Abstract

• It is the purpose of this study to make clear the way in which people can lead a more desirable human life, that is, to ascertain the method of achieving therapeutic change through transaction between nurses and psychiatric patients. The various problems proposed by the above-stated aims of study can be shown, such as: What kind of influences does the method of a nurse's communication have upon the response of psychiatric patiants? 1) What are the general methods of communication used by the nurses? 2! Are there any differences between the control group and experimental group in the patients' "Child" response? 3) Are there any differences between the control group and experimental group in the Patients-"Adult" response? 4) What is the most desirable method of communication for therapeutic change in the patients? In an effort to solve the above questions this study attempted and managed to draw a random sampling of 200 patients being accommodated in the National Mental Hospital by dividing them into two groups, experimental groups and conrol groups, and recording the transactions between nurses and patients. In the course of carrying out this study, the experimental group was interviewed by the nurses specially trained in the P.A.C theory, and the control group interviewed at random by the nurses with no special training in communication. Further, the communication between nurses and patients in a free, relaxed atmosphere was allowed only for 15 minutes, whereupon the nurses were requested to make process-recording according to her memory of nurse- patient transaction. The process-recording which recorded a series of transactions between the nurses and the patients-was analyzed according to Berne and Harris' transactional Analysis Standard. Through this standard, the writer of this study examined the significance of difference to compare the transactions brought forth between the experimental group and the control group. The following is a summary of the study which the writer of this thesis undertook. Hypothesis I. The method of communication which the nurses usually apply to the patients will be higher in "Parent" than in "Adult". The communication which the nurses carried out in the control group turned out fo be not significant between "Adult" and "Parent" Accordingly hypothesis 1. came to be rejected. Hypothesis 2. The patients "Adult" response will be higher in the experimental group than in the control group. According to the result of a CR examination, as the communication showed a significant difference on P<.01 level' hypothesis 2 became affirmative. Hypothesis 3. The patients' "Child" response will be higher in the control group than in the experimental group. Hypothesis 3 proved affirmative since it showed an significant degree on P<.01 level according to the result of a CR examination. Hypothesis 4 "Adult" response of the patient will be higher in frequency by nurses' "Adult" stimulus than nurse's "Parent" stimulus Chi-square examination revealed significant differenne on P<.05 level. H-ypo. 4 is affirmed. The following conclusions are drawn out based on the result of this study. 1) The generally used method of communication stimulus used by nurses for patients proved to be "Adult" and "Parent" in similar proportion. 2) The group in which the nurses could increase pthe atients' "Adult" response proved to be higher in the experimental group than in the control group. Therefore, the communication (or stimulus) which has been applied in the experimental group can be said to be possible method of achieving therapeutic change. 3) Since the patients' "Child" response were higher in the control group than in the experimental group the communication method used in the control group was suggested as the less agreeable method of achieving therapeutic change than that used in the experimental group. 4) "Adult" response of patient was elicited in significantly greater percentage when the "Adult" stimulus was used by the nurse. Therefore, the most desirable method of - communication to give therapeutic change definitely was shown to be the "Adult" stimulus. Recommendations for further studies are as follows: 1) Studies on nurses' role perception in nurse-patient relationships. 2) Studies on patients' response to the method of cammunication used by nurses according to variables such as sex, social status, educational background, state of health. 3) Application of T.A. method to various groups of patients. 4) Study of various methods to improve student skill in use of process recording.

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