Abstract
D.Cur.
Psychiatric nurses are constantly in interaction with psychiatric patients, families,
psychiatrists, auxiliary nurses and other multidisciplinary team members.
Psychiatric nurses, during their basic training, have to complete the course in
interpersonal skills and methods. However, some psychiatric nurses during their
interaction with psychiatric patients, families, psychiatrists and auxiliary nurses
behaved aggressively and passively towards them.
This has led to this research study aimed at describing a model for facilitation of
continuous assertiveness for psychiatric nurses.
A theory-generative design which is qualitative, explorative, descriptive and
contextual in nature was followed. The research method were dealt with in four
steps in theory generation in the following manner:
Step 1 - Concept analysis
This step was dealt with in two phases namely concept identification and concept
definition. During concept identification a qualitative research strategy which is
explorative, descriptive and contextual was used. This was attained through field
research conducted in a specified urban psychiatric hospital in Gauteng Province.
The sample consisted of twelve psychiatric nurses and were purposively selected.
Four different scenarios were role-played, each scenario was role-played twelve
times. Each scenario lasted approximately forty-five minutes. One advanced
psychiatric practitioner from a different hospital took the role of psychiatric patient,
family psychiatrist and auxiliary nurse. Videotaped recordings, transcripts of videorecordings,
non-participating observational field notes as well as written feedback
were used as methods of data collection. Data were analysed according to the
protocol of Tesch 1990 (in Creswell, 1994 : 155) and Bottorff (in Schurink &
Poggenpoel, 1998 : 329) in analysing the videotape recordings. An independent
coder helped in coding the results of videotapes.
The researcher concluded from the results obtained from the fieldwork that
psychiatric nurses are unable to facilitate interaction through assertive behaviour.
This research was characterised by repetitive aggressive and passive behaviour of
psychiatric nurses when in interaction with others.
The result was validated through literature control. The major concept of the model
was identified as "facilitation of continuous assertiveness" for psychiatric nurses.
The concept was analysed thoroughly by looking at different dictionaries (see
bibliography) and subject usage. The defining attributes were identified and
synthesised through a definition. The other related concepts were identified and
classified by using a survey list of Dickoff, James and Wiedenbach (1968: 430).
Step2
This step dealt with the creation of interrelationship statements between concepts
identified in Step 1 so that concepts were able to stand in relation to one another.
Step 3
This step dealt with the description of the model by using strategies proposed by
Chinn and Kramer (1991 ).
Step 4
This step dealt with the description of guidelines for model operationalisation in
psychiatric nursing practice, psychiatric nursing education and psychiatric nursing
research. The proposed model was evaluated by a panel of independent experts.
To ensure valid results a model of trustworthiness proposed by Guba (Lincoln &
Guba 1985) was used. The following criteria for trustworthiness were applied in all
the steps of theory generation : truth-value, applicability, consistency and neutrality.
Ethical measures were applied right through the research.
An unique contribution in the model description is the facilitation of continuous
assertiveness for psychiatric nurses by the advanced practitioner in psychiatric
nursing.