The CPN in primary care: a pilot study of the process of assessment

Abstract

Psychiatric nursing research has come a long way since Professor Annie Altschul’s seminal study of interaction patterns which was published in her famous monograph Patient-Nurse Interaction (Altschul, 1972). However, there has been very little work carried out in the area of the process of care of clients with non-psychotic problems by community psychiatric nurses (CPNs). Other work (for example, Parnell, 1978; Sladden, 1979) has focused on the care of clients who were suffering from schizophrenia. The first study which looked at the nature of community psychiatric nursing contacts with ‘neurotic’ clients was that of Paykel and Griffith (1983) in the well known study at Springfield Hospital. The information from this study was derived from a record which the nurses filled in after every contact, together with material from interviews with nurses, and comments made informally in the regular meetings between the research team and the nurses. In addition, Paykel and Griffith (1983) also collected detailed case reports written by nurses on illustrative cases. The nurses completed their treatment record at each contact with the client and, in all, there were data on 349 contacts. Of these, 322 were face-to-face contacts rather than by telephone. Interestingly, and in marked contrast to the study reported below, contacts in this study were predominantly in the client’s home (93.5%). Paykel and Griffith (1983) categorized the various verbal interactions and the most commonly discussed areas were symptoms of current illness, the nature of the illness and its prognosis, social life and hobbies, interpersonal relationships, employment, family problems with spouse, parents and children, and physical health (Paykel and Griffith, 1983, p. 76).