Observations of professional–patient relationships: A mixed-methods study exploring whether familiarity is a condition for nurses’ provision of psychosocial support

Hill, Hazel Catherine; Paley, John; Forbat, Liz

doi:10.1177/0269216313499960

Cited by 10 publications

(12 citation statements)

References 33 publications

(79 reference statements)

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“…Previous studies regarding the significance of relationships for addressing psychosocial needs, like this study, were mainly based on self-report by the clinician and did not study clients’ perspectives, potentially limiting the usefulness of the data for adequately informing care decisions [60–64]. A more recent study of nurses found that an established relationship is not necessary for the provision of psychosocial support, an established relationship does not guarantee that it is effectively therapeutic for appropriately addressing psychosocial needs, and patients perceive relationships with providers differently from their providers [65]. Whilst Hill’s (2014) [65] study was conducted with nurses, it raises concerns for how social workers’ assumptions about relationships may be influencing role negotiation.…”

Section: Discussionmentioning

confidence: 99%

Ward social workers’ views of what facilitates or hinders collaboration with specialist palliative care team social workers: A grounded theory

Firn

Preston²,

Walshe³

2017

BMC Palliat Care

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BackgroundInpatient, generalist social workers in discharge planning roles work alongside specialist palliative care social workers to care for patients, often resulting in two social workers being concurrently involved in the same patient’s care. Previous studies identifying components of effective collaboration, which impacts patient outcomes, care efficiency, professional job satisfaction, and healthcare costs, were conducted with nurses and physicians but not social workers. This study explores ward social workers’ perceptions of what facilitates or hinders collaboration with palliative care social workers.MethodsGrounded theory was used to explore the research aim. In-depth qualitative interviews with masters trained ward social workers (n = 14) working in six hospitals located in the Midwest, United States were conducted between February 2014 and January 2015. A theoretical model of ward social workers’ collaboration with palliative care social workers was developed.ResultsThe emerging model of collaboration consists of: 1) trust, which is comprised of a) ability, b) benevolence, and c) integrity, 2) information sharing, and 3) role negotiation. Effective collaboration occurs when all elements of the model are present.ConclusionCollaboration is facilitated when ward social workers’ perceptions of trust are high, pertinent information is communicated in a time-sensitive manner, and a flexible approach to roles is taken. The theoretical model of collaboration can inform organisational policy and social work clinical practice guidelines, and may be of use to other healthcare professionals, as improvements in collaboration among healthcare providers may have a positive impact on patient outcomes.

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Section: Discussionmentioning

confidence: 99%

Ward social workers’ views of what facilitates or hinders collaboration with specialist palliative care team social workers: A grounded theory

Firn

Preston²,

Walshe³

2017

BMC Palliat Care

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“…Relationship building is usually considered critical to end-of-life care provision [35], although it may not be a necessary prerequisite for good psychosocial care [36]. However, the emotional experience of care is critically important to patients and carers [37].…”

Section: Discussionmentioning

confidence: 99%

‘Being with’ or ‘doing for’? How the role of an end-of-life volunteer befriender can impact patient wellbeing: interviews from a multiple qualitative case study (ELSA)

Dodd

Hill²,

Ockenden³

et al. 2018

Support Care Cancer

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PurposeTo explore the perspectives of people anticipated to be in their last year of life, family carers, volunteers and staff on the impacts of receiving a volunteer-provided befriending service. Patient participants received up to 12 weeks of a volunteer-provided befriending intervention. Typically, this involved one visit per week from a trained volunteer. Such services complement usual care and are hoped to enhance quality of life.MethodsMultiple case study design (n = 8). Cases were end-of-life befriending services in home and community settings including UK-based hospices (n = 6), an acute hospital (n = 1) and a charity providing support to those with substance abuse issues (n = 1). Data collection incorporated qualitative thematic interviews, observation and documentary analysis. Framework analysis facilitated within and across case pattern matching.ResultsEighty-four people participated across eight sites (cases), including patients (n = 23), carers (n = 3), volunteers (n = 24) and staff (n = 34). Interview data are reported here. Two main forms of input were described—‘being there’ and ‘doing for’. ‘Being there’ encapsulated the importance of companionship and the relational dynamic between volunteer and patient. ‘Doing for’ described the process of meeting social needs such as being able to leave the house with the volunteer. These had impacts on wellbeing with people describing feeling less lonely, isolated, depressed and/or anxious.ConclusionImpacts from volunteer befriending or neighbour services may be achieved through volunteers taking a more practical/goal-based orientation to their role and/or taking a more relational and emotional orientation. Training of volunteers must equip them to be aware of these differing elements of the role and sensitive to when they may create most impact.Trial RegistrationISRCTN12929812

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“…Hill et al [31] challenge the view that ‘familiarity is either a necessary or sufficient condition for the provision of psychosocial support’. Their study of registered and auxiliary nurses in a palliative care setting found that familiarity may result in ‘unwarranted assumptions’ which block rather than facilitate support.…”

Section: Discussionmentioning

confidence: 99%

“…Their study of registered and auxiliary nurses in a palliative care setting found that familiarity may result in ‘unwarranted assumptions’ which block rather than facilitate support. Hill et al [31] suggest that it’s the formation of an interpersonal connection with the client that is important, and this can occur even on initial contact. This is viewed as particularly important in view of the relatively short time frame that may be available for these exchanges, given the palliative care context.…”

Section: Discussionmentioning

confidence: 99%

Factors influencing practitioner adoption of carer-led assessment in palliative homecare: A qualitative study of the use of the Carer Support Needs Assessment Tool (CSNAT)

2017

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IntroductionInformal caregivers play a pivotal role in supporting patients approaching the end of life. The Carer Support Needs Assessment Tool (CSNAT) is designed to facilitate person-centred assessment and support through a process that is practitioner-facilitated, but carer-led. This study explored practitioners’ experiences of implementing the CSNAT in palliative homecare.MethodsWe conducted qualitative interviews/focus groups with 20 practitioners in one UK hospice homecare service (18 nurses, two healthcare assistants) before and after the implementation of the CSNAT. Thematic analysis of the data was underpinned by framework analysis.ResultsNot all practitioners appreciated that using the CSNAT required a shift towards a more person-centred approach to assessment; consequently they tagged the tool onto their existing practitioner-led practice. Practitioners who did use the CSNAT as intended were able to act as role models and support their colleagues in making this transition. Practitioners’ comments revealed a number of contradictions: 1) Most felt that they ‘already do’ identify carer support needs, but feared using the CSNAT could increase their workload; 2) some worried about introducing the CSNAT ‘too soon’, but recognised that it was ‘too late’ once patients were close to the end of life; 3) whilst practitioners stated ‘they were there for the family as well as the patient’, care provision was overtly centred around patients.ConclusionThis study provides vital insights into barriers and facilitators to implementing the CSNAT as part of a person-centred approach to assessment. The findings identified the training and support required to help practitioners make this transition to this new way of working.

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Observations of professional–patient relationships: A mixed-methods study exploring whether familiarity is a condition for nurses’ provision of psychosocial support

Cited by 10 publications

References 33 publications

Ward social workers’ views of what facilitates or hinders collaboration with specialist palliative care team social workers: A grounded theory

Ward social workers’ views of what facilitates or hinders collaboration with specialist palliative care team social workers: A grounded theory

‘Being with’ or ‘doing for’? How the role of an end-of-life volunteer befriender can impact patient wellbeing: interviews from a multiple qualitative case study (ELSA)

Factors influencing practitioner adoption of carer-led assessment in palliative homecare: A qualitative study of the use of the Carer Support Needs Assessment Tool (CSNAT)

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