NURSES' PERSPECTIVES REGARDING THE BARRIERS TO NURSE-PATIENT THERAPEUTIC RELATIONSHIP: A QUALITATIVE DESCRIPTIVE STUDY

Abstract

Background: The nurse–patient therapeutic relationship represents a purposeful and professional interaction founded on trust, empathy, respect, and confidentiality. It plays a crucial role in improving patient outcomes, satisfaction, and adherence to care. Despite its established significance, many nurses continue to face challenges in developing and maintaining such relationships within high-demand healthcare environments, especially in public sector tertiary hospitals, where workload, communication, and cultural diversity contribute to relational difficulties.

Objective: The objective of this study was to explore nurses’ perceptions regarding the barriers to establishing effective nurse–patient therapeutic relationships in public sector tertiary care hospitals.

Methods: A qualitative descriptive study was conducted at Khyber Teaching Hospital, Peshawar, Khyber Pakhtunkhwa. Purposive sampling was used to recruit thirteen (n=13) registered nurses with at least two years of clinical experience in medical, surgical, and intensive care units. Data were collected through semi-structured, face-to-face interviews that were audio-recorded and transcribed verbatim. Thematic analysis was performed following Braun and Clarke’s six-phase inductive framework, ensuring systematic identification of recurring patterns and themes. Ethical approval was obtained from the Ethical Review Board and Advanced Studies Research Board of Khyber Medical University.

Results: Thematic analysis generated 29 codes, 10 subthemes, and 5 main themes: Communication Challenges, Time Constraints, Patient Factors, Cultural and Diversity Factors, and Training and Education. The findings revealed that heavy workloads, linguistic diversity, patient resistance, cultural barriers, and lack of professional development opportunities were significant impediments to effective therapeutic engagement between nurses and patients.

Conclusion: The study concluded that communication barriers, workload pressures, and limited training opportunities significantly undermine therapeutic relationships in public healthcare settings. Addressing these barriers through structured communication training, cultural competence programs, and organizational support systems is essential for improving patient-centered care and enhancing nurse–patient collaboration.