College of Nursing, University of the Philippines Manila, Pedro Gil Street, Manila, Philippines.
Int J Nurs Stud. 2010 May;47(5):608-15. doi: 10.1016/j.ijnurstu.2009.10.007. Epub 2009 Dec 22.
Most instruments on nurse-patient relationship determine the caring behavior of the nurse, but have minimal consideration of the patient's role in the interaction. Moreover, it is the patients that complete many of those instruments, thus leaving out the perspective of the nurse. There is then a need to account for the contributions that both the nurse and the patient bring into their encounter where bonding is formed.
This study aimed to develop and validate an instrument that determines the degree of bonding between nurse and patient based on their openness to each other and their engagement in patient care.
Data were collected from nurses and patients in the wards of four public and private tertiary hospitals in Manila, Philippines, where most Filipino nurses render care to patients before getting employed in other countries.
A total of 420 nurses and patients (i.e., 210 dyads) participated in this research conducted in 2008. Most of the nurses were young females with beginning clinical experience, while the patients had a wider age range with the majority having no college education and no employment.
The Nurse-Patient Bonding Instrument (NPBI), which dimensions were generated from qualitative observations and interviews, and corroborated by literature, was validated at the bedside setting. To determine interrater reliability, two trained raters unobtrusively observed actual nurse-patient interactions and ticked on the NPBI behavioral indicators of openness and engagement. Construct validity was established using known-groups technique. Moreover, bonding score was correlated with patient satisfaction for predictive validity.
Reliability ranged from r=.80 to .95 (p<.01). Factor analysis demonstrated that the subscale scores of patient openness, nurse openness, patient engagement, and nurse engagement all loaded on one factor, the bonding factor, demonstrating a unified structure of the NPBI. Nurses and patients had higher bonding scores in interactions of longer duration than shorter duration, controlling for number of previous encounters. This provided evidence for construct validity using known-groups technique. The NPBI was likewise shown to distinguish groups based on age, education, and civil status. Patient satisfaction correlated positively with bonding score, providing evidence suggestive of the predictive validity of the NPBI.
The NPBI was shown to be a reliable and valid tool for assessing nurse-patient bonding, and can possibly predict patient satisfaction. The openness and engagement of nurse and patient were demonstrated to result in a structure, a nurse-patient dyad. This finding invites further investigations on the characteristics and development of this dyad.
大多数护士-患者关系的评估工具都确定了护士的关怀行为，但很少考虑到患者在互动中的角色。此外，正是患者完成了这些工具中的许多内容，因此忽略了护士的观点。因此，需要考虑到护士和患者在建立联系时所做出的贡献。
本研究旨在开发和验证一种工具，该工具基于护士和患者之间的相互开放程度和参与患者护理的程度来确定他们之间的联系程度。
数据来自菲律宾马尼拉的四家公立和私立三级医院的护士和患者，大多数菲律宾护士在其他国家工作之前都会在那里为患者提供护理。
共有 420 名护士和患者（即 210 对）参加了这项 2008 年进行的研究。大多数护士是年轻的女性，临床经验有限，而患者的年龄范围较广，大多数患者没有大学学历和就业。
护士-患者联系工具（NPBI）的维度是从定性观察和访谈中生成的，并通过文献加以证实，然后在床边环境中进行验证。为了确定评分者间信度，两名经过培训的评分者在不引人注目的情况下观察实际的护士-患者互动，并在 NPBI 的开放性和参与性行为指标上打勾。采用已知组技术确定结构效度。此外，将联系得分与患者满意度相关联，以预测有效性。
信度范围为 r=.80 到.95（p<.01）。因子分析表明，患者开放性、护士开放性、患者参与度和护士参与度的子量表分数都加载到一个因素上，即联系因素，表明 NPBI 具有统一的结构。与持续时间较短的互动相比，护士和患者在持续时间较长的互动中具有更高的联系得分，同时控制了之前的互动次数。这为使用已知组技术的结构效度提供了证据。NPBI 还能够根据年龄、教育程度和婚姻状况区分不同的群体。患者满意度与联系得分呈正相关，这为 NPBI 的预测有效性提供了证据。
NPBI 是一种可靠和有效的评估护士-患者联系的工具，并且可能预测患者满意度。护士和患者的开放性和参与性被证明会产生一种结构，即护士-患者对。这一发现邀请进一步研究这种对的特征和发展。
