Electronic Thesis and Dissertation Repository


Doctor of Philosophy




An Ethnographic Study Examining Nurse-Client Relationships in a Jordanian Mental Health Care Setting

The nurse-client relationship is viewed as the primary human contact that is crucial to providing nursing care. Interaction processes need to be investigated within their cultural context in order for the nurses to establish a therapeutic nurse-client communication that is congruent with the culture in which it takes place.

The purpose of this study was to explore and describe the Jordanian mental health care system, and investigate how the cultural values and beliefs of Jordanians shape nurse-client relationships. The study utilized an ethnonursing approach. Data were collected through observation and interviewing. Nine nurse-client dyads were purposefully recruited from a Jordanian mental health care setting. A total of 34 open-ended semi-structured interviews with the communicators were held to explore their perceptions on nurse-client interactions. Three months of intensive observation-participation were also held on site.

Thematic/pattern analysis of the interviews and field notes was conducted. The main themes of study included: the journey from community to hospital and back to the community, the lack of resources- an obstacle to providing standard care, the establishment of the new model unit- a look into the future, the stigma of mental illness- societal responses and responsibilities, and views on the progress of nurse-client relationships. Several qualities, facilitators, and barriers to nurse-client relationships were identified. Variations were also portrayed with collected data in regular units in the center versus the newly established unit ‘the model unit’.

The quality of mental health care in Jordan is significantly improving. However, limited resources were the main limitations to the nurse-client relationships. Several implications were derived from this study toward improving mental health nursing in Jordan. Implications for practice, education, policy, and future research are provided.