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PubMed2001

The therapeutic relationship: historical development and contemporary significance.

The therapeutic relationship is a concept held by many to be fundamental to the identity of mental health nurses. While the therapeutic relationship was given formal expression in nursing theory in the middle of the last century, its origins can be traced to attendants' interpersonal practices in the asylum era. The dominance of medical understandings of mental distress, and the working-class status of asylum attendants, prevented the development of an account of mental health nursing based on attendants' relationships with asylum inmates. It was left to Peplau and other nursing theorists to describe mental health nursing as a therapeutic relationship in the 1940s and later. Some distinctive features of colonial life in New Zealand suggest that the ideal of the attendant as the embodiment of bourgeoisie values seems particularly unlikely to have been realized in the New Zealand context. However, New Zealand literature from the 20th century shows that the therapeutic relationship, as part of a general development of a therapeutic discourse, came to assume a central place in conceptualizations of mental health nursing. While the therapeutic relationship is not by itself a sufficient basis for professional continuity, it continues to play a fundamental role in mental health nurses' professional identity. The way in which the therapeutic relationship is articulated in the future will determine the meaning of the therapeutic relationship for future generations of mental health nurses.

History, 19th Century↗
PubMed2004

Attachment theory in health care: the influence of relationship style on medical students' specialty choice.

INTRODUCTION: Converging sources suggest that patient-provider relationships in primary care are generally of greater intensity and duration than those in non-primary care specialties. In this study, we hypothesised that Year 2 medical students whose close relationships were characterised by security and flexibility would be more likely than students who were less comfortable in close relationships to plan to pursue primary over non-primary care postgraduate training. METHODS: We determined the relationship styles and demographic characteristics of 144 Year 2 medical students. We also gathered information regarding their predicted choices of postgraduate training, which were clustered into primary or non-primary care categories. We compared student choices with respect to their interpersonal relationship styles based on attachment theory. RESULTS: Prevalences of attachment styles were similar to those found in the general population, with 56% of students rating themselves as having a secure relationship style. Students with a secure style were more likely to choose primary care (61%) over non-primary care compared to those whose styles were characterised by self-reliance, support-seeking or caution (41% chose primary care). Compared to those with a secure relationship style, students with a cautious style [OR = 5.9 (1.9, 18.7)] and students with a self-reliant style [OR = 2.4 (0.96, 5.9)] were more likely to choose non-primary over primary care, after controlling for gender. CONCLUSIONS: Assessing relationship styles using attachment theory is a potentially useful way to understand and counsel medical students about specialty choice.

Adult↗
PubMedDate not supplied

Relationships among bilingualism, critical thinking ability, and critical thinking disposition.

Evidence exists supporting relationships between bilingualism and many cognitive factors. Research, however, has not been conducted to specifically examine the relationships among bilingualism, critical thinking ability, and critical thinking disposition of baccalaureate nursing students. This cross-sectional study used a pooled, within-bilingual, correlational design to examine such relationships. Specific research questions posed were: (1) is there a statistically significant curvilinear relationship between bilingualism and critical thinking ability, (2) is there a statistically significant curvilinear relationship between bilingualism and critical thinking disposition, and (3) is there a statistically significant relationship between critical thinking disposition and critical thinking ability? A convenience sample of nursing students (N = 111) was administered a French language Cloze Test (C-Test), an English language C-Test, as well as the California Critical Thinking Skills Test, and the California Critical Thinking Disposition Inventory. Multiple regression analysis was used to test the hypotheses. Findings failed to provide sufficient evidence to support the existence of a relationship between either bilingualism and critical thinking ability, or between critical thinking disposition and critical thinking ability. However, there was sufficient evidence to support the existence of a curvilinear relationship between bilingualism and critical thinking disposition. Implications for nursing education are presented.

Adult↗
PubMedDate not supplied

Family-provider relationships and well-being in families with preterm infants in the NICU.

