Nurses as Guests or Professionals in Home Health Care

Öresland, Stina; Määttä, Sylvia; Norberg, Astrid; Jørgensen, Marianne Winther; Lützén, Kim

doi:10.1177/0969733007088361

Cited by 60 publications

(90 citation statements)

References 43 publications

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“…The relatively high proportion of concerns/cues expressed spontaneously by patients found in the present study is likely a feature of the home care setting. The home of the patient and the language used in home care may help level out the asymmetrical care relationship compared with consultations taking place in medical offices with a narrow clinical purpose [44, 45], and could encourage the older person to express their worries on their own initiative more freely. In addition, both the number of concerns/cues expressed in general and the number of concerns/cues expressed spontaneously by patients were higher in the Norwegian material compared with a similar analysis from home care in Sweden [14], which may indicate the need to explore further how culture influences emotional talk.…”

Section: Discussionmentioning

confidence: 99%

The use of supportive communication when responding to older people’s emotional distress in home care – An observational study

et al. 2017

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BackgroundResponding to older people’s distress by acknowledging or encouraging further discussion of emotions is central to supportive, person-centred communication, and may enhance home care outcomes and thereby promote healthy aging. This observational study describes nursing staff’s responses to older people’s emotional distress, and identify factors that encourage further emotional disclosure.MethodsAudio-recorded home care visits in Norway (n = 196), including 48 older people and 33 nursing staff, were analysed with the Verona Coding Definitions of Emotional Sequences, identifying expressions of emotional distress and subsequent provider responses. The inter-rater reliability (two coders), Cohen’s kappa, was >0.6. Sum categories of emotional distress were constructed: a) verbal and non-verbal expressions referring to emotion, b) references to unpleasant states/circumstances, and c) contextual hints of emotion. A binary variable was constructed based on the VR response codes, differentiating between emotion-focused responses and responses that distanced emotion. Fisher’s exact test was used to analyse group differences and determined variables included in a multivariate logistic regression analysis to identify factors promoting emotion-focused responses.ResultsOlder people’s expressions of emotional distress (n = 635) comprised 63 explicit concerns and 572 cues. Forty-eight per cent of nursing staff responses (n = 638) were emotion-focused. Emotion-focused responses were observed more frequently when nursing staff elicited the expression of emotional distress from the patients (54%) than when patients expressed their emotional distress on their own initiative (39%). Expressions with reference to emotion most often received emotion-focused responses (60%), whereas references to unpleasant states or circumstances and contextual hints of emotion most often received non-emotion-focused responses (59%). In a multivariate logistic model, nursing staff’s elicitation of the emotional expression (vs patients initiating it) and patients’ expression with a reference to an emotion (vs reference to unpleasant states or contextual hints) were both explanatory variables for emotion-focused responses.ConclusionsEmotion-focused responses were promoted when nursing staff elicited the emotional expression, and when the patient expression referred to an emotion. Staff responded most often by acknowledging the distress and using moderately person-centred supportive communication. More research is needed to establish generalizability of the findings and whether older people deem such responses supportive.

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Section: Discussionmentioning

confidence: 99%

The use of supportive communication when responding to older people’s emotional distress in home care – An observational study

et al. 2017

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“…A study [32] shows that time and geographical distance are important factors when building relationships between nurses and persons in home-based nursing care. Another study [33] shows that time and the continuity between the nurse and the person are preconditions for establishing a trusting relationship.…”

Section: Discussionmentioning

confidence: 99%

Caring Relationships in Home-Based Nursing Care – Registered Nurses' Experiences

Wälivaara

Sävenstedt²,

Axelsson

2013

TONURSJ

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The caring relationship between the nurse and the person in need of nursing care has been described as a key concept in nursing and could facilitate health and healing by involving the person’s genuine needs. The aim of this study was to explore registered nurses’ experiences of their relationships with persons in need of home-based nursing care. Individual interviews with nurses (n=13 registered nurses and 11 district nurses) working in home-based nursing care were performed. A thematic content analysis was used to analyze the transcribed interviews and resulted in the main theme Good nursing care is built on trusting relationship and five sub-themes, Establishing the relationship in home-based nursing care, Conscious efforts maintains the relationship, Reciprocity is a requirement in the relationship, Working in different levels of relationships and Limitations and boundaries in the relationship. A trusting relationship between the nurse and the person in need of healthcare is a prerequisite for good home-based nursing care whether it is based on face-to-face encounters or remote encounters through distance-spanning technology. A trusting relationship could reduce the asymmetry of the caring relationship which could strengthen the person’s position. The relationship requires conscious efforts from the nurse and a choice of level of the relationship. The trusting relationship was reciprocal and meant that the nurse had to communicate something about themself as the person needs to know who is entering the home and who is communicating through distance-spanning technology.

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“…Guest and host identities echo the culturally strong concern for home privacy, and the orientation to professional and client identities signals the blurring of boundaries between institutional and home spaces. Previous interview studies have demonstrated that workers feel that they walk a tightrope between the roles of a guest and a professional when doing care work at service users' homes (Twigg, 1999;Öresland et al, 2008). Our study examines in detail how workers and service users balance between different identities in the home visit settings.…”

Section: Host-guest and Professional-client Pairsmentioning

confidence: 93%

Interaction during mental health floating support home visits: managing host–guest and professional–client identities in home-spaces

Juhila

Hall

Raitakari

2015

Social & Cultural Geography

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Mental health work has been transformed by 'shifting geographies of care' from institutions to care in communities, in particular by the emergence of support located within home-spaces. This article studies a floating support service targeted at people with mental health problems and contributes to research on post-institution and home care geographies. The data contain 17 audio-recorded home visits conducted by professional care workers. An ethnomethodological analysis informed by geographies of care in home-spaces shows how the home as a material space has consequences for conversations and the relations between the service users and workers. The parties orient to two relational and shifting identity pairs in their 'home-space talk': a hostguest pair (social call talk) and a professional-client pair (targeted intervention talk).Professional-client pair dominates, and in this sense floating support produces 2 institutionalisation of home-spaces. However, social call talk that enables service users to act as hosts governing their home-spaces has important functions. Orientations to hosts and guests create symmetry and trust among the parties, that encourages recovery promoting interaction. The article also demonstrates the applicability of the methods developed in the geographies of mental health and home in the ethnomethodological interaction analysis, and the other way round.

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Nurses as Guests or Professionals in Home Health Care

Cited by 60 publications

References 43 publications

The use of supportive communication when responding to older people’s emotional distress in home care – An observational study

The use of supportive communication when responding to older people’s emotional distress in home care – An observational study

Caring Relationships in Home-Based Nursing Care – Registered Nurses' Experiences

Interaction during mental health floating support home visits: managing host–guest and professional–client identities in home-spaces

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