Module Assignment: Therapeutic Relationships and Patient Outcomes

This annotated bibliography explores the significance of therapeutic relationships in healthcare, focusing on their impact on patient outcomes. It includes a literature search summary, detailing the search strategy and databases used to gather relevant research. Three annotated bibliographies are presented, covering topics such as nurse-patient relationships in inpatient psychiatry, enhancing therapeutic interpersonal relationships in acute healthcare settings, and perceived barriers to effective therapeutic communication. The discussion emphasizes the importance of culturally relevant services, effective communication, and addressing barriers like pain and emotional distress to foster successful patient experiences. The study concludes that therapeutic relationships are crucial for improving patient satisfaction and overall quality of care.

Running Head: THERAPUTIC RELATIONSHIP AND PATIENT OUTCOMES
Impact of Therapeutic Relationship on Patient Outcome
Student’s Name
Affiliate Institution

IMPACT OF THERAPEUTIC RELATIONSHIP ON PATIENT CARE
Table of Contents
Introduction................................................................................................................................4
Summary of the Literature Search.............................................................................................5
Search Strategy Table................................................................................................................5
Annotated Bibliographies...........................................................................................................9
Discussion................................................................................................................................12
Conclusion................................................................................................................................15

IMPACT OF THERAPEUTIC RELATIONSHIP ON PATIENT CARE
Introduction
According to Pullen and Mathias (2010), therapeutic nurse-patient relationship refers
to absolute mutual trust and honoring, the health of a patient by satisfying spiritual, emotional
and physical. Nurses should be prepared for the challenges that come with providing medical
services to patients. Though patients might be challenging to communicate with, health
provider should give them time to adjust and be willing to understand what they are going
through (Haverinen, 2017).
Subsequently, effective verbal and non-verbal communication is a crucial factor in
nurse-patient interactivity in providing care that enables the patient to have equal treatment
despite their shortcomings. Effective communication between health providers and patients is
critical in the delivery of quality services (Ross, 2018). However, nurses should be genuine
to the patient to promote a trustful relationship. Judgemental actions and discriminating
patients with disabilities may affect patients’ outcome. A nurse should be aware of how to
treat different conditions using different techniques. Pushing personal interests or spiritual
beliefs to patient may create a judgmental environment. Therefore, nurses should adopt the
method of listening and only talk when asking relevant questions and communicating the
treatment that will be used.
Subsequently, we will analyze why it is vital for patients to be transparent when
giving information to nurses. They should not omit any data since it might have a drastic
impact on the treatment. A therapeutic relationship should apply to all kinds of patients, be it
disable, mentally challenged or other health disorders.
Asking questions, allowing patients to express their feelings, and reassuring patients
support are effective communication skills that enhance satisfaction. Excellent healthcare
environment, active working practice promotes physical and psychological safety. This

IMPACT OF THERAPEUTIC RELATIONSHIP ON PATIENT CARE
annotated bibliography will explore three pieces of studies, and they include; interpersonal
relationship, interaction with mentally ill patients health and therapeutic relationship through
effective communication and possible barriers to cooperation.
Summary of the Literature Search
This research is completed through a descriptive method. The researcher gathers
current and past information from other scholars along with user experience and compares
the level of satisfaction concerning the relevance of therapeutic relationships in developing
quality health services. The research will capture data in two parts; the first part focuses on
secondary data obtained via the internet, journals, and books to ensure the information is
about therapeutic relationship. Secondary data is useful because it is reliable. Moreover, the
study was conducted by experts who had an interest in improving the experience of services.
Using primary data is also relevant in providing accurate information since one is able to
acquire current issues related to therapeutic relationship.
Secondly, the primary data will consist of an open questionnaire to conduct the
investigation. The research will explore, analyze and describe the relevance of therapeutic
relationship for nurses and health experts when providing care for physically, emotionally,
and mentally challenged patients. Moreover, the research will examine the nurse’s perception
of therapeutic relationship by comparing qualification, interpersonal skills, and experience.
Lastly, the study will propose the necessary recommendations to enhance the
development and sustainability of therapeutic relationship. It will analyze how pain,
emotional distress, lack of trust and unskilled nurse affect the overall quality of service given.
Search Strategy Table

IMPACT OF THERAPEUTIC RELATIONSHIP ON PATIENT CARE
Database
name
Search terms/
key words
database
headings
search
limits
results Decisions made
Dove medical
Press ltd
health, integrative
review, acute care,
and therapeutic
interpersonal
relationships,
N/A English
language 2016
10
studies
The research
emphasized on
therapeutic relationship
and how nurses and
health practitioner
should be equipped
with the skills.
The research provides a
vast amount of
literature, following a
change in search words
literatures were found.
Physical restraint,
therapeutic
relationship, quality
services, and mental
health nursing
N/A English
language
8 I went through the
research literature and
could not locate any
relevant information.
Due to of relevance I
couldn’t implement it
in the research which I
had to abandon.
SAGE Interpretive Not 2015-2016 15 The use of the search