OBJECTIVE: The purposes of this study were the following: (1) to describe maternal perceptions of family-provider relationships in the neonatal intensive care unit (NICU) and (2) to examine associations between maternal perceptions of family-provider relationships in the NICU and well-being in families with preterm infants. DESIGN: The study's design was descriptive and correlational. SETTING: The study took place in 5 NICUs in midwestern United States. PARTICIPANTS: The study included 55 mothers of preterm infants hospitalized in the NICU. MEASURES: Self-report measures: the Family-Provider Relationships Instrument-NICU, Ryff's measure of psychologic well-being, and the General Scale of the Family Assessment Measure. RESULTS: Mothers of preterm infants who depicted their family's relationship with their child's primary health care providers in the NICU as positive and family-centered reported more satisfaction with the care received. In addition, these mothers expressed a greater willingness to seek help from health care providers. When mothers reported a discrepancy between what they wanted the family-provider relationships to be like and what they believed the relationship was like, they were less satisfied with care received. Mothers who wanted and believed they had positive family-centered relationships with providers were more satisfied with the care received and they reported higher levels of psychologic well-being. CONCLUSION: The nature of the relationships that families develop with health care providers in the NICU may have a profound influence on how individuals and families respond to the experience of having a preterm infant. Health care providers who incorporate the key elements of family-centered care into their practice can have a positive influence on well-being in families of preterm infants.

Adolescent↗
PubMed2003

Facilitativeness, conflict, demand for approval, self-esteem, and satisfaction with romantic relationships.

This study is an examination of the extent to which satisfaction with a main current romantic relationship is associated with negative conflict, demand for approval, self-esteem, and the 3 facilitative conditions of unconditional regard, empathy, and congruence. One or more of these conditions have been proposed as important determinants of relationship satisfaction by various relationship-enhancement approaches such as behavioral marital therapy and cognitive-behavioral marital therapy. College students (86 women and 58 men) completed S. S. Hendrick's (1988) Relationship Satisfaction Scale, a measure of negative conflict formulated by the author, R. G. Jones's (1969) Demand for Approval Scale (modified for a particular relationship), M. Rosenberg's (1965) Self-Esteem Scale, and a shortened modified version of G. T. Barrett-Lennard's (1964) Relationship Inventory. Relationship satisfaction was most strongly related to the level of regard and empathy, which is consistent with approaches to relationships that emphasize empathy training.

Adult↗
PubMed1989

Converging evidence for identification of recurrent relationship themes: comparison of two methods.

The therapeutic process is complex, and researchers and clinicians alike search for organizing principles or underlying structures that will reduce this complexity and thereby augment the efficacy of their respective endeavors. As other papers in this issue indicate, one such organizing principle is the concept of a recurring relationship theme that can be identified in the patient's descriptions of current and past relationships, as well as observed in the patient's interaction with the therapist. This concept has its origins in Freud's discovery of the transference phenomenon (1912), wherein the patient reenacts early relationships with significant others in the relationship with the analyst, and in Sullivan's interpersonal theory of psychiatry, with its central tenet that "personality is the relatively enduring pattern of recurrent interpersonal situations which characterize a human life" (1953, pp. 110-11). In the psychoanalytic and interpersonal therapies, these recurrent interpersonal themes, associated with the patient's difficulty in living and characterized as self-defeating and self-perpetuating, can potentially serve three main purposes: diagnosing and describing patients' difficulties, focusing therapeutic interventions, and measuring change on an individual basis. However, until recently, research on transference and rigidity of interpersonal style has been hampered by the lack of objective and clinically relevant measures for quantifying this clinical phenomenon (Kiesler 1986; Luborsky and Spence 1978). Luborsky (1977) developed the first reliable method for operationalizing the transference concept. Since then, as the companion papers in this issue point out, several different methods have been developed (e.g., Gill and Hoffman 1982; Horowitz 1979; Schacht et al. 1984). Although these methods differ in the postulated structural composition or components of the transference theme or recurrent relationship theme, they operate from similar methods of assessment. This paper presents the results of an initial investigation into convergent validity (Cronbach and Meehl 1955) of two of the major relationship theme methods--the Core Conflictual Relationship Theme (CCRT) of Luborsky and colleagues (Luborsky 1977), and the Cyclical Maladaptive Pattern (CMP: formerly called the "dynamic focus") of the Vanderbilt group (Schacht et al. 1984; Schacht and Henry, in press). In our investigation, developers of the approaches independently applied their methods to the same interview with a depressed patient. It was hypothesized that aside from differences due to the structural composition, the two methods would identify a similar relationship theme.

