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The Client Encounter Form: conceptual development, reliability analysis, and clinical applications.

M Bear1, L Holcomb

  • 1School of Nursing, University of Central Florida, Orlando, USA. mbear@pegasus.cc.ucf.edu

Public Health Nursing (Boston, Mass.)
|May 13, 1999
PubMed
Summary
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A new Client Encounter Form (CEF) reliably measures nurse practitioner-client interactions. Interactions differ between preventative and problem visits, with preventative care emphasizing health promotion.

Area of Science:

  • Nursing Practice
  • Health Behavior Models
  • Primary Care

Background:

  • Client-nurse practitioner interaction is crucial in primary care.
  • Existing measures may not fully capture interaction dynamics.
  • Cox's Interactional Model of Client Health Behavior provides a framework for understanding these interactions.

Purpose of the Study:

  • To assess the reliability and usability of the Client Encounter Form (CEF) for measuring client-nurse practitioner interactions.
  • To describe the domains of interaction during problem-oriented and preventative visits in primary care.

Main Methods:

  • A descriptive correlational study design was employed.
  • The Client Encounter Form (CEF) was developed based on Cox's Interactional Model.
  • Data were collected via retrospective chart review (n=60) and direct observation of clinic visits (n=41).

Related Experiment Videos

  • Interrater reliability was tested using Cohen's Kappa.

    • Main Results:

    • The CEF demonstrated high interrater reliability (Kappa range: 0.78-1.0) and usability in a primary care setting.
    • Consistent interaction domains included health information, affective support, goal setting, and technical procedures.
    • Preventative visits showed higher levels of health promotion information, psychological affective support, and goal-setting behaviors.
    • Problem-oriented visits involved more diagnosis, medication, and treatment information, with increased affective support for physical conditions.

    Conclusions:

    • The Client Encounter Form (CEF) is a reliable and usable tool for assessing nurse practitioner-client interactions.
    • Distinct interaction patterns exist for preventative versus problem-oriented visits.
    • Findings support the integration of health promotion and tailored affective support within the nurse practitioner model of care.