IMPACT OF THERAPEUTIC RELATIONSHIP ON PATIENT CARE
Publications methods, interviews,
mental health
nursing, and
phenomenology
suggested English
language
Peer reviewed
sources
words and limits
facilitated more
beneficial literature for
the research topic.
From the data collected
from this study the
researchers suggest that
therapeutic relationship
is necessary in mental
ill patient. The study
provides a basis on
how emotional stability
is relevant in-patient
care. Establishing
common grounds and
friendliness is a
primary factor that has
been examined.
Interviews, mental
illness, and nurse-
patient relationship
Not
suggested
English
language
Peer reviewed
sources
25 After changing the key
terms and applying
the same limits as
the previous search.
The research provides
relevant literature. I
reviewed all of the

IMPACT OF THERAPEUTIC RELATIONSHIP ON PATIENT CARE
literature, of which 10
were relevant.
Informa UK
Limited
Barriers, Effective
Therapeutic
communication,
nurses, and patients
Not
suggested
2017-2018
Akan and
English
language
112 The research identifies
some of the barriers to
effective therapeutic
relation. Pain, emotions
and mental illness my
hinder interactions. The
research emphasizes on
effective and skillful
communication.
Effective
communication,
nurse-patient
relationship
N/A None 100 The research provide a
manageable amount of
result but difficulties
arose when I was
review the literature. I
had to research on the
key terms provide in
the literature so that I
could understand the
purpose of the study.
Outcome After reviewing the data, three research papers were decided upon from the relevant
literature identified. The research papers were selected by going through abstracts and
identifying which papers appeared to facilitate my outcome of a critical assessment. The
selection maximizes on improving nurse-patient relationship and involved diverse

IMPACT OF THERAPEUTIC RELATIONSHIP ON PATIENT CARE
literature that analyzed therapeutic relationship. Some of the key elements that led to the
selection of the research; and they include common ground, frontline, therapeutic
relationship, effective communication and nurse patient relationship.
Annotated Bibliographies
Thibeault, Catherine. (2016). An Interpretation of Nurse–Patient Relationships in
Inpatient Psychiatry. Global Qualitative Nursing Research, [online] 3. Available
at: https://journals.sagepub.com/doi/full/10.1177/2333393616630465.
The principle intent of this study is to illuminate the relationship between inpatient
psychiatric mental wellness nurses and their patient. Mental health is an essential thing for
every human being. Individuals that have the illness should have access to the effective
nurse-patient relationship to allow them to express themselves easily. The author, Catherine,
uses semi-structured interview and non-participants observation which focuses on
phenomenological inquiry. Information and data gathered were transcribed from the audio
recorded during the interview.
Subsequently, the study shows that nurse-patient communication with mentally ill
patients has decreased, due to prolonged stay pressures. Interviews lasted for 1 hour for
participant and 40hours for nonparticipants. Moreover, nine inpatient mental health nurses
and six patients were involved in the study. Out of the 15 participants, only half took part in
the study, due to, patient discharge, scheduling problems and lack of interest.
The study emphasizes the theme of mindfulness and why it is essential when nurses
are communicating to patients since they experience psychological distress. Moreover, the
study uses secondary data from multiple sources that helped to explore on psychiatric

IMPACT OF THERAPEUTIC RELATIONSHIP ON PATIENT CARE
patients. However, the researched used common grounds and frontline as sub-themes to
emphasize reducing miscommunication and enhancing the nurse-patient relationship.
Kornhaber, R., Walsh, K., Duff, J. and Walker, K. (2016). Enhancing adult therapeutic
interpersonal relationships in the acute health care setting: an integrative review.
Journal of Multidisciplinary Healthcare, Volume 9, pp.537-546
Therapeutic interpersonal relationships are an essential element in health care that
facilitates excellent clinical-patient outcomes. The study uses integrative research technique
which involves; review, synthesis and critical analysis of literature. Integrative reviews
promote a broad understanding of the existing gaps and the knowledge available. The
research uses both qualitative and quantitative methods of research. Moreover, the study was
conducted in seven countries, and they include; USA, Canada, Australia, the United
Kingdom, Denmark, and the Netherlands. Participants of the involved in the research
included; patients, physicians, and nurses from the different hospitals. More so, the study was
conducted in mental health medical trauma, gerontology, oncology section, and the surgical
unit.
The study initially identified 900 papers after eliminating duplicates. Furthermore, the
authors independently identified 37 prospective documents based on inclusion and exclusion
standards. Disagreements that arose during the research were resolved by debating. During
the evaluation process, ten papers were qualified after using the inclusion criteria. However,
out of the ten studies, seven of them used the qualitative approach by the use of semi
structured interview and limited analysis of data that were frequently used. More so, two of
the studies used questionnaires, observations, and interviews. Lastly, the remaining research
used the qualitative method with pre and post-intervention questionnaire.

