Abstract

Historically the most outstanding feature of the nursing profession has been its genuine concern for the human being, and quality care of the sick has been its manifestation. However, technology with its high level of development and pervasiveness in the culture of the United States has threatened not only our society at large but also the nursing profession. "Depersonalized" and "nursing" are contradictory terms, and if used together certainly cannot denote a high quality of nursing care. In order to meet this threat, concerned health care professionals are studying ways to increase the empathetic element in nursing care in order to ensure delivery of quality health care.

In certain modalities of nursing care, such as functional nursing, the nurse's focus is on the task rather than the patient. In team nursing, the main focus is on the personnel supervised by the nurse. The registered nurse has little patient contact in these modalities to effectively personalize care. The indirect opportunity to assess, plan, implement, and evaluate patient care often leads to fragmentation of nursing care delivery, which not only is unfair to the patient, but also lowers the quality of nursing care.

Patients have been documented as experiencing dissatisfaction with team nursing, doubtless because fragmentation of care is ineffective in meeting the patient's total needs. While team nursing may be effective in terms of efficiency and and utilization of personnel, it does not take into account the human element in patient care. Nurses practicing this modality have been documented as exhibiting less caring attitudes than those practicing other modalities of care.

Primary nursing, developed to met the total needs of the patient by diminishing fragmentation of care, has as its objective established of an effective interpersonal relationship with the patient in order to more accurately determine and meet his needs. The primary nurse's role includes assessment of the patient's needs, involvement of the patient in the planning of care, and responsible implementation and evaluation of care. This modality of making the patient the major focus is a return to the concept of "my patient, my nurse." From admission to discharge the registered nurse assumes responsibility for the patient for twenty-four hours a day. The primary nurse works one eight-hour shift and two associate nurses cover the two remaining shifts. They collaborate with the patient in planning and implementing care. Patients have been documented as starting that in primary nursing, the nurse is more concerned, interested, and understanding than in other nursing care modalities.

Thirty female registered nurses participated in this study, the purpose of which was to determine empathy levels of nursing practicing primary and team nursing. One problem was to determine whether there is a difference in empathy levels among nurses practicing these two modalities of care. Since the concept of field dependence may be related to empathy capacity, this relationship was investigated to determine whether there is a difference in field dependence between primary and team nurses. Investigation of relationships between empathy levels and field dependence of the total group of primary and team nurses was also completed to determine whether a correlation exists between these two concepts.

The three hypotheses formulated were as followed:

  1. There will be no significant difference between the empathy scores of registered nurses practicing primary nursing as compared to that of nurses practicing team nurses. (α=.05)
  2. There will be no significant difference in the field dependence of registered nurses practicing primary nursing as compared to that of nurses practicing team nursing (α=.05)
  3. There will not be a positive correlation between the empathy scores and field dependence of total group of primary and team nurses (α=.05).

The study was pre-experimental. The setting was four nursing units in a 546-bed medical center (Unit A, a primary surgical nursing unit; Unit B, a team surgical nursing unit; Unit C, a primary medical oncological nursing unit; Unit D, a team surgical oncological nursing unit).

The criteria for selection of the subjects were that they be female registered nurses and that they had completed an orientation to their respective units. Consents were obtained from the nurses participating in the study, which was conducted over a six-week period in 1979.

The data were analyzed by use of Mann-Whitney and Spearman’s Rho tests. The difference between the primary and team nurses’ rank scores on Hogan’s Empathy Scale and Group Embedded Figures Test was measured for the two groups of nurses. Spearman’s Rho determined the correlation coefficient on the basis of rank scores of the total group of nurses on both Hogan’s Empathy Scale and the Embedded Figures Test to correlate empathy levels with field dependence. The results of these analyses are included in the following paragraphs.

At the end of the study, Hypothesis one (on difference in empathy levels between primary and team nurses) was supported, by the fact that scores on the Mann-Whitey test showed no significant difference. Hypothesis two (on difference in field dependence between primary and team nurses) also was supported by the absence of any statistically significant difference between field dependence of primary and of team nurses. Hypothesis three (on correlation of empathy levels and field dependence) likewise was sustained by the absence of correlation of levels for the two group of nurses as tested by Spearman’s Rho.

Since the test scores revealed no significant differences between primary and team nurses in the areas of empathy levels and field dependence and showed no correlation of empathy levels with field dependence, the results demonstrate that regardless of the modality of nursing care practiced, nurses have similar empathy levels. Primary nurses, it is true, expressed more interest in the emotional aspects of the nurse-patient relationship and had more contact with their patients; however, further studies are necessary to determine the relationship between these qualities and empathy. The nonconclusive correlation between the cognitive style of field dependence and empathy capacity demonstrates the need for further studies to determine if a relation does indeed exist between these two concepts.

LLU Discipline

Nursing

Department

Nursing

School

Graduate School

First Advisor

Evelyn L. Elwell

Second Advisor

Nancy S. Testerman

Third Advisor

Ruth Weber

Degree Name

Master of Science (MS)

Degree Level

M.S.

Year Degree Awarded

1979

Date (Title Page)

12-1979

Language

English

Library of Congress/MESH Subject Headings

Nurse-Patient Relations

Type

Thesis

Page Count

vii; 88

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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