The effect of nurse–patient interaction.

The effect of nurse–patient interaction on anxiety and depression in cognitively intact nursing home patients

Gørill Haugan, Siw T Innstrand and Unni K Moksnes

Aims and objectives. To test the effects of nurse–patient interaction on anxiety and depression among cognitively intact

nursing home patients.

Background. Depression is considered the most frequent mental disorder among the older population. Specifically, the

depression rate among nursing home patients is three to four times higher than among community-dwelling older people,

and a large overlap of anxiety is found. Therefore, identifying nursing strategies to prevent and decrease anxiety and depres-

sion is of great importance for nursing home patients’ well-being. Nurse–patient interaction is described as a fundamental

resource for meaning in life, dignity and thriving among nursing home patients.

Design. The study employed a cross-sectional design. The data were collected in 2008 and 2009 in 44 different nursing

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homes from 250 nursing home patients who met the inclusion criteria.

Methods. A sample of 202 cognitively intact nursing home patients responded to the Nurse–Patient Interaction Scale and

the Hospital Anxiety and Depression Scale. A structural equation model of the hypothesised relationships was tested by

means of LISREL 8.8 (Scientific Software International Inc., Lincolnwood, IL, USA).

Results. The SEM model tested demonstrated significant direct relationships and total effects of nurse–patient interaction on

depression and a mediated influence on anxiety.

Conclusion. Nurse–patient interaction influences depression, as well as anxiety, mediated by depression. Hence, nurse–

patient interaction might be an important resource in relation to patients’ mental health.

Relevance to clinical practice. Nurse–patient interaction is an essential factor of quality of care, perceived by long-term nurs-

ing home patients. Facilitating nurses’ communicating and interactive skills and competence might prevent and decrease

depression and anxiety among cognitively intact nursing home patients.

Key words: anxiety, depression, nurse–patient interaction, nursing home, structural equation model analysis

Accepted for publication: 11 September 2012

Introduction

With advances in medical technology and improvement in the

living standard globally, the life expectancy of people is

increasing worldwide. The document An Aging World (US

Census Bureau 2009) highlights a huge shift to an older popu-

lation and its consequences. Within this shift, the most rapidly

growing segment is people over 80 years old: by 2050, the per-

centage of those 80 and older would be 31%, up from 18% in

1988 (OECD 1988). These perspectives have given rise to the

notions of the ‘third’ (65–80 years old) and the ‘fourth age’

(over 80 years old) in the lifespan developmental literature

(Baltes & Smith 2003). These notions are also referred to as

the ‘young old’ and the ‘old old’ (Kirkevold 2010).

Authors: Gørill Haugan, PhD, RN, Associate Professor, Faculty of

Nursing, Research Centre for Health Promotion and Resources,

Sør-Trøndelag University College, HIST, Trondheim; Siw T

Innstrand, PhD, Associate Professor, Research Centre for Health

Promotion and Resources Norwegian University of Science and

Technology, NTNU, Trondheim; Unni K Moksnes, PhD, RN,

Associate Professor, Faculty of Nursing, Research Centre for

Health Promotion and Resources, Sør-Trøndelag University

College, HIST, Trondheim, Norway

Correspondence: Gørill Haugan, Associate Professor, Research

Centre for Health Promotion and Resources, HIST/NTNU, NTNU,

SVT/ISH, 7491 Trondheim, Norway. Telephone:

+47 73 55 29 27.E-mail: gorill.haugan@hist.no

The effect of nurse–patient interaction.

For many of those in the fourth age, issues such as physi-

cal illness and approaching mortality decimates their func-

tioning and subsequently lead to the need for nursing home

(NH) care. A larger proportion of older people will live for

shorter or longer time in a NH at the end of life. This

group will increase in accordance with the growing popula-

tion older than 65, and in particular for individuals older

than 80 years. Currently, 1�4 million older adults in the USA live in long-term care settings, and this number is