IMPACT OF THERAPEUTIC RELATIONSHIP ON PATIENT CARE
Some of the themes that emerged as a result of the study include emotions and
continuing needs, responding to patients, and prioritizing patients, and engagement through
the establishment of a therapeutically relationship. The three themes interlink and lead to the
establishment of therapeutic interpersonal relationships.
Maame Kissiwaa Amoah, V., Anokye, R., Boakye, D. and Gyamfi, N. (2018). Perceived
barriers to effective therapeutic communication among nurses and patients at
Kumasi South Hospital. Cogent Medicine, 5(1).
The search explores the relevance of skillful and effective communication skills in
quality service. The purpose of the research is to investigate the possible barriers to enhanced
therapeutic interaction. More so, the study uses a descriptive research design using the
quantitative method to gather data. The study participants consisted of registered nurses and
clients specifically in the emergency, medical, recovery section and surgical unit of the
Hospital. A sample of 72 nurses and 40 patients was used for the research. Data collected was
by the use of close-ended questionnaires.
The key findings from the information collected revealed that anxiety, pain, and
discomfort from patients and overloading nurses are the key major issue that affects
therapeutic relationship. Participants had to identify their level of disagreement or agreement
by the use of a health system that had questions concerning nurse and patient barriers to
effective therapeutic communication. The scale used was; 5= strongly agree, 4= Agree, 3=
Disagree, = disagree, 1= Strongly disagree.
The ethical standards of the research are excellent. The researchers sent a letter to the
institution to request for investigating the hospital. Moreover, participants, we willing to
engage in the study and the research caused no harm.

IMPACT OF THERAPEUTIC RELATIONSHIP ON PATIENT CARE
Discussion
Nursing is a broad, demanding, interactive, and rewarding career. Health providers
are educated to be efficient in providing services to all persons regardless of skin complexion,
age, language, and gender. Similarly, the purpose of nurses is to provide culturally relevant
services. Eliminating obstacles of interaction is crucial for hospitals. Culture and language
difference and health awareness are some of the elements that may hinder the delivery of
service and may be obstacles to how doctors give treatment to consumers of health services.
According to Brabers, Rademakers, Groenewegen, van Dijk & de Jong (2017), health
awareness refers to the act of acquiring, interacting and understanding simple health data and
services that will promote appropriate health decision making.
Over the years, the therapists have confirmed that therapeutic relationship is an
essential element in achieving successful patient experience. Despite the difficulties
experienced by inpatient PMH nurses, they continue to find opportunities to engage in
therapeutic work. Catherine’s study is crucial since it emphasizes on mental health and why
nurses should set aside their interests when communicating with patients. When patients are
in pain, emotionally unstable and psychological unwell they tend to be resentful. Nurses
should understand the condition of the patient and try offering solutions such as painkillers
which will help the patients express themselves.
Moreover, the study explores the need for nurses to set up a common ground which
will allow patients to engage and willing to share their health issues. Subsequently, the data
collected from the research was accurate. Patients and nurses involved in the study were
willing to provide information that would help diminish the shortcomings of the health
facility. However, the study’s major limitation is the fact that it used a few participants which

IMPACT OF THERAPEUTIC RELATIONSHIP ON PATIENT CARE
might lead to inaccurate information. Moreover, the study was only conducted in a single
facility which might also mean that some of the issues may not apply in other facilities.
Secondly, Communication refers to the act of conveying and receiving information
from one person to the other. Lack of practical communication skills by nurses or health
practitioners can be an obstacle in providing health care services. Unclear communication
may lead to misdiagnosis, health complications, misinterpretation, misunderstanding, and
dissatisfaction. The nurse-patient relationship can only be attained in effective therapeutic
communication. Besides, the therapeutic connection is the process of interacting face-to-face
between nurse and patient to achieve physical and emotional health of a patient.
The shortcoming of the third annotation may be the use of convenience sampling
method such that; only the participants available at the time were used. Moreover, some of
the nurses were not sure about the intention of the study which might have triggered the
disclosure of some information (Haverinen, 2017). Additionally, one of the researchers works
at the hospital which might have altered the responses. However, the findings of the research
were not affected by the constraints. The research made use of convenience sampling
methods and therefore only the participants who were involved and at the convenience of the
researchers were used. A group of nurses were doubtful on the purpose of the study and
therefore were not ready to and give out information.
Therapeutic interpersonal relationships are the primary element in healthcare and can
transform and improve the patient experience. Consequently, the study found that listening,
reacting to the client’s emotions and continuing needs, and patient prioritization is the
primary element in improving therapeutic relationships.
To successfully attain therapeutic relationships nurses should acquire the right skills
such as consider their interpersonal communication skills. Verbal and non-verbal interaction