Development of Nurse-Client Relationships: What Helps?

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Abstract
BACKGROUND: The orientation phase of the nurse-client relationship may be prolonged when the client has a chronic mental illness. However, there is a lack of information about the factors that influence the duration of the orientation phase or the percep tion of the relationship. OBJECTIVE: The purpose of the study was to identify factors that influenced the progress of the therapeutic relationship during the orientation phase. The correlations be tween demographic variables and the progress in the relationship, specifically the length of time in the orientation phase and the quality of the therapeutic relationship, were examined. STUDY DESIGN: Secondary analysis of data was conducted The original study used a prospective, longitudinal panel design. The study used a nonprobability, purposive sample of 124 newly formed nurse-client dyads. Data were collected multiple time points. RESULTS: Variables related to a shorter orientation phase included longer nurse-client meetings, more total time in such meetings, and shorter previous client hospitaliza tions. The age and experience of the nurse, the age of the client, the total time spent in nurse-client meetings, the number of previous hospital admissions, and the length of time the nurse and client knew one another before working together were factors that influenced the progress of the therapeutic relationship. CONCLUSIONS: Some demographic variables that were related to the progress of the therapeutic relationship, for example, patient age, cannot be altered However, other variables that influence the duration and perception of the nurse-client relation ship can be changed. Thus, organizational and practice changes could be made to facilitate the movement of the nurse-client relationship. (J AM PSYCHIATR NURSES A SSOC [1995J. 1,146-153)