Perceived professional support and the use of blocking behaviours by hospice nurses

A prospective study of the impact of training 41 hospice nurses in assessment skills was used to test hypotheses that blocking behaviours would be used more when patients disclosed feelings and used less when nurses perceived that they had satisfactory professional support. Each nurse was asked to assess a patient's current problems before and after feedback training and 8 months later. Audiotape recordings of these interviews were rated by trained raters. They determined the frequency of nurses' responses which had the function of blocking patient disclosure and the emotional level of patient disclosure. Before each patient assessment each nurse was interviewed and questionnaires administered to measure her perceptions of the support she received. Blocking behaviours were most evident when patients disclosed their feelings (Kendalls r = 0.36, P < 0.001). In interviews containing most patient disclosure of feeling, blocking was significantly less (r = -0.24, P < 0.5) when the nurse felt that practical help would be available if needed and when the nurse felt that her direct supervisor was concerned about the nurse's own welfare (r = -0.37, P < 0.005).