The Development of Nurse-patient Relationship Scales in Chronic Care
Bibliographic record
Abstract
Quality of life and well-being of patients living in chronic care (CC) are determined to a considerable extent by the relationships these patients have with nursing personnel caring for them. Given the importance of these relationships, there is an absence of empirical research and measurement tools to assess these relationships from a patient’s perspective. The purpose of this study was to develop and test valid and reliable instruments to determine what qualities of the humanistic relationships between cognitively competent patients and nursing personnel in CC settings were most important to patients and what they experience most. A conceptual framework based on the Humanistic Nursing Theory by Paterson and Zderad (1976) served as a foundation to develop two scales; the Humanistic Relationship Importance Scale (HRIS) assessed what attributes of the relationship are most important, and the Humanistic Relationship Experience Scale (HRES) assessed what attributes of the relationship are experienced. Sixty-nine content relevant items based on six dimensions of the Paterson and Zderad theory were developed and tested for content validity resulting in the deletion of 20 items. Forty patients completed the now 49-item scales to establish their initial internal consistency reliability, test-retest reliability and construct validity. Another 25 items were deleted in the process. The 24-item scales were completed by 249 patients in five CC facilities and the results subjected to a \niii \nprincipal axis analysis (PAA). An oblique rotation resulted in a five factor solution labeled: relational availability, promoting quality of daily life, recognizing and supporting choice, forming connections, and supporting human uniqueness. This was a simplification of the original six dimensions of the Paterson and Zderad theory. A PAA of the 24-item HRES resulted in a one factor solution labeled humanistic connection. Reliability testing of the factors resulted in the deletion of one more item and an HRIS with a Cronbach′s alpha of .87 indicating strong internal reliability and an HRES with a Cronbach′s alpha of .98 suggesting some redundancy of items. Relational availability was rated as the most important factor in the nurse-patient relationship although all factors were important to patients. The mean score of the HRES indicated that patients experience a moderate level of humanistic connection in terms of frequency and intensity with nurses who generally care for them. Findings of this study have contributed to a better understanding of the nurse-patient relationship, and support the care, research, and theoretical knowledge of nurses and patients in these environments.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.050 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".