Measuring development of therapeutic relationship

Therapeutic relationships between a caregiver and child help to promote social, emotional, cognitive and physical development. The purpose of this study is to determine the effectiveness of an educational program, " Pediatric Nurturing-care" at Children's Medical Center Dallas by which healthcare providers developed competencies for therapeutic nurturing relationships. The program was based on the Nursing Child Assessment Satellite Training, (NCAST) and included lectures, videos, case studies, and "hands-on" experiences. Development of competencies was assessed by comparison of pre and post-tests as well as pre and post-observations. Participants were observed utilizing a standardized assessment tool, the NCAST-PCI scale. All study observers were certified by NCAST-AVENUW. A total of 11 providers participated in the study. Results using t-tests indicated a significant difference between the pre and post-test data (p< 0.05) and pre and post-observations (p< 0.05). Study means for education and different ethnic groups were higher than the NCAST database. Although there was evidence of nurturing behaviors, participants could not consistently identify or articulate infants' responses. Factors such as busy work schedules and an acute care setting prevented participants from actively promoting infant mental health. Recommendations from the study included: study replication; changes in the Pediatric Nurturing Care curriculum; organizational changes and changes in the patient-care delivery model. Pediatric hospitals have the opportunity to partner with families to build a strong foundation for development of brain architecture. They can begin by helping health professionals develop competencies for therapeutic relationships with children and families.