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Article Dans Une Revue Clinical Research and Trials Année : 2018

A qualitative evaluation of patient’s perceptions of therapeutic alliance on mental health acute inpatient wards

Résumé

Background: Since the research of H. Peplau, the question of relational psychiatry has been defined as the heart of the profession of mental health nursing. The therapeutic relationship has evolved in its design to become Therapeutic Alliance (Zetzel), or Helping Alliance (Luborsky) or Working Alliance (Bordin). Recent articles show that these concepts are still very powerful despite the appearance of computer tools and that they are still today major determinants in the management of people suffering from mental disorders. Objective: To gain insights into the construction of TA from the patients’ perspective. How do patients see the development of the Therapeutic Alliance with nursing staff? And, for example, does the way patients are admitted to hospital (if detained under the mental health act) impact on the formation of TA? Methods: Qualitative, semi-structured interviews were carried out with patients on acute wards in four inpatients sites, EPS Maison Blanche Paris, between 2014/07 and 2018/07. All interviews were recorded and transcribed, and data were analysed using Nvivo software. Results: Thirty-one participants were recruited to the study. Reporting of good quality TA did not appear to be linked to whether participants were detained in hospital, nor to their diagnosis. Close proximity is the first value described by patients as a creator of TA and refers to the concept of attachment. We will develop the Proximal Zone of TA (PZTA) concept further in this paper presentation, in addition to our data which indicated that nurses may be sought by inpatients’ as attachment figures as recalled by Gwen Adshead or Kenneth Ma. Three themes were extracted in relation to close proximity: i) during the somatic care (“I am alone with the nurse”); ii) during therapeutic communication face to face “(nurse give me advice”; “they explained me things”; “they listen to me)”; iii) the continued presence (“I was accompanied”; “they know how to manage me”; “they are present; reactive; respectful”).

Dates et versions

hal-03957543 , version 1 (26-01-2023)

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Jean-Manuel Morvillers, Monique Rothan-Tondeur. A qualitative evaluation of patient’s perceptions of therapeutic alliance on mental health acute inpatient wards. Clinical Research and Trials, 2018, 4 (1), ⟨10.15761/CRT.1000205⟩. ⟨hal-03957543⟩
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