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  • 1.
    Johnsson, Anette
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level. Jönköping University, School of Health and Welfare, Sweden.
    Boman, Åse
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Wagman, Petra
    Jönköping University, School of Health and Welfare, Sweden.
    Pennbrant, Sandra
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Voices used by nurses when communicating with patients and relatives in a department of medicine for older people: An ethnographic study2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 7-8, p. E1640-E1650Article in journal (Refereed)
    Abstract [en]

    AIM: To describe how nurses communicate with older patients and their relatives in a department of medicine for older people in western Sweden.

    BACKGROUND: Communication is an essential tool for nurses when working with older patients and their relatives but often patients and relatives experience shortcomings in the communication exchanges. They may not receive information or are not treated in a professional way. Good communication can facilitate the development of a positive meeting and improve the patient's health outcome.

    DESIGN: An ethnographic design informed by the sociocultural perspective was applied.

    METHOD: Forty participatory observations were conducted and analyzed during the period October 2015 to September 2016. The observations covered 135 hours of nurse-patient-relative interaction. Field notes were taken and 40 informal field conversations with nurses and 40 with patients and relatives were carried out. Semi-structured follow-up interviews were conducted with five nurses.

    RESULTS: In the result, it was found that nurses communicate with four different voices: a medical voice described as being incomplete, task-oriented and with a disease perspective; a nursing voice described as being confirmatory, process-oriented and with a holistic perspective; a pedagogical voice described as being contextualized, comprehension-oriented and with a learning perspective; and a power voice described as being distancing and excluding. The voices can be seen as context-dependent communication approaches. When nurses switch between the voices this indicates a shift in the orientation or situation.

    CONCLUSION: The results indicate that if nurses successfully combine the voices, while limiting the use of the power voice, the communication exchanges can become a more positive experience for all parties involved and a good nurse-patient-relative communication exchange can be achieved.

    RELEVANCE TO CLINICAL PRACTICE: Working for improved communication between nurses, patients and relatives is crucial for establishing a positive nurse-patient-relative relationship, which is a basis for improving patient care and healthcare outcomes. This article is protected by copyright. All rights reserved.

  • 2.
    Johnsson, Anette
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level. Jönköping University, School of Health and Welfare, Jönköping, Sweden.
    Wagman, Petra
    Jönköping University, School of Health and Welfare, Jönköping, Sweden.
    Boman, Åse
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Pennbrant, Sandra
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Striving to establish a care relationship -Mission possible or impossible?: Triad encounters between patients, relatives and nurses2019In: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 22, no 6, p. 1304-1313Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: When patients, relatives and nurses meet, they form a triad that can ensure a good care relationship. However, hospital environments are often stressful and limited time can negatively affect the care relationship, thus decreasing patient satisfaction.

    OBJECTIVE: To explain the care relationship in triad encounters between patients, relatives and nurses at a department of medicine for older people.

    DESIGN: A qualitative explorative study with an ethnographic approach guided by a sociocultural perspective.

    METHOD: Participatory observations and informal field conversations with patients, relatives and nurses were carried out from October 2015-September 2016 and analysed together with field notes using ethnographic analysis.

    RESULT: The result identifies a process where patients, relatives and nurses use different strategies for navigating before, during and after a triad encounter. The process is based on the following categories: orienting in time and space, contributing to a care relationship and forming a new point of view.

    CONCLUSION: The result indicates that nurses, who are aware of the process and understand how to navigate between the different perspectives in triad encounters, can acknowledge both the patient's and relatives' stories, thus facilitating their ability to understand the information provided, ensure a quality care relationship and strengthen the patient's position in the health-care setting, therefore making the mission to establish a care relationship possible.

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  • 3.
    Johnsson, Anette
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level. Jönköping University, School of Health and Welfare, Jönköping University, Sweden.
    Wagman, Petra
    Jönköping University, School of Health and Welfare, Jönköping University, Sweden.
    Boman, Åse
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Pennbrant, Sandra
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    What are they talking about? Content of the communication exchanges between nurses, patients and relatives in a department of medicine for older people: An ethnographic study2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 7-8, p. E1651-E1659Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To explore and describe the content of the communication exchanges between nurses, patients and their relatives in a department of medicine for older people in western Sweden.

    BACKGROUND: Information, messages and knowledge are constantly being communicated between nurses, older patients and relatives in the healthcare sector. The quality of communication between them has a major influence on patient outcomes. A prerequisite for good care to be given and received is that there is mutual understanding between the parties involved.

    DESIGN: An ethnographic study was informed by a sociocultural perspective.

    METHOD: Data were collected through 40 participatory observations of meetings between nurses and older patients and/or relatives which covered 135 hours of nurse-patient-relative interaction, field notes, 40 field conversations with 24 nurses and 40 field conversations with patients (n=40) and relatives (n=26). Five semi-structured interviews were conducted with nurses. An ethnographic analysis was performed.

    RESULTS: The analysis identified three categories of content of the communication exchanges: medical content focusing on the patient's medical condition, personal content focusing on the patient's life story, and explanatory content focusing on the patient's health and nursing needs. The content is influenced by the situation and context.

    CONCLUSIONS: Nurses would benefit from more awareness and understanding of the importance of the communication content and of the value of asking the didactic questions (how, when, what and why) in order to improve the patients' and relatives' understanding of the information exchanges and to increase patient safety.

    RELEVANCE TO CLINICAL PRACTICE: Nurses can use the communication content to create conditions enabling them to obtain a holistic view of the patient's life history and to develop an appropriate person-centered care plan. This article is protected by copyright. All rights reserved.

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