The effect of a psychiatric nursing approach during hospital admission with Alaskan native patients

Much of the current nursing research is based upon the assumption that admission to a hospital is a distressing experience. These studies generally employ a clinical experimental method in which reduction of distress is achieved through a warm, personalized nursing approach. Measurements of systolic blood pressure, radial pulse, oral temperature and respiratory rate have been commonly used as an index of nursing effectiveness in reducing patient distress. The patient sample in this study consisted of 54 Eskimo, Aleut and Athapaskan patients who were admitted over a three month period for elective medical and surgical conditions. The purpose of the study was to measure the influence of a psychiatric nursing approach upon the reduction of emotional distress during hospital admission of Alaska native patients. The experimental group received a warm, personalized approach from the psychiatric nurse who attempted to identify and respond to patient feelings about hospitalization. The control group received the routine admission from the hospital staff with the assumption that admission procedures in a large hospital are often task-oriented, hurried and impersonal. Pre and post admission measures of systolic and diastolic blood pressure, radial pulse, oral temperature and respiratory rate were used as indices of emotional distress. A post admission interview was conducted by an independent observer to determine patient feelings about admission. It was hypothesized that Alaskan patients receiving a personalized nursing approach as part of the hospital admission procedure would experience greater reduction in their vital sign measures and greater relief from their emotional distress than patients receiving a less personal approach. It was further expected that the group difference in vital sign decrease would reflect a difference in the amount of emotional stress reduction. Results indicated no significant difference between the experimental and control groups in the five vital sign measures. This indicated that the experimental psychiatric nursing approach was no more effective in reducing patient distress than the routine admission administered by the hospital staff, at least from the vital sign measures. Post admission interview results concurred with the statistical findings.