An observational study of the development of a nurse-patient relationship.

The purpose of this exploratory descriptive case study was to identify features of nurse-patient interactions (NPI) in the development of a nurse-patient relationship (NPR). Observations of interactions in a cancer treatment unit included 60 videotaped, sequential, naturally occurring NPIs involving one dyad over a 3-day period. A microanalysis of the interactions was conducted using qualitative ethological methods. The analysis focused on identifying important recurring behavioral clusters and characteristic patterns of behavior that comprised these clusters. Important features of NPIs in the development of an NPR were identified and described in detail. The active and complementary roles of both participants in this process and the contribution of social exchange, trust, and humor are highlighted. The findings illustrate the importance of continuity of nursing care if NPRs are to be used to their fullest extent to address complex patient care needs.

Comforting: exploring the work of cancer nurses.

In a study to identify and describe nurses' use of comforting strategies, techniques of qualitative ethology were used to analyse videotaped recordings of nurse-patient interactions on an active cancer treatment ward. Comforting strategies nurses were observed to use included gentle humour, physical comfort measures, emotionally supportive statements, and comforting and connecting touch. In addition they increased physical proximity, provided patients with information, supported patients' active participation in decisions regarding their care, and offered opportunities for patients to engage in social exchange. These strategies appeared to play a major role in helping cancer patients endure the discomforts associated with their illness and/or treatment. Various combinations of comforting strategies were used in four different contexts, including: helping patients put experiences into perspective; helping them stay in control; providing opportunities to function as normally as possible; and providing emotional support. The findings of this study support conceptualizations of comforting that extend beyond measures related to symptom control and indicate that comforting strategies used by cancer nurses comprise a significant part of their work.