Adult↗
PubMedDate not supplied

Changes over time in sexual and relationship functioning of people with multiple sclerosis.

Relationship and sexual satisfaction among people with multiple sclerosis (MS) has received little research attention. This article reports on a longitudinal investigation of the impact of coping style and illness-related variables among people with MS and the general population on sexual and relationship functioning. Both men (n = 120) and women (n= 201) with MS and men (n = 79) and women (n = 160) from the general population participated in the study at two points in time, 6 months apart. People with MS experienced lower levels of sexual activity, sexual satisfaction, and relationship satisfaction and higher levels of sexual dysfunction. Generally speaking, the time 1 levels of the health and coping variables explained little of the variance in the time 2 sexual and relationship variables. However, sexual activity at time 1 contributed significant unique variance to relationship satisfaction at time 2 for MS men, and coping strategies at time I contributed to relationship satisfaction among general population women at time 2. Furthermore, for those respondents who had been diagnosed with MS for less than 7 years, levels of sexual activity at time 2 were predicted by levels of sexual and relationship satisfaction, as well as levels of sexual activity at time 1. These results suggest that strategies used to cope with illness may not play a major role in sexual and relationship satisfaction. However, an examination of these strategies over a longer time frame is needed.

Adaptation, Psychological↗
PubMed1995

The relationship between contractile force and intracellular [Ca2+] in intact rat cardiac trabeculae.

The control of force by [Ca2+] was investigated in rat cardiac trabeculae loaded with fura-2 salt. At sarcomere lengths of 2.1-2.3 microns, the steady state force-[Ca2+]i relationship during tetanization in the presence of ryanodine was half maximally activated at a [Ca2+]i of 0.65 +/- 0.19 microM with a Hill coefficient of 5.2 +/- 1.2 (mean +/- SD, n = 9), and the maximal stress produced at saturating [Ca2+]i equalled 121 +/- 35 mN/mm2 (n = 9). The dependence of steady state force on [Ca2+]i was identical in muscles tetanized in the presence of the Ca(2+)-ATPase inhibitor cyclopiazonic acid (CPA). The force-[Ca2+]i relationship during the relaxation of twitches in the presence of CPA coincided exactly to that measured at steady state during tetani, suggesting that CPA slows the decay rate of [Ca2+]i sufficiently to allow the force to come into a steady state with the [Ca2+]i. In contrast, the relationship of force to [Ca2+]i during the relaxation phase of control twitches was shifted leftward relative to the steady state relationship, establishing that relaxation is limited by the contractile system itself, not by Ca2+ removal from the cytosol. Under control conditions the force-[Ca2+]i relationship, quantified at the time of peak twitch force (i.e., dF/dt = 0), coincided fairly well with steady state measurements in some trabeculae (i.e., three of seven). However, the force-[Ca2+]i relationship at peak force did not correspond to the steady state measurements after the application of 5 mM 2,3-butanedione monoxime (BDM) (to accelerate cross-bridge kinetics) or 100 microM CPA (to slow the relaxation of the [Ca2+]i transient). Therefore, we conclude that the relationship of force to [Ca2+]i during physiological twitch contractions cannot be used to predict the steady state relationship.

