Instruments measuring behavioural aspects of the nurse–patient relationship: A scoping review

Rebecca Feo, Tiffany Conroy, Rick Wiechula, Philippa Rasmussen, Alison Kitson

Research output: Contribution to journalReview articlepeer-review

27 Citations (Scopus)


Aims and objectives
To identify and map tools measuring behavioural aspects of the nurse–patient relationship.
The behaviours nurses employ to develop relationships with patients form a key part of nursing practice. Systematically measuring these behaviours provides an objective means of assessing and evaluating how nurses establish and maintain relationships with patients in a variety of settings. Whilst tools exist to measure these behaviours, little is known about their aims/scope, structure, method of development and contexts of use. Such knowledge is crucial for understanding the nature of the literature, including in which contexts and for which patient groups existing tools are suited.
Scoping review informed by Joanna Briggs Institute methodology.
A database search was undertaken using CINAHL, PsycINFO, Pubmed and Embase. Primary research articles, theses and methodological papers that developed, refined and/or administered tools measuring behavioural aspects of the nurse–patient relationship, in any setting and for any patient group, were included. Tools had to measure actual not hypothetical behaviour (e.g., perceptions regarding importance). Data from included studies and tools were mapped. Results are reported in accordance with PRISMA‐ScR guidelines.
One hundred and twenty‐seven studies, containing 35 tools, were included. The literature was characterised by substantial variability, stemming from the continued refinement of tools (e.g., reduction to short forms) but also the development of new tools that appeared to duplicate existing work and the inconsistent use of tools across studies.
The volume of tools available demonstrates the importance of measuring the nurse–patient relationship. However, the existing duplication and variability create challenges in choosing amongst the tools available and show that, as a concept, the nurse–patient relationship remains poorly understood.
Relevance to clinical practice
Research is required to synthesise, and assess the quality of, existing tools, enabling clinicians, leaders/managers, educators and researchers to administer appropriate tools to evaluate the nurse–patient relationship.
Original languageEnglish
Pages (from-to)1808-1821
Number of pages14
JournalJournal of Clinical Nursing
Issue number11-12
Early online date25 Jun 2019
Publication statusPublished - 1 Jun 2020


  • behaviour
  • measure
  • nurse–patient relations
  • nurse–patient relationship
  • nursing care
  • tool


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