Table 1.

Nurse Interaction Behaviors and Definitions

Positive Behaviors (14)
Sharing	Facing the patient, the nurse offers him/her such items as a blanket, pillow, ice chips, prescribed food (ex: ice cream), the patient’s CD, TV (ex: on/off or closer), or MP3 player or some other objects* used to support the patient’s wellbeing or treatment. *objects should not include medication or treatments (Ex: offering pain medication or suction)”
Praising	Verbal comments involving approval, recognition or praise to the patient, such as “good”, “that was very well done”, “you look much better today”, and “you are recovering real fast”. All comments must involve clear, audible and a kind tone of voice, and may or may not involve such physical contact as patting the patient’s feet, arms, hands or shoulders.
Visual Contact	The nurse looks the patient in the eyes for as long as the nurse is at the patient’s bedside (unless engaged in incompatible technical procedures, assessment of monitor, or interruptions by family, clinical or other healthcare professionals), regardless of whether the patient is looking at her/him. *This is limited to when the nurse is within the camera frame.
Brief Contact	The nurse stands at a distance no longer than arm’s length from the patient, for a period no shorter than five seconds
Brief Contact with speech	The nurse stands at a distance no longer than arm’s length from the patient, for a period no shorter than five seconds AND includes spoken information from the nurse
Proximity	The nurse stands at a distance no longer than arm’s length from the patient, for a period longer than five seconds
Proximity with speech	The nurse stands at a distance no longer than an arm’s length from the patient’s upper body (from waist up), for a period of > five seconds AND includes spoken information from the nurse. The nurse may be performing medical interventions or procedures.
Physical contact	The nurse touches, pats or hugs the patient. Physical contact includes attention getting touch and touch for comfort. Does NOT include technical/procedural touch.
Social Politeness	The nurse uses terms including “please”, “thank you”, and greets the patient by name. Social politeness also includes asking the patient permission before an action. Ex: “Can I turn off the light”
Preparatory Information	Information given before a procedure. Examples include “you are going to feel a mild sting but it will hurt very little”, “we’re going to give you a sponge bath”. *To achieve “present’, the procedure needs to be started within 10 seconds of preparatory information being given. This does NOT apply if preparatory information occurs simultaneously to the procedure or in reaction to a patient response.
Expanded Preparatory information (education)	Information given before a procedure that includes expanded explanation/education prior to starting the procedure. Examples include: “I am going to give you your medication now. I have your Pepcid. It is used to help prevent stomach ulcers and treat reflux”. To achieve “present’, the procedure needs to be started within 10 seconds of preparatory information being given. This does NOT apply if preparatory information occurs simultaneously to the procedure or in reaction to a patient response.
Preparatory Information with Brief Delay	Same definition as preparatory information but the start of the procedure is > 10 seconds after the information is given as long as the nurse stays on task (ex: collecting supplies, drawing up medications)
Expanded Preparatory information with Brief Delay	Same definition as expanded preparatory information but the start of the procedure is >10 seconds after the information is given as long as the nurse stays on task (ex: collecting supplies, drawing up medications)
Smiling	Lifting lips corners while looking the patient in the eyes
Modeling	Body changes or movements accompanied by the corresponding descriptive verbalization, reproduced by the patient within the following ten seconds (“Please cough like this”, “lift your tongue like this”). Requires patient to model nurses’ gestures, such as thumbs up.
Laughing	Lifting the lips corners or congruently opening the mouth while emitting the characteristic voiced laughter sound, with or without an appropriate comment such as “that was funny Mrs/Mr.(patient’s name)”.
Augmenting	Augments patient’s auditory comprehension be writing, gesturing, showing object, etc.
Negative Behaviors (3)
Disapproving	Verbalizations implicating disagreement, negation, disgust or criticism of the patient. Ex: “No, not like that”, “I’ve already told you how to turn around”.
Yelling	Loud verbalizations or utterances containing comments, threats, criticism or disapproval of the patient. Ex: “Hey, that was really bad!”, “Don’t get out of bed!”, “Don’t remove that bandage!”
Ignoring the Patient	After a request or summons by the patient, the nurse does not answer verbally within five seconds in a congruent manner, or does not perform the requested action or does not give an explanation of why it cannot be done, or simply nods (yes or not), without establishing distinct visual contact with the patient

Note. These definitions have been revised from previous by de los Ríos Castillo, J.L. and Sánchez-Sosa, J. (2002). Changes to the original definitions are identified with italics.