Animals↗
PubMed2004

Ending the doctor-patient relationship in general practice: a proposed model.

BACKGROUND: The doctor-patient relationship in general practice is often viewed by practitioner and patient alike as a long-term 'personal' relationship. Little, however, is known about how such relationships are ended in general practice. METHODS: This paper uses theoretical insights obtained from the sociology and social psychology of social relationships, together with the authors' own empirical work on the removal of patients from GPs' lists, to develop a theoretical model of ending the doctor-patient relationship in general practice. RESULTS: Ending the relationship involves 'breakdown' and 'termination'. 'Breakdown' in the relationship occurs when one party decides that the other has acted in such a way as to threaten that party's identity as a 'good' patient or doctor. 'Termination' may be patient initiated, doctor initiated or by mutual consent. CONCLUSIONS: It is proposed that further research is needed to delineate the rules and rituals governing entry into and maintenance of the doctor-patient relationship in general practice as well as those that govern its ending.

Attitude of Health Personnel↗
PubMed2003

Differences between older men and women in the self-rated health-mortality relationship.

PURPOSE: The aims of this study were to examine differences between older men and women: (a) in the ability of self-rated health to predict mortality, (b) in the effect of different follow-up periods on the self-rated health mortality relationship, and (c) in the relative importance of self-rated health and self-rated change in health in predicting mortality. DESIGN AND METHODS: By using data from the Nottingham Longitudinal Study of Activity and Ageing, the author assessed relationships between self-rated health and self-rated change in health and 4- and 12-year mortality in separate unadjusted and adjusted Cox proportional hazards regression models in men and women. RESULTS: The differences between men and women in the hazard ratios for poor self-rated health were not significant, although there were differences in the explanatory factors. The relationship between self-rated health and short-term and long-term mortality was explained by age and health among men. The relationship between self-rated health and short-term mortality was explained by age, physical and mental health, and physical activity among women. The relationship between self-rated health and long-term mortality was explained by age, physical health, and physical activity among women. The relationship between self-rated change in health and short-term mortality was explained by age among men and women. The relationship between self-rated change in health and long-term mortality was explained by age and physical health among men and women. Social engagement was an independent predictor of short- and long-term mortality among men and women in this study. IMPLICATIONS: The finding that low self-rated health was not an independent predictor of mortality among men or women, contrary to many, but not all, previous studies, may be related to differences in study design and/or across cultures. Further research investigating relationships between self-rated health and mortality and potential explanatory variables should analyze men and women separately and should consider the length of follow-up period. The benefits of individual physical and social activities in reducing mortality merit further investigation.

Age Distribution↗
PubMed1998

Junior faculty members' mentoring relationships and their professional development in U.S. medical schools.

PURPOSE: To determine (1) the prevalence of mentoring relationships for U.S. medical school junior faculty; (2) the quality of these mentoring relationships; (3) any variation by gender or race; and (4) the relationship between mentoring and junior faculty members' perceptions of institutional professional support; research-, teaching-, and clinical-skills development; allocation of time to professional activities; and career satisfaction. METHOD: In 1995 a 177-item survey was mailed to 3,013 full-time faculty at 24 randomly selected U.S. medical schools stratified on an area of medical specialization, graduation cohort, and gender. Mentoring was defined as "dynamic reciprocal relationship between an advanced career incumbent (the mentor) and a junior faculty member (the protégé) aimed at fostering the development of the junior person/protégé." Because mentoring is most crucial for junior faculty, the study focused on mentoring relationships within the previous three years ("recent mentoring") for faculty who were not full professors. Chisquare tests, analysis of variance, and principal-components analysis were used to analyze the data. RESULTS: In all, 1,808 (60%) of the 3,013 faculty surveyed, of whom 72% were junior faculty, returned completed questionaires. Fifty-four percent of the junior faculty had had a recent mentoring relationship. There was no significant difference between the men and the women faculty or between majority and minority faculty in the prevalence and quality of the mentoring relationships. The faculty with mentors rated their research preparation and research skills higher than did the faculty without mentors. Most of the women faculty (80%) and the minority faculty (86%) who had had mentors reported that it was not important to have a mentor of the same gender or minority group. CONCLUSION: Mentoring relationships are prevalent in academic medicine and should be promoted to support the career growth of junior faculty.

