a nurse, the student through applying critical thinking, specific nursing knowledge, techniques and procedures are enacted through the medium of interpersonal interaction between the nurse and the patient (Ku & Minas, 2010) [16]. This is particularly important in aged care/mental health clinical placements when students encounter patients with various psychological/emotional problems, and physical disability (the elderly ones in particular).…”