BARCELONA

Nurse in charge: Antonio R. Moreno Poyato

Entity/Agency in charge: Escola Superior d’Infermeria del Mar

Description

The goals of the project were: firstly, generating changes in the nurse clinical practice on the Therapeutic Relationship in psychiatry units thanks to the implementation of evidences through a Participative Investigation-Action. And secondly, evaluating the effectiveness of the implementation of these evidences through a Participative Investigation-Action in terms of the impact on the therapeutic alliance and the empathy of nurses.

A blended design was suggested. A qualitative one, through the Participative Investigation-Action, evidences on Therapeutic Relationship were implemented. And a quasi-experimental, pretest-posttest design of only one group to measure quantitatively the effectiveness of the implementation of such evidences.

The participants were 9 nurses from two psychiatric units from the Hospital del Mar in Barcelona. The data collection for the qualitative practices took place through discussion groups and reflective diaries. The WAI-S and IRI questionnaires were the instruments used for the collection of quantitative data.

The nurses conceptualized the Therapeutic Relationship in their practice, discovering facilitating elements and describing limitations. They could confront their clinical practice with the recommendations of the scientific evidences, they built 3 improvement proposals for the Therapeutic Relationship, they implemented them and evaluated them afterwards.

Quantitatively, the level of therapeutic alliance increased among nurses, especially regarding the agreement of goals and tasks with the patients. As for the degree of empathy, no differences were obtained. However, the nurses’ feeling of usefulness in patient care improved and their feelings of fear, anxiety and discomfort before patients diminished.

This research has demonstrated that nurses in the psychiatric units can undergo changes and improvements in regards to the Therapeutic Relationship. In addition, it has confirmed that the implementation of evidences through participative methods, such as the Participative Investigation-Action, is valid in producing changes and is effective in their results.

Design of the project:

• Phase 1:Quantitative methodology: Quasi-experimental / One Pretest-Posttest group ………….Measuring the pretest therapeutic alliance and empathy (WAI-S, IRI Scales)

• Phase 2:Qualitative methodology: participative investigation-actionCycle 1  – Recognition and action and analysis / observation / Planification / ReflectionCycle 2  – Action and observation / Re-planification / Final reflection and conclusions
• Phase 3:Methodology: Quasi-experimental / One Pretest-Posttest group …………Measuring the posttest therapeutic alliance and empathy (WAI-S, IRI Scales)