Individuals with schizophrenia have difficulty forming social relationships. New research has identified deficits in social cognition. These findings have not been applied to studying the nurse-client relationship. The aim of this pilot study is to describe the verbal and nonverbal communication between a psychiatric clinical nurse specialist and clients with schizophrenia through assessment of their videotaped interactions. Clients showed differing levels of ability to respond to the voice and body/facial features of the nurse. The data obtained can be used as a basis for further investigations regarding the interactions between nurses and those clients with severe and persistent mental illnesses.

The goal was to explore the clinical relevance of accurate understanding of patients' thoughts and feelings. Between 2010 and 2012, four groups of participants (nursing students, medical students, internal medicine residents, and undergraduate students) took a test of accuracy in understanding the thoughts and feelings of patients who were videorecorded during their actual medical visits and who afterward reviewed their video to identify their thoughts and feelings as they occurred (Test of Accurate Perception of Patients' Affect, or TAPPA). Participants' accuracy scores were then correlated with participants' attitudes toward patient-centered care, clinical course background, recall of clinical conversation, evaluations of clinical performance made by preceptors, evaluations of interpersonal skill made by standardized patients in clinical encounters, and independent coding of behavior in a clinical encounter. Accuracy in understanding patients' thoughts and feelings was significantly correlated with nursing students' clinical course experience, clinicians' favorable attitudes to psychosocial discussion, standardized patients' evaluations of medical students' interpersonal skill, independent coding of medical students' patient-centered behavior while taking a social history, and undergraduates' more accurate recall of what an actor-physician said on video. Accuracy in perceiving patients' thoughts and feelings can be objectively measured and is a skill relevant to clinical performance.

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The science of social cognitive psychology offers nursing a new perspective on the evolving therapeutic nurse-patient relationship with patients with chronic and persistent mental illnesses. It has implications for clinicians, educators, and nurse scientists.