Interpersonal skills of nurses in simulated initial interactions with patients
Date
1981
Authors
Hills, Marcia
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Abstract
Nurses' responses to initial interactions with patients were collected by a videotaped simulation in order to provide a descriptive account of their interpersonal skills. The selection of interpersonal skills to be considered followed guidelines described by Carkhuff (1969) and Gerrard (1980) . Those skills selected were empathy, respect, warmth and initiating. In addition , the nurses' statements were categorized into the response mode system of Goodman and Dooley (1976) to describe the types of responses used in interactions with patients. The present study also was concerned with the relationships between these interpersonal skills and both experience and training.
Nurses were selected from general medical - surgical wards in two urban hospitals. Approximately equal numbers were selected for three experience groups - Novice, Intermediate, and Experienced - from among volunteers. Data were collected from two male and 45 female nurses.
Nurses were tested individually with the Behavioral Test of Interpersonal Skills which presented a series of 16 videotaped vignettes of patient situations. Nurses' responses were recorded on audiotape. Scores were independently assigned on five scales and the responses were categorized into the response modes.
The nurses' average scores on both the Gerrard and Carkhuff scales were below the level of 3.0 judged to be minimally facilitative. The scores were particularly low on Gerrard's empathy scale but on the initiating scale they approached a facilitative level . Approximately half of the responses were advisements and information giving. Questioning also was used frequently. In contrast, neither reflection nor self disclosure was used more than 10% of the time despite the view that these modes are particularly appropriate for initial interactions.
In considering years since graduation , it was found that the Novice group scored higher on the empathy scale (p <. 05) and gave more reflection responses (p < . 05) than the other groups. Statistically significant correlations were found between years since graduation and empathy scores (Carkhuff; r = -.42 and Gerrard; r = -.34) , respect scores (r = -.24), number of advisements (r = . 28), and number of reflection responses (r = -.31).
A particularly important interpersonal skills was found aspect of training to be the provision of supervised practice. Nurses who experienced this type of training scored higher on empathy, respect, warmth and initiating than did other nurses (p < .05). These nurses also gave significantly more reflections and fewer advisements that did other nurses.
These results supported the conclusion that the interpersonal skills of many nurses , as measured by the Behavioral Test of Interpersonal Skills, are not consistently at the facilitative level. Typically nurses gave many advisements, provided much information and asked many questions. The patients' perceptions and feelings were often ignored. This pattern of interacting seemed to reflect nurses' emphasis on the technical aspects of providing care. The training of nurses also did not provide for supervised practice and intensive study of interpersonal skills. The approach used in the present study provides a means for assessing these skills and a framework for a training program for nurses.