Assignment of nurses to patients with depression based on aptitude
Toewijzing van verpleegkundigen aan depressieve patiënten gebaseerd op hun geschiktheid
Haspeslagh, Marc; S0068627
Assignment of nurses to patients is common practice on psychiatric units. This study investigates this practice from the viewpoint of aptitudes. Aptitude is an innate personality trait and the third component of competence, besides knowledge and skills, following the definition of Nordhaug (1993). Aptitudes underlie the development of knowledge and skill and are basic for performance in the job. This study is an explorative research to gain insight both in the aptitudes of the nurses and their relationship with care outcomes of depressed patients. We hypothesise that patients who are cared for by nurses with more adjusted aptitude have better outcomes. All nurses are apt in caring for depressed patients. Their aptitudes can be typified by three constructs: (1) an overall aptitude for caring for depressed patients; (2) the aptitude for maintaining boundaries; and (3) the aptitude for empowering patients. The aptitude for maintaining boundaries and the aptitude for empowering patients measure the propensity to one of two related but opposing attributes. Focusing the patient and being self-aware are the attributes of the aptitude for using boundaries. Therapeutic use of self and establishing rapport are the attributes of the aptitude for empowering patients. The nursescan be grouped into three groups of professional rank along their overall aptitude for caring for depressed patients: novice, proficient and master. Some other associations with patient outcome are also indicated. The aptitude for empowering patients of novice nurses has associations with the change in intensity of depressive feelings, the change in type of functioning and the change in performance impairment of the patient. When the novice nurse tends to establishing rapport there is an improvement of the intensity of depressive feelings and performance impairment. When she tends to therapeutic use of self there is a change in type of functioning towards negative attitudes toward self.The aptitude for empowering patients of proficient nurses has an association with the change in performance impairment of the patient. When the proficient nurse tends to therapeutic use of self an improvement of performance impairment of the patient ensues.The aptitude for maintaining boundaries and the aptitude for empowering patients of master nurses have associations with the change in negative attitudes toward self of the patient. When the master nurse tends to self-awareness while maintaining boundaries and tends to establish rapport while empowering patients an improvement of the patients negative attitudes toward self follows.The different attributes of aptitudes refer to a therapeutic style of the nurse. Novice, proficient and master nurses have a different therapeutic style that results in other associations with patient improvement.These study results suggest that aptitude-based assignment of nurses to depressed patients should be possible if the assignment starts from an assessment of the patients needs.The depressive feelings of the patient differ in intensity and type of functional impairment. Along the intensity and type of functional impairment another nurse should be assigned. Moreover when the patients functional impairment changes during hospitalisation, another nurse that better matches the patients functional impairment should be assigned.This study reveals that it is important to take into account the individual patient and nurse in the management of patient assignment.