AN INVESTIGATION OF THE RELATIONSHIPS BETWEEN ADOLESCENT HOPEFULNESS, CARING BEHAVIORS OF NURSES AND ADOLESCENT HEALTH CARE OUTCOMES (SUBSTANCE ABUSE, LONGITUDINAL DESIGN, VISUAL ANALOGUE).

Abstract

The primary purpose of this study was to describe relationships between the concepts of caring behaviors of nurses, adolescent hopefulness and adolescent health care outcomes. The secondary purpose was to test and refine instruments developed to index those concepts. The conceptual framework used for the study was derived from two sources: an existential theory of nursing, Humanistic Nursing, as developed by Paterson and Zderad (1976). and a set of inductive studies on nurse-adolescent patient interactions (Hinds, 1983). A longitudinal, descriptive-correlational design having three data collection points was used. The study sample consisted of 25 adolescents (x age 15.6 years) receiving inpatient treatment for substance abuse. The data collection points occurred at 24-48 hours after admission (T₁), 96-120 hours before discharge (T₂), and 4-5 weeks after discharge (T₃). Adolescents completed visual analogue instruments and responded to a set of open-ended questions indexing the study concepts. Instrumentation data were analyzed using descriptive and correlational statistics and tests of significance for change. Qualitative data resu1ting from the interviews were content analyzed. Findings included statistically significant positive relationships between the concepts of caring behaviors of nurses and adolescent hopefulness at T₁, and T₂. Secondly, the relationship between adolescent hopefulness and adolescent health care outcomes was statistically significant at T₃. The concepts of caring behaviors of nurses and adolescent hopefulness changed significantly in a positive direction from T₁ to T₂. Content analysis findings indicated the concept of adolescent hopefulness was qualitatively different at each of the data collection points. Findings provide support for the theorized link between nurse-patient relationships and positive patient change. The purposeful use of a caring self for positive patient change represents the blend of art and science that defines the nursing profession.