title: The impact of nurses' opinion of client behaviour and level of social functioning on the amount of time they spend with clients.
abstract: The impact of nurses' opinion of client behaviour and level of social functioning on the amount of time they spend with clients For people afflicted with different kinds of psychiatric disorder, suffering is a common denominator. The time the nurses spend with psychiatric clients may mirror their attitudes towards and feelings for these clients. The aim of this study was to investigate the connections between the time spent together and the nurses' opinion of client behaviour and social functioning in community-based psychiatry. In this quantitative study, 29 clients were assessed by 30 nurses, who answered the Global Assessment of Functioning Scale (GAF) and the Positive and Negative Syndrome Scale (PANSS). At the same time, 11,200 non-participant observations of clients were registered using the Patient Activity Classification (PAC) to investigate how they spent their time at two psychiatric group dwellings. The PAC instrument revealed that clients spent an average of 60.8% of time alone, while only 20% of their daily time was spent with the nurses. Based on a factor analysis, indices were made by setting cut-off points for the PANSS and the GAF scores, and four small groups of clients were generated: a relatively high level of social functioning and a low degree of psychiatric symptoms (A); a relatively high level of social functioning and a high degree of psychiatric symptoms (B); a low level of social functioning and a low degree of psychiatric symptoms (C); and, finally, a low level of social functioning and a high degree of psychiatric symptoms (D). The clients judged as having a low level of social functioning in combination with high degrees of psychiatric symptoms, that is, the most vulnerable and dependent individuals, receive less staff attention (18%) and are the clients who spend the most time alone (71.4%). It might be possible to interpret the results of this study in the light of a process of dehumanization.
authors.affiliation: Department of Health Sciences, Mid-Sweden University, Sundsvall, Karolinska Institutet, Stockholm, Sweden. lisbeth.kristiansen@muin.se
authors.forename: L
authors.initials: L
authors.lastname: Kristiansen
authors.forename: A
authors.initials: A
authors.lastname: Dahl
authors.forename: K
authors.initials: K
authors.lastname: Asplund
authors.forename: O
authors.initials: O
authors.lastname: Hellzén
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000451:nursing*; D008875:Middle Aged; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D011568:Psychiatric Nursing / Q000379:methods*; D012919:Social Behavior; D013997:Time Factors