Development of an observational instrument to study nurse-patient touch

A detailed analysis of videotaped data of nurse-patient interactions (NPIs) was used to identify the structure of NPIs and the important behaviors comprising touching interactions that could serve as a basis for the development of an observational instrument to study nurse-patient touch. The resulting coding system enabled observers to record types of nurse attending, eye gaze, proximity, nurse-patient dialogue, nurse activity, patient condition, presence of others in the room, and characteristics of nurse-patient touch. To evaluate this instrument, two samples of videotaped NPIs were selected and coded by three observers. Acceptable levels of interobserver and intraobserver agreement and observer reliability were established and maintained throughout the coding process, with the exception of two categories (i.e., nurse activity and intensity of touch). The two samples were compared to provide further support for the content validity of the coding system and to evaluate the sensitivity of the measure to the same behaviors in different samples of NPIs. It was concluded that this instrument has potential for use in describing the patterns of touch nurses use in a more comprehensive and detailed way than has been done in the past and that this instrument warrants further study in other clinical contexts.