Meaning and significance of interpersonal Relationship

• An interpersonal relationship is an association or relationship between two or more people. Eg. Doctor – patient relationship, Nurse - patient relationship, nurse – patient – visitors etc. • Interpersonal relationship is very important factor. • For example:- death of an individual in a hospital, a number of individual might be involved that is other patient, nurses, doctors, relatives, friends of patient, administrators, cleaners etc. Death is a unique experiences for his relatives, visitors which may be specific and significant response. But this situation to doctors, nurses and other health personnel will be different as they encounter the situation frequently. Although they feel upset they cannot deeply be involved and go to the mourning instead they have to manage the situation by helping the visitors of the death patient. • Interpersonal relationship take place in a great variety of content such as : family, friends, marriage, work, club, office, neighbor etc. • They may be regulated by law, custom, or mutual agreements and the basis of social group and society as a whole.

Component of relationship

• Positive Regard • Acceptance • Genuine interest • Empathy • Trust • Self awareness • Therapeutic use Nurse Patient Relationship • Needful and therapeutic relationship between nurse and the patient is known as nurse patient relationship.

Significance of nurse patient relationship

• Nurse patient relationship should be reciprocal that is give and take. • To identify the patient exact need or the problems through assessment. • To identify the exact causes of diseases condition. • To identify the socioeconomic status of the patient • To explore their attitude and practices regarding illness and their health seeking behavior. • To motivate to change their wrong behavior and practices by providing scientific rational. • To make them independent to cure simple illness in the home situation. • To identify their belief and perception regarding diseases causation and modify accordingly. • To make confident to solve their problems themselves by participating them inpatient care. • To remove rumors and misconception towards the attitudes of the health personnel.

Talcott Parson’s sick – Role Model

Status Patient’s Role Doctors/health professional’s role Obligations (Duty) To be motivated to get well Act for the welfare of the patient (orientation to collective vs self) To seek competent help Be guided by the professional rules (universalism vs particularism) To trust the doctor or to accept Be objectivity with emotionally competence gap detached.

Benefits of this model

• Forms the performance of normal social obligation • Form responsibilities for one’s own state. • Professional dominance

Criticism

• Modern medicine is organized about the application of specific knowledge to the problems of illness and health to control disease. • Lack of uniformity in illness response among various persons and social groups. • Less applicability for chronic illness such as cancer, heart disease. • It is based an traditional one to one interaction. It cannot be applied to a group of individual. • Middle class oriented.

Saaz – Hollender Sick Role Model

Model Physician/Health Patient role Clinical Application Prototype (Original) personnel role Activity – Passivity Does something or Recipient (Unable to Anesthesia, acute Parent-Infant everything to patient respond) trauma, coma, delirium Guidance - cooperation Tells patient what to do Co-operator (Obeys the Acute infection, Certain Parent-Child instruction) procedure (adolescent) Mutual-Participation Helps patient to help Participation in Most chronic illness etc Adult-adult himself partnership (uses expert) Communication Pattern between modern provider, Consumers and indigenous Providers Communication pattern should be clear between modern providers, consumers and indigenous provider. Consumers communicates both with the modern and indigenous Modern Provider Indigenous Provider Registration system is necessary. No registration, personal contacts System of health seeking is institutional that is hospital, health System of health seeking behavior is individual and family. posts clinics etc. Communication is done through written document Communication is done through verbal fixation Strict on date and time Flexible on date and time Lab assessment or supporting alternatives to confirm the Sacrifices of animals, worshipping etc is used for diagnosis. Diagnosis Should have good technical knowledge to use the instruments Decisions are made on approximate Responsibilitiesare more and easy to predict No any specific responsibilities and haphazard prediction Follow up is done in routine basis that is weekly, monthly etc No system of routine follow up, frequent visits as needed. Patient should go to the health institution. Faith healers themselves visit the patient’s house. Relationship is short term and sometime long term Relationship is long term with family system.

Consumers’ Relationship

• Professionals play an important role to provide health facilities to those person who seek and need health care. Therefore consumers relationship with health personnel should be reciprocal. Similarly because of the following condition health personnel relation should be good with the consumers. • This relationship is considered psychologically and socially as half cure treatment. Medicines are not only responsible for the recovery of illness but behavior of health personnel plays the vital roles. • Thus relationship of health personnel and consumers should be trustworthy and good. Eg. It is seen in various part of health care delivery where the health care provider’s behavior is very rough/rude and some behave according to payments. • When patient admitted in hospital, patient parties are emotionally disturbed due to the problem, they feel that problem is only happen to them, they need and except the prompt services and if they don’t get, they become violent and conflicts, quarrels and distortion occurs. • Therefore the relationship between care provider and consumers is very complex and critical though it should be reciprocal. Both sides should play their role as partners accepting system and the situation.

Barriers in effective professional – patient Relationship

• Lack of knowledge about the medical system • in sufficient health resources • Egoism, professional’s constrict that is superiority ego and inferiority complex • Lack of socio-cultural economic knowledge and psychological barriers. • Heavy duty of the professional and misunderstanding • Lack of information and communication • Rumors related to services, procedures and health services. • Lack of budget in organization, lack of beds, medicines, equipments. • Low job satisfaction and morale • Political pressure (parties source and force) • War and violence • Money centered behavior of medical professionals