Client–caregiver–nurse coalition formation in decision‐making situations during home visits

Abstract

Although the study sample was small, the findings expand understanding of the relation between types of decisions and formation of coalitions during triadic interactions in home health care, and provided empirical support for a portion of the Theory of Collaborative Decision-Making in Nursing Practice for Triads.

‘Mutual intacting’: a grounded theory study of clinical judgement practice issues

“…The patient is viewed as an ‘object’ and a repository of clinical cues, the patient encounter serves as a conduit for collecting pre‐determined data, and the practitioner is an ‘expert’ in knowing which clinical cues to collect. ‘Mutual intacting’ challenges the degree to which clinical practitioners in this study worked within the principles of clinical judgement as presented by these writers, and supports findings from other patient‐centred studies that suggest that there is a considerable level of incongruence between the ideals underpinning clinical judgement and the reality of community care practice (Offredy 1998, Dalton 2005).…”

Negotiating the balance: The triadic relationship between spousal caregivers, people with dementia and Admiral Nurses

“…These coalitions could occur in any encounters with other health care professionals. In a study of decision-making between caregivers, caregivers and clients, Dalton (2005) reported that often coalitions occurred between the nurse and caregiver against the client. Coalitions could also occur in encounters with social care providers (Twigg, 1989).…”

Recognizing decision needs: first step for collaborative deliberation in dementia care networks

“…Quinn, Clare, McGuinness and Woods [5] have described how triads of people with dementia, their spouses and nurses must constantly negotiate the balance between their own needs and the views of the others involved. In this context, coalitions may be formed between participants to reach solutions for certain problems [4,5]. Professionals should be aware of these coalition strategies, because they may involve overruling the perspectives of either the person with dementia or the informal caregiver.…”

“…Care networks are networks including a patient, and a mixture of often multiple informal caregivers and professionals who collaborate to care for this particular person [3]. Few publications address the nature of interactions among networks of clients, informal caregivers and health professionals when making decisions [4,5]. The evidence till now indicates that professionals tend to overlook the possible role of the informal caregivers in decision-making; their role is often not discussed by professionals and they are not facilitated to contribute their unique perspectives [6].…”