PATTERNS OF NURSE-PATIENT INTERACTION IN LABOR: AN ANALYSIS OF IMPACT ON PATIENT PERCEPTIONS OF SATISFACTION AND CONTROL IN CHILDBIRTH.
Contributors: University of Texas at Austin.
Published: 1986
Number of pages: 362
Subjects: Health Sciences, Nursing.
Description: Nurse-patient interaction during labor was described and examined in relation to its impact on patient perceptions of satisfaction and control in labor. The rationale for the investigation was based upon women's growing dissatisfaction with current childbirth practices and upon the significance of childbirth as an important life event. A major theoretical assumption was that the social reality of health and illness experiences is constructed through the interaction of the participants in the situation.

Verbatim nurse-patient interaction records were obtained for 16 high risk and 16 low risk primiparas using a time and event sampling strategy. Within 36 hours of delivery, all patients completed two semantic differential instruments rating the concepts "myself in labor" and "my childbirth experience". All interaction data were coded according to Stiles' Taxonomy of Verbal Response Modes.

Nurses were more verbal than patients during all phases of labor. Nurses interacted the most with laboring women during the second stage of labor, while patients showed the highest level of verbal activity during the active phase. Nurse-patient interaction occurred mainly during three nursing care activities: coaching with breathing, performing patient maintenance activities, and during general conversation. Patients most frequently used disclosure modes to express themselves. Nurses most often used advisements to guide patient behavior.

Four major patterns of nurse-patient interaction emerged from a principal components factor analysis of verbal response mode frequencies. The first pattern involved the nurse sharing and requesting information from the patient; the second, the patient disclosing information; the third, the nurse coaching the patient; and the fourth, a nurse-patient edification and acknowledgement exchange. No relationship was found between patterns of nurse-patient interaction and patient perceptions of satisfaction and control in labor. The results are discussed within the context of a "social constructivist" theoretical framework and the medical model of childbirth. Implications for nursing practice and nursing research are presented.
Notes: Source: Dissertation Abstracts International, Volume: 47-05, Section: B, page: 1925.

Thesis (PH.D.)--THE UNIVERSITY OF TEXAS AT AUSTIN, 1986.

School code: 0227.