Faculty, Medical↗
PubMed1994

Consistent condom use in relationships between seropositive injecting drug users and sex partners who do not inject drugs.

OBJECTIVES: To study how condom use in injecting drug users' (IDU) relationships differs according to whether they are HIV-infected, and to whether their sex partner is an IDU. DESIGN AND METHODS: A total of 317 street-recruited IDU were HIV-antibody tested and interviewed about 421 relationships with particular sex partners. RESULTS: Condoms were consistently (100%) used in sex between partners (during the previous 30 days) in 33% of these relationships, and their use was significantly more frequent in relationships of seropositive IDU and in relationships with non-IDU partners. In relationships between seropositive IDU and non-IDU, consistent condom use was reported to be high (68%); this remained unchanged under multivariate controls. CONCLUSIONS: Self-reported condom use by IDU in New York, with its relatively mature epidemic, appears to be concentrated where it may most reduce the spread of HIV to non-IDU heterosexuals, i.e., in relationships between infected IDU and non-IDU partners. Differential condom use by serostatus and by partners' drug injection should be incorporated into mathematical models of the HIV epidemic. Causes of the high level of condom use in this subset of relationships may include drug injector altruism and pressure by sex partners; prevention programs should develop ways to use both of these factors to motivate increased condom use.

Adult↗
PubMed1999

Sexual risk behaviour among gay men in a relationship.

OBJECTIVE: To examine whether gay men in a relationship have adopted negotiated safety as an HIV risk reduction strategy. METHODS: A confidential, anonymous questionnaire was completed by 1004 gay men attending gyms in central London in September-October 1997. Information was sought on sociodemographic characteristics, HIV testing and sexual risk behaviour. Men reporting unprotected anal intercourse (UAI) in the previous 3 months were classified as 'status-unknown' if they did not know their own HIV status, that of their UAI partner(s) or both. Men who knew their own and their UAI partner's HIV status were classified as 'status-known'. RESULTS: Of the 1004 men surveyed, 986 provided complete information on relationship, personal HIV test history and HIV status of UAI partner. Over half (539) said they were currently in a relationship with another man, of whom 173 reported UAI in the previous 3 months; 140 (80.9%) with their main partner only, 18 (10.4%) with a casual partner only and 15 (8.7%) with both their main and casual partners. Of the 140 men reporting UAI only with their main partner, 62 (44.3%) did not know their own HIV status or that of their partner. Overall, a quarter (26.0%) of the men in a relationship reported UAI only with their main partner in the previous 3 months; 11.5% status-unknown UAI, 14.5% status-known UAI. In a multivariate logistic model, both age and being in a relationship were significantly associated with UAI (status-unknown and status-known). CONCLUSION: Gay men in a relationship, surveyed in central London gyms, have for the most part adopted the first principle of negotiated safety: only to have UAI with their main partner. However, not all have embraced the second principle: to establish HIV seroconcordance. Nearly half the men reporting UAI only with their main partner were unaware of their own HIV status, their partner's or both. As a consequence, more than one in 10 men in a relationship reported high-risk (i.e. status-unknown) UAI with their main partner. Because the study population, from central London gyms, was not randomly selected, these findings may not be generalizable to all gay men in London. Nonetheless, HIV prevention programmes should continue to encourage gay men in a relationship to seek an HIV test and establish seroconcordance if they wish to have UAI with each other.

Adult↗
PubMed2005

Excellence through evidence: securing collegial/collaborative nurse-physician relationships, part 1.

