The nurse must help clients become aware of what is happening to them. The orientation phase is influenced by the attitude of clients and nurses towards giving and receiving care from a mutual person. The final stage, resolution, involves the termination of the therapeutic interaction and the dissolution of the nurse-client bond. Satisfaction with the therapeutic interaction also depends on the nurse's availability to the ward.
As the interaction continues, the clients should be able to realize that they are part of the whole process. The nurse should not take all the power and authority as this makes the client to be passive recipients of care. Through ongoing assessment, the community psychiatric nurse must be able to understand the clients' behavior (Forman, 1993). A community psychiatric ability. This section attempts to describe the demographic characteristics of the focus group participants. The population for the study was all clients attending Escoval House.
Community Psychiatric Clinic and its five satellite clinics. The focus group took place in one of these clinics.
Clients' Perceptions of Therapeutic Interaction
The findings are presented under two themes, namely, clients' perceptions of the therapeutic interaction and clients' expectations of the therapeutic interactions. Within these themes, a number of sub-themes emerged and these were: nurse-client relationships, therapeutic strategies and outcomes. Findings will be presented according to the categories identified within these sub-themes. The findings in this section will be presented in narrative form.
Nurses' Attitudes
They always say they are busy and want to help others get home.
Nurse's Commitment
Client Involvement/ Participation
The results of the survey show that clients want to be equipped to deal with their problems. Rather, nurses give clients a date by which to return to the clinic. It is important that they do not see us as children, but as people who can also make decisions and are adults.
Most of us are married and we care for other people, so nurses shouldn't think of us as children. They should equip us with knowledge so that we can make decisions about our well-being. I feel like I should be asked when I feel comfortable coming again for a repeat, rather than just being given a date where they don't even know if I'll be free or not.
Clients come to the clinic with a variety of problems that they expect the nurses to help the clients solve. Within the therapeutic interaction, nurses also use the strategy of assessing and monitoring progress to ensure that the interventions and treatment given to clients are effective and result in the clients' well-being. It also emerged under the sub-theme of the relationship that providing information is vital to problem solving and health promotion. Giving information is another strategy that nurses use to equip clients with skills to manage their problems and.
Problem solving
Progress Monitoring and Evaluation
Clients reported that nurses are able to change treatment if it does not help the clients.
Information Giving
People are also ignorant about their illness because they cannot ask nurses for information because of the way they answer questions. If all nurses were polite, then we would have no problems asking for information about our illness.
Fostering of Hope and Encouragement
Clients' perceptions of how nurses treat them have an impact on how clients use services and how they can deal with their problems (empowerment). The findings of the study indicate that clients had their own perceptions regarding how they would be influenced by the nurses interacting with them.
Service Utilization
When nurses do not treat clients well, most of us lose trust in them and are discouraged from seeking treatment. They visit our homes when they see that we are not coming for treatment to find out what is stopping us from coming to receive treatment. When nurses do not treat clients well, most of us lose trust in them and are discouraged from seeking treatment.
Empowerment
Clients' Expectations of Therapeutic Interaction
We should be treated as adults because it annoys you when you are treated like children. They should welcome us and make us feel that there are people who will help us with our problems.
Nurses' Commitment
Client Involvement / Participation
I feel like I need to be asked when I will feel comfortable coming back for a repeat instead of just being given a date where they don't know if I will be free or not. They should make us feel responsible for our recovery by making sure we know what we need to do to get well.
Problem Solving and Identification
Progress Monitoring and Collection of Medication
Sometimes when we tell our problems, I think that we can't be as stressed as we always are when we come to the clinic. Findings indicated that clients had recommendations about what they thought nurses could do to improve the nurse-client interaction at the clinics. Clients reported that it would be very important if they were involved in the quality evaluation of the care they receive at the clinic.
They indicated that clients may not be given enough time because nurses are rushing to complete the large number of clients assigned to only a few nurses. Clients recommend that nurses organize so that there is enough when they come to the clinic. Clients also reported that clients need to be made aware that nurses are also human beings who have different personalities. They indicated that it should be a mutual interaction in which nurses and clients must work together to satisfy each other. Clients also recommended that nurses remember that they are dealing with people with mental illness.
They suggested that when interacting with clients, nurses should understand that clients do not make certain mistakes on purpose. This section will present the findings for demographic analysis for the participants who filled out questionnaires. It will also present results for the clients' responses to perceptions and expectations of therapeutic interaction with nurses at the clinic.
The researcher filled in participants' responses by circling and marking the responses given by the respondents as their perceptions and expectations of therapeutic interaction. The sample consisted of one hundred and sixty participants who all completed the questionnaires, although some questions were left unanswered. Findings of the study show that out of one hundred and sixty participants, 87 participants (45.6%) were female and participants were male.
Marital status
Findings from the study show that the nurses develop rapport with their clients. Nurses' attitudes and nurses' commitment and clients' involvement in their care indicate the type of therapeutic interaction that exists between the nurses and the clients at the clinic. The majority of clients felt that nurses showed them respect during the interaction. The majority of clients reported that the nurses were polite, although a large number of clients also reported that the nurses yelled at them when they made mistakes.
Clients reported that most of the time nurses do not involve them in making decisions or formulating goals for their care. The results of the study show that nurses do not equip clients to deal with their problems. Clients reported that they have no autonomy in decision-making and goals. Clients reported that nurses impose a date on clients to return to the clinic.
One of the approaches that nurses use when helping clients with their problems within the nurse-client relationship is to involve them in their interventions. Clients reported that there is a need for goals to be mutually planned and formulated between nurses and clients. The study findings do not show any relationship between demographic data and customer perceptions. The findings of the study have shown that the nurses in the clinic develop a good rapport with their clients in the interaction during the monthly attendance. Clients reported that nurses greet them and ask them to feel free and comfortable (table 1). Clients have also reported that nurses develop a trusting relationship with clients because they receive the necessary respect from nurses.
Sibeko and Greeff (1995) reported that most of the times when clients tried to approach a psychiatric nurse, the nurses turned the clients away. Findings from the study show that clients reported that the nurses did not involve them in their care. Within therapeutic relationships there is a need for the clients to be involved in choosing the actions to be taken as interventions for their illness.
Clients indicate that nurses do not inform them about the purpose of their visit to the clinic. The majority of clients only know that they come to the clinic to pick up medication. This is especially important because the results of the survey show that only a small proportion of clients have a job.
RESEARCH ETHICS COMMIITEE
I am enrolled as a student at the University of Natal in the School of Nursing, pursuing a master's degree in community health. The title of the study is clients' perceptions of therapeutic interaction with nurses at EscovalHouse Community Psychiatric Clinic.
2 4 . DEC 2002
I am registered as a student at the University of Natal in the School of Nursing, pursuing a taught Master's Degree in Community Health Nursing. The title of the study is clients' perceptions of therapeutic interaction with nurses at Escoval House Community Psychiatric Clinic. I am Macksham Bvumbwe a student undertaking a Masters in Community Health Nursing at the University of Natal, School of Nursing.
This letter asks for your consent to participate in this research study after you have been randomly selected. The purpose of the study is to explore your perceptions and expectations of how nurses interact with you in the Escoval House community. Please answer the questions about your perception and expectation of the therapeutic interaction in the clinic. The researcher will read the questions to you and you will be asked to provide your answers to the questions. The researcher will then record the responses to the questionnaire. No names will be used in this study. No nurse will have access to the responses, the Researcher will store all responses. The findings of this study will be used entirely for academic purposes.
