The Relationship Competences Guiding Tool (NarratUN)

The Relationship Competences Guiding Tool: A Development, Content Validation and Implementation Study

Aim: The aims of this study are: (1) to present the development, content validation and implementation study of the Relationship Competences Guiding Tool (RCGT); (2) to show some examples of how each of the items of the guide may be reflected on clinical narratives written by nurses, and justify its corresponding scores after the evaluation; (3) to present how the language and content of the narratives are interpreted with this guide and to describe an exemplar; (4) to present barriers and facilitators of its application.

Background: From a person-centred care approach, the fostering of authentic relationships with patients is key for therapeutic benefits. Therefore, it is essential to help nurses to establish meaningful relationships with patients and help them to achieve these abilities. In this line, clinical narratives can be used as a way to promote reflective practice and professional competences development between nurses. A guide to evaluate the knowledge, skills, attitudes and values necessary for developing authentic encounters with patients reflected by nurses on clinical narratives was developed and implemented.

Design: Design and evaluation of the RCGT, and evaluation of its implementation Methods: This study was conducted in three major steps. Step one entailed the conceptualization. Step two included the generation of items and content validation. Then, in step three, the tool was used to independently evaluate 25 narratives by two researchers, in order to identify and exemplify the attributes of the nurse patient relationship defined on the guide and identify barriers and facilitators. One of the narratives was linguistically analysed in the light of the guide, in order to provide a comprehensive view of the interpretative strategies deployed by evaluators.

Results: The RCGT helped to identify nursing professional competences reflected in clinical narratives. The tool guided in the process of assigning scores to the corresponding items. The use of the tool helped to identify some barriers and facilitators before and during the narrative evaluation process.

Conclusions: A clear, relevant, conceptually and linguistically adequate guide for assessing clinical narratives was obtained. The RCGT can be applied to accurately interpret how nurses reflect professional competences in a clinical narrative as a preliminary step to design a measurement tool.

Study Overview

• Status: Completed
• Conditions: Nurse-Patient Relations; Professional Role; Narration
• Intervention / Treatment: Other: Writing a clinical narrative

Detailed Description

This study is the first to present a valid guide for interpreting the essential aspects (respect, intentional presence and knowing the person) of the nurse-person relationship using clinical narratives. This is therefore an innovative tool to facilitate the nurses' work in caring patients and families, ensuring the success of a person-centred care for the target population. Moreover, this study describes the rigorous process that has been carried out both for the content validation of the RCGT, as well as for its application by two researchers independently with different backgrounds and perspectives.

• Study Type: Interventional
• Enrollment (Actual): 25
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Spain
  • Navarra
    • Pamplona, Navarra, Spain, 31008
      • Clinica Universidad de Navarra

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: ADULT; OLDER_ADULT; CHILD
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• nurses who agreed to participate and signed informed consent.
• nurses from different hospitals and clinical departments/services, such as general hospital wards, intensive care units, outpatient services, and other departments (i.e., perioperative, elder care, and haemodialysis, emergency, etc).

Exclusion Criteria:

. other health professionals different from nurses.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: OTHER
• Allocation: NA
• Interventional Model: SINGLE_GROUP
• Masking: NONE

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: Writing a clinical narrative; The participants had to write a clinical narrative regarding a significant encounter with a patient.	Other: Writing a clinical narrative; The participants had to write a clinical narrative regarding a significant encounter with a patient.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Professional competence 1: respect	The knowledge, skills, attitudes and values necessary for developing respect towards the patient. The Relationship Competences Guiding Tool was used to evaluate this competence.	One month

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Professional competence 2: intentional presence	The knowledge, skills, attitudes and values necessary for developing intentional presence towards the patient. The Relationship Competences Guiding Tool was used to evaluate this competence.	One month
Professional competence 3: knowing the person	The knowledge, skills, attitudes and values necessary for knowing the person. The Relationship Competences Guiding Tool was used to evaluate this competence.	One month

Collaborators and Investigators

• Sponsor: Clinica Universidad de Navarra, Universidad de Navarra
• Investigators: Principal Investigator: Ana Choperena, PhD, University of Navarra

Publications and helpful links

General Publications

• Choperena A, Oroviogoicoechea C, Zaragoza Salcedo A, Olza Moreno I, Jones D. Nursing narratives and reflective practice: A theoretical review. J Adv Nurs. 2019 Aug;75(8):1637-1647. doi: 10.1111/jan.13955. Epub 2019 Feb 27.
• Choperena A, Pardavila-Belio MI, Errasti-Ibarrondo B, Oroviogoicoechea C, Zaragoza-Salcedo A, Goni-Viguria R, Martin-Perez S, Llacer T, La Rosa-Salas V. Implementation and evaluation of a training programme to promote the development of professional competences in nursing: A pilot study. Nurse Educ Today. 2020 Apr;87:104360. doi: 10.1016/j.nedt.2020.104360. Epub 2020 Jan 29.

Study record dates

Study Major Dates

• Study Start (Actual): September 1, 2019
• Primary Completion (Actual): February 1, 2020
• Study Completion (Actual): February 1, 2022

Study Registration Dates

• First Submitted: August 24, 2022
• First Submitted That Met QC Criteria: August 31, 2022
• First Posted (Actual): September 6, 2022

Study Record Updates

• Last Update Posted (Actual): September 6, 2022
• Last Update Submitted That Met QC Criteria: August 31, 2022
• Last Verified: August 1, 2022

More Information

Terms related to this study

• Keywords: Patient centred care; Clinical narrative; Guide
• Other Study ID Numbers: 2020.002

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: We will not share the clinical narratives. We will use the conclusions of the study for educational purposes.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No