GROUNDED THEORY METHODOLOGY

Grounded theory methodology research proposal on nature of mental health nurses' therapeutic relationships with adolescents with eating disorders



Research Proposal Grounded Theory Methodology

Nursing literature is rich in articles that explore the theme of the therapeutic relationship. The importance of this relationship in older adolescents diagnosed with anorexia is also well established, but there is enough research to provide a thorough understanding of these difficulties and why they develop or how nurses believe that the therapeutic relationship could be improved. This article presents a study undertaken as a contribution to understanding this. Throughout the article, "adolescents with anorexia" terms, "people with anorexia," or "patients with anorexia" refers to adolescents diagnosed with anorexia nervosa.

Background

A therapeutic relationship is a dynamic, two-way, reciprocal relationship between a doctor and a patient and sometimes the patient's family (and Barnsteiner McKlindon 1999). The relationship is "careful, clear, bounded, positive and pro-fessional (McKlindon and Barnsteiner 1999, p. 238). Nurses in acute care facilities are well suited to partner with patients and caregivers, 24 hours a day, 7 days a week, thus providing a substantial amount of physical care, psychological and emotional (Nichols1993).

But anorexia nervosa is a chronic disease and this is one of several reasons why nurses find it difficult to develop therapeutic relationships with patients in acute care wards. Peplau (1952) and later researchers have identified the elements that are essential for a relationship to be therapeutic. These are: trust and commitment (Morse, 1991), accurate empathy, unconditional positive regard and genuineness (Rogers 1973), honesty and support (Halek 1997a), confidentiality, non-judgmental attitude, responsibility and consistency siveness (Murray and Huelskoetter 1991, Dexter and Lave, 1995).

Objective

The purpose of this study was to explore the nature of the relationship of mental health nurses' therapeutic adolescents with eating disorders.

Literature Review

Garrett (1991) studied nurses working with severely anorexic patients in five units of eating disorder hospital in Sydney. His interviews were examined nurses' experiences of patients with anorexia nervosa nursing and their perceptions of the rewards and difficulties in caring for these patients. King and Turner (2000) studied the emotional journey "roller coaster" that nurses pass through the care of adolescents with anorexia in public hospitals in Victoria. We explored the "maximum" and "low" of work and focused on the values of nurses and how these were challenged, frustration and anger set in

Both studies suggest a strong need to support educational programs for nurses, for new treatments and plans for nurses are more involved in the development of treatment programs. My study of adolescents with anorexia in a pediatric environment designed to expand these two studies. My initial goal was to explore the development of successful therapeutic relationships with this unique group of patients, but, as King and Turner (2000), found that nurses are striving to develop partnerships and I rise to record and explain difficulties and obstacles impeding the formation of the therapeutic relationship. It was not my intention to replicate (2000) and King of Turner study, but my results were very similar to ...