Patient‐reported outcomes of the nurse–patient relationship in psychiatric inpatient hospitals: A multicentred descriptive cross‐sectional study

Abstract

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...

Associated factors of nurse‐sensitive patient outcomes: A multicentred cross‐sectional study in psychiatric inpatient hospitals

“…Reflection during e.g. in‐depth clinical intervision sessions can enhance nurses' sensitivity for and responsiveness to their role in the nurse–patient relationship and the treatment context, both fundamental to person‐centered care (Desmet et al, 2023; Wheeler, 2013).…”

“…First, based on the comment that 'numbers are easier to check than their origin', referring to the dominance of statistics to scrutinize patients' stories into numerical data of assessment in psychotherapy research, our findings should be interpreted with caution and the use of the MH-NURSE-POS should not be considered as a routine tool for outcome measurement or quality measurement in clinical settings (Desmet et al, 2023;Hyde, 2004). Currently, there is a tension between collecting patient-reported data for knowledge Second, an important limitation of this study is the crosssectional design, which precludes the identification of causal relationships among the different variables.…”

“…However, the variations in scores imply contrasting perceptions of outcomes of the nurse–patient relationship. Considering how the variations in the MH‐NURSE‐POS scores are affected can be helpful for psychiatric and/or mental health nursing to enhance the outcomes of the nurse–patient relationship (Desmet et al, 2023).…”

“…This lack of evidence is a barrier on improving the quality of the nurse–patient relationship in clinical mental health nursing practice and in nursing education (Connell et al, 2022; Coster et al, 2018; González‐Blanch et al, 2021; Moorhead et al, 2018). The lack of evidence is also a threat to guiding clinical‐shared decision‐making, supporting directions in nursing education to improve the therapeutic alliance, improving quality assessment of the nurse–patient relationship, identifying important directions for research (Bladon, 2018; Coster et al, 2018; Desmet et al, 2023; de Bienassis et al, 2022; Lorien et al, 2020). Therefore, measuring nurse‐sensitive patient outcomes of the nurse–patient relationship and its associated factors is an important strategy.…”