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~ A thesis proposal~
INTRODUCTION
most nursing situations (1). However, in psychiatric/mental health nursing, the interpersonal
interaction is the core of practice (2,3) making the therapeutic relationship a fundamental
element of mental health care (4). Indeed, the therapeutic relationship employed in mental
health care has been associated with therapeutic outcomes across a range of clinical settings
the patient is considered important. It is the interaction that is toward enhancing the client's
well-being, and the client may be an individual, a family, a group or a community. The patient
will experience better health when all their needs are fully considered in the relationship.
Ironically, despite the therapeutic relationship being vital to treatment outcomes, the
formation of a quality therapeutic relationship between the psychiatric/mental health nurse &
the psychiatrist and patient is not an instinctive occurrence and requires great skill to be
established (6). Berg and Hallberg (7) found that caring for people with mental illness
„demands an intensified presence, not allowing one to glide away, close the door or just
disappear‟ (p. 329). The daily work demand requires psychiatric/mental health nurses have
the capacity to handle continually new and unpredictable experiences ( 7). In short,
psychiatric/mental health nurses require specialized skills in order to develop and maintain
therapeutic relationships are elusive (8). Weissmark and Giacomo (9) concluded in their
discussion of measuring therapeutic relationships, that although global rating methods can
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use items such as “warmth” and “judgementalness‟ to distinguish good from poor
relationships, these terms do not specify what the therapist does to establish a therapeutic
relationship. As long as these interpersonal attributes remain vague, opportunities for high
The researcher conducted this study on the responses of schizophrenic patients to the
therapeutic relationship rendered by their psychiatric nurse and their psychiatrist in psychiatric
a. Age
b. Sex
c. Civil Status
d. Educational Attainment
a. Beliefs
b. Feelings
c. Relationships
beliefs, feelings, and relationship as provided by the psych nurse and psychiatrist and
a. Psychiatrist
b. Psychiatric Nurse
CONCEPTUAL FRAMEWORK
terms of beliefs, feelings, and relationship as provided by the psych nurse and psychiatrist
considering the client‟s age, sex, civil status, educational attainment, and number of years
diagnosed as schizophrenics. This also projects the difference of the average perception of
Schizophrenics concerning their belief, feeling, and relationship with their psychiatrist and
psychiatric nurse.
Peplau's theory implies the health care provider's importance in the patient's social
network. Peplau proposes that the relationship between the patient and the primary
healthcare-provider (PHCP) is the basis of therapeutic practice and that every aspect of a
patient's care centers around that relationship (Howk et al., 1998). A positive relationship
between the patient and the PCHP is vital to achieving a positive outcome. This study
conceptualizes the influence of the relationship between schizophrenic clients and their PHCP
as one of the most important factors in determining the prognosis of their illness. In a
therapeutic relationship, the PCHP and a mentally-ill patient come together, identify a problem,
Communication requires honesty and self-scrutiny on the part of the PHCP and the patient.
During interactions with the patient, PCHPs must diligently analyze their own behavior and
assess what their behavior is communicating to the patient. PHCPs need to understand that
their own behavior can facilitate or deter positive health behaviors by the patient.
unconditionally, recognition of the patient‟s readiness for growth, and the shift of power in
the relationship to the patient. This theory will help the researcher to organize and establish
With scheme, nursing researchers follow the major assumption that patient‟s problems
were within the person‟s phenomena and were dealt inside the nurse-patient interaction
studies.
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Her theory is based on reality. It could be tested and observed using pure examination,
METHODS
Research Design
This study was carried out through a quantitative research design that a descriptive
correlational method of inquiry is used. The researcher compared the relationship between
dissimilarity between the mean perception of Schizophrenics concerning their beliefs, feeling,
At intake, the patient‟s average age was 33 6.6 years; 60% were males and 40% were
females.
Setting
The setting of the study was in 2 psychiatric care home facilities in eastern Manila,
namely: Holy Spirit Psychiatric and Custodial Care Home and Grace Halfway Home with a
Measures
The tool used was the Helping Alliance Questionnaire, Patient Version developed by
they may feel or behave in relation to another person, their therapist. They were requested to
consider carefully their relationship with their therapist, and then mark each statement
according to how strongly they agree or disagree. The tool measured the extent
The Alliance Questionnaire, Patient Version is a widely used 19-item questionnaire that
measures the strength of the patient-therapist therapeutic alliance. It is divided into 3 sections:
(1) Belief s with 6 questions, (2) Feelings with 5 questions, and (3) Relationship with 8
question. Each item is rated on a 6-point Likert scale (1 = I strongly feel it is not true, 6 = I
DATA ANALYSIS
Quantitative and correlational analysis was used to explore the question of whether
there was evidence difference between the mean perception of Schizophrenics concerning
their beliefs, feeling, and relationship with their therapist, the psychiatric nurse and the
psychiatrist.
Peplau‟s work for evidence of the existence of a therapeutic relationship, the analysis focused
on the interaction between interviewer and participant reflective of the content of that
“institutionalized” rather than ordinary, everyday conversation in the sense that they were
systematically scheduled and occurred between a health care professional and resident in an
REFERENCES
3. Cleary M, Edwards C, Meehan T. Factors influencing nurse patient interaction in the acute
psychiatric setting: an exploratory investigation. Australian and New Zealand Journal of Mental
Health Nursing. 1999;8:109-116. (s)
5. McCabe R, Priebe S. The therapeutic relationship in the treatment of severe mental illness. A
review of methods and findings International Journal of Social Psychiatry. 2004;50(2):115-128.
(s)
7. Berg A, Hallberg IR. Psychiatric nurses' lived experiences of working with inpatient care on a
general team psychiatric ward. Journal of Psychiatric and Mental Health Nursing. 2000;7:323-
333. (s)
9. Weissmark MS, Giacomo DA. Measuring therapeutic interaction: Research and clinical
applications. Psychiatry. 1995;58(2):173. (s)
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APPENDIX
Sociodemographic Questionnaire
Instructions: These are ways that a person may feel or behave in relation
to another person, their therapist. Consider carefully your relationship
with your therapist and then mark each statement according to how
strongly you agree or disagree. Please mark every one.
1 2 3 4 5 6
Helping Alliance Questionnaire
SD D SD SA A SA
Beliefs
Feelings
Relationship