Client–nurse relationships in home‐based palliative care: a critical analysis of power relations

Oudshoorn, Abe; Ward‐Griffin, Catherine; McWilliam, Carol L.

doi:10.1111/j.1365-2702.2006.01720.x

Cited by 49 publications

(56 citation statements)

References 38 publications

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“…Relationships between patients and caregivers are asymmetric and, because of this, patients are always more vulnerable and have less power than the caregivers. According to Oudshoorn et al [27], one consequence of this imbalance in the care relationship, can be demonstrated through caregivers' exercise of power. An example of this is the dominance gained by having information about the patients that the patients did not choose to disclose.…”

Section: Discussionmentioning

confidence: 99%

Patients' and Caregivers' Attributes in a Meaningful Care Encounter: Similarities and Notable Differences

Snellman

Gustafsson

2012

ISRN Nursing

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In today's healthcare system, there is an imbalance between what patients expect of caregivers' care and their perception of the care they get. How is it possible to reduce this imbalance? The aim of this paper was to describe attributes associated with meaningful encounters in the Swedish healthcare system based on patients' and caregivers' written narratives and to note the differences and similarities between the attributes identified by the two groups. This paper is a qualitative descriptive study. The analysis was guided by qualitative content analyses. Based on patients' narratives, attributes associated with a meaningful encounter fell into four categories: the kind-hearted caregiver, the thoughtful caregiver, the mutually oriented caregiver, and the helpful caregiver. Based on caregivers' narratives, the attributes were categorized as being humane, caring through physical contact, caring by nurturing communication, joy and laughter in care, and a sense of mutuality. The results show that there are both similarities and differences in patients' and caregivers' opinions about the attributes of a meaningful encounter. Knowing more about the attributes associated with meaningful encounters makes it possible for caregivers to individualize care for patients and makes it easier to help and support patients in what they most need support with.

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Section: Discussionmentioning

confidence: 99%

Patients' and Caregivers' Attributes in a Meaningful Care Encounter: Similarities and Notable Differences

Snellman

Gustafsson

2012

ISRN Nursing

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“…Other demonstrations of this power found in the experiences lived by the patients are the attention the nurse gives to the person who is the patient and his problems, involving them in decisions over their care, using humor, stimulating them to act and basing all intervention upon respect and mutual trust (Fagerberg and Jönhagen 2002;Kettunen et al 2002;Oudshoorn et al 2007;Shatell 2005, Halldorsdottir 2008). …”

Section: The Power or The Lack Of It In Nursing Carementioning

confidence: 94%

RETRACTED ARTICLE: The encounter with the vulnerable body: applying the lens of caring practice

Laranjeira

2014

Med Health Care and Philos

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Humans can never escape their existential vulnerability and it is shown even in the example from holistic care, where health care providers really try to understand the complexities of care and life itself. Applying a integrated and humanistic approach, this theoretical paper analyses the ways and mechanisms of power that appear in a nurse-patient relationship as both a challenge and an imperative of contemporary caring practice. This will be demonstrated by one example from caring practice that illustrates the strategies of power that emerge in a body care interaction. Findings indicate the existence of power exercised by the nurse over and with the patient and concurrently another power exercised upon the nurse, that leads the nurse to control his/her participation in care, as well as that of the patient-the power of organization the nurse feels as regulator of time and obligation to render care. The control of participation in care is a mode of exercising power that frames and disciplines real time as a function of dividing activities in organized time. It is the responsibility of the nurse to be aware of the power imbalance, to recognize the potential for patients to feel intimidated and to create a therapeutic alliance. The right use of power in the nurse-patient interaction guarantees the patient's needs are foremost and the patient's vulnerability is sheltered.

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“…As an example, usual power relations are disturbed when care is delivered at home. 21,43,44 Nurses in particular appear to adopt the role of guest, 45 gaining authority by persuasion rather than by virtue of knowledge and skill 21,46 potentially hindering their ability to effectively manage the interaction.…”

Section: Discussionmentioning

confidence: 95%

Effectiveness of Pain Management in Hospital in the Home Programs

Duke

Botti

Hunter

2012

The Clinical Journal of Pain

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Treatment of pain at home was suboptimal with patients experiencing moderate-to-severe pain and discomfort during the treatment phase of their illness. Lack of appropriate discharge planning strategies meant that patients went home without adequate analgesia and use of nonprescribed pain medication was common. The number of patients transferred home without analgesics indicates a worrying underrecognition of the need for analgesia in this care context and poses a risk to patient safety that is no less significant because patients are at home.

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Client–nurse relationships in home‐based palliative care: a critical analysis of power relations

Abstract: The insights gained through this investigation may assist nurses and other health professionals in reflecting on and improving practices and policies within home-based palliative care and within home care in general.

Cited by 49 publications

References 38 publications

Patients' and Caregivers' Attributes in a Meaningful Care Encounter: Similarities and Notable Differences

Patients' and Caregivers' Attributes in a Meaningful Care Encounter: Similarities and Notable Differences

RETRACTED ARTICLE: The encounter with the vulnerable body: applying the lens of caring practice

Effectiveness of Pain Management in Hospital in the Home Programs

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