Multiple nurse-physician (RNMD) relationships coexist on hospital units; collegial and collaborative (C/C) relationships positively impact, more than others, patient outcomes. The goal of this multisite evidence-based management practice initiative was to identify structures that enable C/C RNMD relationships. In part 1, the authors discuss the methodology and selection of the sample of 141 physicians, managers, and staff nurses from 44 clinical units in 5 hospitals that had previously demonstrated extensive C/C RNMD relationships. These 141 experts were interviewed to identify structures enabling C/C RNMD relationships. Part 1 presents the structures that enable C/C RNMD relationships as described and tested in the literature, as well as a description of the characteristics of the clinical units, experts, and C/C RNMD relationships found in this study. In part 2, the structures identified by the experts as needed for securing C/C RNMD relationships will be presented, along with suggestions for attainment.

Adult↗
PubMed2000

The relationship between %HRpeak and %VO2peak in patients with chronic obstructive pulmonary disease.

PURPOSE: The relationship between the percent peak oxygen consumption (%VO2peak) and percent peak heart rate (%HRpeak) has been suggested as a method for exercise prescription. According to the American College of Sports Medicine (ACSM), 50, 60, 80, and 85% of VO2peak represent 62, 70, 85, and 90% of HRpeak, respectively. Recent research with young healthy adults has shown that this relationship is not as ACSM suggests. Furthermore, it has been suggested that this relationship be examined in populations with low functional capacity. METHODS: The present study evaluated the relationship between %HRpeak and %VO2peak in 125 patients with chronic obstructive pulmonary disease before and then after 3 months of exercise intervention. RESULTS: The mean percentages of HRpeak for the COPD patients at baseline were 70, 76, 87, and 90% at 50, 60, 80, and 85% of VO2peak. Percentages of HRpeak at 50, 60, and 80% of VO2peak were significantly different from those suggested by ACSM. The mean percentages of HRpeak after the 3-month exercise intervention were 71, 77, 87, and 90% at 50, 60, 80, and 85% of VO2peak. Percentages of HRpeak at 50, 60, and 80% of VO2peak were significantly different from those suggested by ACSM. There were no significant differences between the slopes and the intercepts of the two equations used to describe the relationship between %HRpeak and %VO2peak. Therefore, we pooled the data from the pre- and post-intervention tests to form the following equation to describe the relationship between %HRpeak and %VO2peak for COPD patients: %HRpeak = 0.55 (+/- 0.01)%VO2peak + 43.2 (+/- 1.4). CONCLUSION: In conclusion, the relationship between %HRpeak and %VO2peak described by ACSM is not applicable to patients with COPD. Furthermore, this relationship does not change with exercise training and can be described by a single equation.

Aged↗
PubMedDate not supplied

Moderating effects of coping on the relationship between stress and the development of new brain lesions in multiple sclerosis.

OBJECTIVE: Many patients with multiple sclerosis (MS) report that stress can trigger disease exacerbations. Considerable research has supported a relationship between stress and both clinical exacerbation and the development of new brain lesions. However, these relationships are not always consistent either within patients or across patients, suggesting the presence of moderators. This study examined the hypothesis that coping moderates the subsequent relationship between stress and the development of new brain lesions in MS. METHODS: Thirty-six patients (mean age = 44.4; 22 women, 14 men) with relapsing forms of MS were assessed once every 4 weeks for 28-100 weeks. New brain lesions were identified using monthly Gd+ MRI. Stress was measured within 24 hours before MRI using a modified version of the Social Readjustment Rating Scale that assessed Conflict and Disruption in Routine. Coping was measured at baseline using the Coping with Health Injuries and Problems questionnaire, which produces four scales: distraction, instrumental, palliative, and emotional preoccupation. Data were analyzed using mixed effects logistic regression to account for within-subject correlations. Analyses were lagged such that stress assessments predicted new Gd+ MRI brain lesions 8 weeks later. RESULTS: As reported previously, stress was significantly related to the development of new Gd+ brain lesions 8 weeks later (OR = 1.62, p =.009). Greater use of distraction was found to be a significant moderator of the relationship between stress and new Gd+ lesions (OR = 0.69, p =.037) such that greater use of distraction was associated with a decreased relationship between stress and new Gd+ lesions. Increased instrumental coping was marginally associated with a decreased relationship between stress and new Gd+ lesions (OR = 0.77, p =.081), while increased emotional preoccupation was marginally associated with an increased relationship between stress and new Gd+ lesions (OR = 1.46, p =.088). There was no significant moderating effect for palliative coping (p =.27) and no significant main effects for any coping variables and the subsequent development of new Gd+ brain lesions (p values >.21). CONCLUSIONS: These findings provide modest support for the hypothesis that coping can moderate the relationship between stress and the MS disease activity. Several limitations in this study are discussed. While these findings suggest areas of potentially fruitful research, readers are cautioned that these are preliminary results; inferences regarding the clinical importance of these findings are premature.

