Observations of professional-patient relationships: a mixed-methods study exploring whether familiarity is a condition for nurses' provision of psychosocial support.

Abstract

There is a popular belief that the professional-patient relationship is a prerequisite in the provision of psychosocial support. Studies suggest that professionals must know, or be familiar with, a patient in order to effectively provide psychosocial support. To examine the association between familiarity and the provision of psychosocial care by professionals. A mixed-methods study involving participant observation, interviews and organisational and documentary analysis was conducted over 8 months in an inpatient hospice setting. In total, 38 nurses (registered and auxiliary) and 47 patients were included in a maximum variation sampling strategy. Data were analysed using both qualitative and quantitative techniques. The data disconfirm the belief that familiarity is either a necessary or sufficient condition for the provision of psychosocial support. Nurses familiar with patients did not necessarily respond to patients' psychosocial needs, and nurses with no prior contact with the patient immediately dealt with psychosocial needs. Psychosocial support can be provided on a patient's first contact with a clinician and does not rely on building a professional-patient relationship. This suggests that high-quality psychosocial care can be provided in the short time frame available to palliative care clinicians.