It takes two to tango: A dyadic approach to understanding the medication dialogue in patient-provider relationships

Schoenthaler, Antoinette; Basile, Melissa; West, Tessa V.; Kalet, Adina

doi:10.1016/j.pec.2018.02.009

Cited by 10 publications

(4 citation statements)

References 34 publications

(32 reference statements)

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“…Therefore, according to the findings of the two studies above, good relationship between the nurse and the patient can itself be viewed as a nonpharmacological pain management method. In addition, a qualitative study by Schoenthaler, Basile, West, and Kalet (2018) also reported that communication styles can either facilitate or hinder pain management. Thus, the successful use of nonpharmacological pain management interventions depends on the patient–nurse relationship being one in which the patient can open up and speak freely.…”

Section: Discussionmentioning

confidence: 99%

Nurses’ experiences of providing nonpharmacological pain management in palliative care: A qualitative study

Munkombwe¹,

Petersson

Elgán

2020

Journal of Clinical Nursing

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This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. AbstractAim and objectives: To explore the experiences and views of nurses who provide nonpharmacological therapies for chronic pain management in palliative care.Background: Nursing expertise in palliative care is essential in providing pain relief to patients with chronic diseases. Examinations of the use of nonpharmacological therapies for chronic pain management in palliative care have revealed what nonpharmacological therapies have been used, but there is insufficient knowledge regarding nurses' attitudes, views and experiences regarding pain therapies in this context. Design:A qualitative descriptive design was chosen.Methods: Data were collected through individual interviews in a purposive sample with 15 nurses to ensure maximum variation. The data were analysed using qualitative content analysis. This study aligns with the consolidated criteria for reporting qualitative research (COREQ) checklist. Results:The analysis yielded four categories, as follows: "building and sustaining favourable therapeutic relationships" involved the creation of trust and a solid relationship; in "recognising the diversity of patients' needs," person-centred care is expressed as being vital for individualised nonpharmacological pain management; "incorporating significant others" describes how nurses can help to ease the patient's pain by identifying positive encounters with family members or friends; and in "recognising the existence of barriers," nurses highlight vulnerable groups such as children, for whom nurses require special education to enable optimal nonpharmacological pain management. Conclusion:The unique knowledge that nurses gain about the patient through the nurse-patient relationship is central and crucial for successful nonpharmacological pain management. Relevance to clinical practice:This study emphasises the need for nurses to get to know their patient and to be open and sensitive to patients' descriptions of their unique life situations, as this provides the necessary knowledge for optimal care and

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Section: Discussionmentioning

confidence: 99%

Nurses’ experiences of providing nonpharmacological pain management in palliative care: A qualitative study

Munkombwe¹,

Petersson

Elgán

2020

Journal of Clinical Nursing

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“…The clinical dyad, involving one patient and one healthcare practitioner, is the typical format for most healthcare consultations. Acknowledged challenges to the quality of such consultations include informational and interactional discordance between doctor and patient (Coran, Koropeckyj-Cox & Arnold, 2013), and power imbalance (Schoenthaler et al, 2018). Patient centeredness theory (Balint, 1969;Mead & Bower, 2000), for example, has been proposed to help improve doctor-patient dyadic communication, and advice and guidelines are available for doctors at all levels (Kurtz & Silverman, 1996;Silverman et al, 2016) to ensure that the best communication takes place, as effective communication is necessary to ensure optimal healthcare provision.…”

Section: Introductionmentioning

confidence: 99%

Antenatal group consultations: Promoting wellbeing

Fage-Butler

Brannigan

2022

QHC

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Background: Most healthcare encounters take place in a dyadic encounter between a patient and healthcare practitioner, and improving dyadic communication has been the object of much health communication research. However, it seems that an alternative to the dyadic encounter – group consultations – may have distinct advantages for the promotion of patients’ wellbeing. Aim: This article focuses on antenatal group consultations (AGCs), where groups of pregnant women meet with one or more healthcare practitioners instead of meeting their midwife individually, and explores how the presence of other pregnant women in AGCs may promote wellbeing. Methods: Adopting a post-intentional phenomenological approach, we analysed the transcripts of 16 semi-structured interviews undertaken with pregnant women who attended AGCs in Denmark, focusing on their accounts of being with each other. Results: The presence of other pregnant women helped to generate trust, with the participants’ pregnant bodies symbolising their common situation. The presence of peers prompted feelings of identification and solidarity, generally decreased the women’s concerns, and normalised their experiences of pregnancy. Discussion and conclusion: This article develops understandings of how patients experience interpersonal healthcare encounters, and suggests the value of alternatives to the clinical dyad, such as group consultations, for promoting the wellbeing of other patient groups.

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“…A typical approach to IA care (Box 1) acknowledges patients' rights to be involved in their own health‐care decisions, appears to limit consequences of IA and contributes to better outcomes for patients . However, studies illuminate how the ideals of patient‐centred care and shared decision making do not guarantee patients' involvement in their health‐care decisions. There is considerable variability in people's desire and ability to participate .…”

Section: Introductionmentioning

confidence: 99%

Appropriating and asserting power on inflammatory arthritis teams: A social network perspective

Hartford

McKinnon

et al. 2020

Health Expectations

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Background Therapeutic interventions for people with inflammatory arthritis (IA) increasingly involve multidisciplinary teams and strive to foster patient‐centred care and shared decision making. Participation in health‐care decisions requires patients to assert themselves and negotiate power in encounters with clinicians; however, clinical contexts often afford less authority for patients than clinicians. This disadvantage may inhibit patients' involvement in their own health care. Objective To identify communication attributes, IA patients use to influence and negotiate their treatment with members of their health‐care network. Method A qualitative social network approach was used to analyse data from a larger study that investigated IA patients' overall experiences of multidisciplinary care. Fourteen patients with IA attended individual semi‐structured interviews. Researchers used thematic analysis to identify patterns of assertiveness and influence in the data. Results Participants experienced loss of identity, control and agency in addition to the physical symptoms of IA. However, they had a sense of personal responsibility for managing their health care. Perceptions of health‐care team support enhanced patients' influence in treatment negotiations. Notably, there appeared to be an underlying tension between being empowered or disempowered. Discussion and conclusions The findings have significant implications for treatment decision communication approaches to IA care. A social network perspective may provide a pathway for clinicians to better understand the complexities of communication with their patients. This approach may reduce unequal power dynamics that occur within clinician/patient interactions and afford people with IA agency, control and affirmation of identity within their health‐care network.

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It takes two to tango: A dyadic approach to understanding the medication dialogue in patient-provider relationships

Abstract: Examining the processes that underlie dyadic communication in patient-provider interactions is an essential first step to developing interventions that can improve the patient-provider relationship and patient health behaviors.

Cited by 10 publications

References 34 publications

Nurses’ experiences of providing nonpharmacological pain management in palliative care: A qualitative study

Nurses’ experiences of providing nonpharmacological pain management in palliative care: A qualitative study

Antenatal group consultations: Promoting wellbeing

Appropriating and asserting power on inflammatory arthritis teams: A social network perspective

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