From inside the Peplau’s () theory, nursing is understood to be a social, therapeutic process that takes place when benefits, especially knowledgeable to get nurses, engage in therapeutic matchmaking with folks who want fitness characteristics.
During the short term orientation phase, hospitalized clients discover needed help and then try to conform to its current (and sometimes new) event. Among roles that nurses guess within their connections having people, the first character for the direction stage is that off stranger. Very first, nurses are expected so you can anticipate patients toward “admiration and you will positive notice accorded a complete stranger” (Peplau, , p. 44). Clients and you can nurses easily move across this phase and you can nurses need certainly to continue steadily to display using and you can admiration on about three levels. Just chatroulette profile search like the functions of one’s orientation phase was proceeded regarding most other a few phase; in the modern investigation, brand new direction stage was not first hypothesized as a latent factor.
The next thing is the functional phase, which is the reason many nurses’ go out that have customers. Within this phase, nurses build tests on the people to use during training while adding to the fresh new interdisciplinary plan of worry (Peplau, ). Inside functioning stage, the brand new opportunities of nurses become more familiar so you can people; they begin to accept nurses once the fitness educators, financing persons, counselors, and you will care organization. Nurses habit “nondirective paying attention” so you’re able to helps patients’ enhanced awareness of its emotions regarding their altering fitness (Peplau, , p. 43). With this particular healing brand of telecommunications, nurses provide reflective and you will nonjudgmental viewpoints to clients toward purpose out of helping them explain its view. Inside investigation, the working phase is actually operationalized of the measuring the new reviews to the HCAHPS Activities 1, 2, step 3, cuatro, 8, 9, eleven, 13, fourteen, sixteen, and 17 (pick Contour 1 ).
The last stage is the cancellation stage, that’s additionally looked at as discharge think (Peplau, 1992). The prosperity of the fresh new cancellation stage is dependent on how well customers and nurses navigated the latest orientation and dealing phases. A primary area of the cancellation stage happens when nurses show patients regarding the danger sign administration and you will recuperation in the home. Contained in this investigation, new cancellation phase try operationalized because of the measuring the feedback to the HCAHPS Circumstances 19, 20, 23, 24, and you may twenty-five (select Shape 1 ).
Relevant Literature
Nurses contribute enormously to patients’ experiences. The first published, nation-wide evaluation of the HCAHPS, which included data collected over 1 year (2006-2007) from 2,429 hospitals (with a 36% response rate), found that patients who rated their overall experiences as most positive were significantly more likely to have had higher numbers of nurses per patient days (Jha, Orav, Zheng, & Epstein, 2008). Hospital characteristics and HCAHPS ratings were examined using multivariate regression models that adjusted for potential confounding variables such as numbers of beds in hospitals or percentages of patients receiving Medicaid health benefits. The sample was divided into quartiles, and among the quartile reflecting the lowest ratio of nurses to patients, only 60.5% of patients reported the highest global ratings. However, among the quartile reflecting the highest ratio of nurses to patients, 66.7% reported the highest global ratings category (p < .001; the exact value of ? 2 is not reported for this chi-square test).
Peplau theorized one to nursing assistant-patient relationship need go through about three phases in order to be successful: (a) orientation, (b) doing work, and you can (c) termination
Likewise, the HCAHPS items reflecting the communication with nurses’ factor have been found to correspond strongly with patients’ perceptions about their hospital experiences. Investigating the relations between putative factors on the HCAHPS survey with overall patient experience scores, Wolosin, Ayala, and Fulton (2012) found that higher nurse communication factor scores were significantly related to achieving the highest possible overall HCAHPS scores (OR = 1.05; 95% CI not provided; p < .001). This study used binary logistic regression and controlled for age, gender, race, education, preferred language, and self-reported health status of randomly sampled subjects (N = 136,546) and had an overall average response rate of 34%. More recently, a Canadian study that utilized the HCAHPS survey items with 27,492 discharged, English-speaking patients over a 3-year period found that of all the HCAHPS factors, the nurse communication factor had the strongest Pearson correlation with overall experience ratings (r = .45, p < .001) (Kemp, McCormack, Chan, Santana, & Quan, 2015). Additionally, it was found that the factors of pain management, room cleanliness, and room quietness were also significantly related to overall experience ratings (r = .31 to .42, p <.001). These factors largely reflect practices under the influence of nursing.
