Therapeutic communication strategies used by Hong Kong mental health nurses with their Chinese clients

Abstract

Therapeutic communication is central to mental health nursing and through this process nurse-client relationships can be enhanced. In Hong Kong, mental health nurses are educated in 'western' theories and strategies in using therapeutic communication and the field of communication is predominantly Eurocentric. However, the majority of people in Hong Kong are Chinese and little research has been conducted into how Hong Kong nurses communicate with their Chinese clients. This qualitative study focused on identifying the therapeutic communication strategies used by mental health nurses with Chinese clients in Hong Kong. Three case study vignettes with some of the characteristics of Chinese culture were developed to elicit information about the strategies that respondents used in therapeutic communication. The purposive sample of 20 comprised 10 admission ward nurses and 10 community nurses from two psychiatric hospitals. All participants had at least five years post-registration experience. Content analysis revealed categories of communication and theme clusters for the nurses' response to the vignettes. The result showed a unique cultural influence emerged in communication patterns. In view of the scant nature of existing literature and studies in this area, this research provided some valuable data for further studies. Implications for mental health nursing education and practice in Hong Kong are raised, as are implications for nurses working in multicultural countries such as Australia, the UK and the USA, where there are significant numbers of Chinese clients who would benefit from nurses practising with a deeper understanding of communication strategies which are culturally bound.

Family Systems Nursing

“…The nurses who were involving families more tended to be working in the out patient or community mental health care settings. Previous reported research with psychiatric nurses in Hong Kong indicated those working in the community tended to be more consistent in using supportive-expressive, analytic, and consultative approaches than did the nurses working in the acute psychiatric care setting (Arthur et al, 1999). Community mental health nurses also deliver care closer to the context of family than nurses in the acute care setting.…”

“…This may be because many of the educational models taught in the psychiatric nurse education curriculum are adapted from the West and are also individually focused. In addition, psychiatric treatment strategies tend to be didactic and directive, which contradict many of the postmodern ideas evolving in health care today (Arthur, Chan, Fung, Wong, & Yeung, 1999). There is also a predominance of the medical model in the health care system in Hong Kong that has a major influence on nursing.…”

Clients and facilitators’ experiences of participating in a Hong Kong self‐help group for people recovering from mental illness

“…Hong Kong's mental health care system, since its inception has been influenced by British models of institutional care, and until recently little research has been conducted into the unique cultural needs of the majority of clients who are Chinese (Arthur et al 1999). As community focused care begins to take shape in Hong Kong (Health and Welfare Bureau 2000;Hong Kong Government 1991) and mental health workers begin to acknowledge the importance of a model of care which encompasses the needs of local people, in-depth studies are needed to provide an important foundation.…”

Satisfaction Scale for Community Nursing: development and validation

“…Cultural factors influence communication patterns. Chinese people are more submissive and passive in the presence of authority (Wu 1982), and Chinese patients expect a community nurse, as an authority figure, to give expert advice to solve their health problems (Arthur et al. 1999).…”

“…Cultural factors influence communication patterns. Chinese people are more submissive and passive in the presence of authority (Wu 1982), and Chinese patients expect a community nurse, as an authority figure, to give expert advice to solve their health problems (Arthur et al 1999). However, existing satisfaction questionnaires developed in Western countries included items that required patients express their feelings towards the nurses (Gilleard & Reed 1998).…”