A model for facilitation of continuous assertiveness for psychiatric nurses in a psychiatric context

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