Adaptation, Psychological↗
PubMed1993

Atopy in childhood. III. Relationship with pulmonary function and airway responsiveness.

The relationship between atopy and pulmonary function in children, and how these relate directly or indirectly to airway hyperresponsiveness, is uncertain. We have examined these relationships in a sample of 13-year-old children. A questionnaire on respiratory symptoms, skin-prick tests to 11 common allergens, spirometry and an abbreviated methacholine challenge test were completed by 662 members (341 boys) of a birth cohort of New Zealand children followed longitudinally to age 13. There was a significant relationship between the presence and degree of atopy, and baseline pulmonary function. Low FEV1/VC ratios were associated with a greater likelihood of airway responsiveness, not only in subjects with diagnosed asthma, but also in the full cohort and in the sub-group of 426 children who denied asthma or current wheeze. The relationships between baseline FEV1/VC and airway responsiveness were stronger in atopic than in non-atopic children, with the strongest relationships in children sensitive to house dust mite and/or cat dander. In the presence of atopy, progressively lower levels of lung function were strongly associated with a higher prevalence of airway responsiveness (P<0.001). In non-atopic subjects, only those with the most impaired lung function (FEV1/VC < 75%) showed any substantive prevalence of airway responsiveness. The relationship between the degree of atopy and the FEV1/VC ratio, although significant in univariate analysis, became completely non-significant after accounting for airway responsiveness. In 13-year-old children, atopy, especially to house dust mite and cat dander, was correlated with pulmonary function expressed as FEV1/VC ratio. Airway responsiveness likewise correlated with impaired baseline lung function. The apparent relationship of lung function to atopy occurred primarily as a result of the relationship between atopy and airway responsiveness. Atopy and impaired lung function were additive factors predicting airway responsiveness.

Adolescent↗
PubMed2006

Psychiatric nurses' perceptions of the constituents of the therapeutic relationship: a grounded theory study.

Psychiatric nursing is invariably linked with a therapeutic role; however, the question remains unanswered in relation to the extent psychiatric nurses perceive the importance of the constituents of the therapeutic relationship. The aim of this research is to ascertain the nature and comprehension psychiatric nurses assign the development of this therapeutic relationship. Grounded theory methodology was utilized to develop these conceptualizations to elicit a theory relating to what comprises the therapeutic relationship. Semi-structured depth interviews were conducted with 6 registered psychiatric nurses who have 2-10 years of experience. The main findings of the research related to how psychiatric nurses learn to form these relationships and what skills are utilized within the relationship. The research discovered that the therapeutic relationship is therapeutic, but the degree of positive change is difficult to measure. The results of the study indicate that the process of developing therapeutic relationships is a combination of a learned experience through the acquiring of interpersonal skills; however, these skills are redundant if the individual has not acquired sufficient life experience to intuitively appreciate the therapeutic aspect of the relationship.

Attitude of Health Personnel↗