Dimensions/components of
Therapeutic nurse patient relationship
The nurse must possess certain
skills and qualities to establish and maintain a therapeutic relationship.
Specific core conditions for facilitative interpersonal relationship can be
divided into responsive dimensions and action dimensions.
I. Responsive dimensions
The responsive dimensions include genuineness,
respect, empathetic understanding and concreteness. The responsive
dimensions are crucial in a therapeutic relationship establish trust and open
communication. The nurse's goal is to understand the patient and to help the
patient gain self-understanding and insight.
1.Genuineness:
Genuineness means that the nurse is an open, honest, sincere person who is
actively involved in the relationship. Genuineness means that the nurse's
response is sincere, that the nurse is not thinking and feeling one thing and
saying somethino different.
2.Respect: Respect
also called as non possessive warmth or unconditional positive regard, does not
depend on the patients behavior. Caring, liking and valuing are other terms for
respect.
3.Empathetic understanding:
Empathy is the ability to enter into the life of another person and to
accurately perceive his or her current feelings and their meanings. Rogers
(1975) described it as "to sense the clients private world as if it were
on your own, but without losing the as if quality.
4.Concreteness: It
involves using specific terminology rather than abstractions when discussing
the patient's feelings, experiences and behavior. It avoids vagueness and
ambiguity.
II. Action dimensions
The action oriented conditions for
facilitative interpersonal relationship are confrontation, immediacy,
therapist self-disclosure, catharsis and role play.
1. Confrontation: It
is an expression by the nurse, of perceived discrepancies in the patient's
behavior. Confrontation is an attempt to by the nurse to make the patient
aware of incongruence in his or her
feelings, attitudes, beliefs and behaviors.
2. Immediacy:
Immediacy involves focusing on the current interaction of the nurse and
the patient in the relationship. It
involves sensitivity to the patient's feelings and a willingness to deal with
these feelings rather than ignoring them.
3. Self-disclosure: Self-
disclosures are subjectively true, personal statements about the self,
intentionally revealed to another person. The nurse may share experiences or
feelings that are similar to those of the patient and may emphasize both
similarities and differences. It is an expression of genuineness and honesty by
the nurse and is an aspect of empathy.
4. Emotional catharsis:
occurs when patient is encouraged to talk about thin as that are most
bothersome. It brings fears, feelings and experiences out into the open so that
they can be examined and discussed with the nurse.
5. Role playing: It
involves acting out a particular situation. It increases the patient's insight
into human relations and can deepen the ability to see the situation from
another person's point of view
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