Older persons’ worries expressed during home care visits: Exploring the content of cues and concerns identified by the Verona coding definitions of emotional sequences

Abstract

PostprintThis is the accepted version of a paper published in Patient Education and Counseling. This paper has been peer-reviewed but does not include the final publisher proof-corrections or journal pagination. Citation for the original published paper (version of record):Hafskjold, L., Eide, T., Holmström, I K., Sundling, V., van Dulmen, S. et al. (2016) Older persons' worries expressed during home care visits: Exploring the content of cues and concerns identified by the Verona coding definitions of emotional sequences. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Methods: An observational exploratory two-step approach was used to investigate audiotaped recordings from 38 Norwegian home care visits with older persons and nurse assistants. First, 206 cues and concerns were identified using VR-CoDES. Second, the content and context of these expressions were analysed inductively. Patient Education andResults: Four main categories emerged: worries about relationships with others, worries about health care-related issues, worries about aging and bodily impairment, and life narratives and value issues, with several subcategories showing the causes of worry and emotions involved. Conclusion:The two-step approach provides an in-depth knowledge of older persons' worries, causes of worries, and their related emotions.Practice implications: The subcategories described in a language close to the experience can be useful in practice development and communication training for students and health careproviders.

Registered Nurses’ and nurse assistants’ responses to older persons’ expressions of emotional needs in home care

“…Previously, few studies have focused on communication of older persons' emotional needs in home care (Hafskjold et al 2016, Sundler et al 2016, Sundler et al 2017. Still more knowledge is needed on how to respond to these needs and how to enable a more personcentered communication based on older persons' needs and concerns.…”

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

“…Addressing emotional issues is recognized as a salient communication challenge and an important skill for nursing staff providing home care for older people [10, 11, 14, 43]. Nursing staff may see themselves as well informed about worries experienced by the individual patient, given that the care relationships are often are continuous over time, allowing for deep insight into the person’s daily life.…”

“…Studies also indicate a need for nurses to address topics not just relating to nursing or therapeutic issues [11–13]. In an observational study of Swedish home care visits, older people communicated emotional distress to nursing staff in about half of the visits [14].…”

“…In an observational study of Swedish home care visits, older people communicated emotional distress to nursing staff in about half of the visits [14]. Older people’s expressions of emotional distress communicated during home care visits have been described as relating to four main categories: a) worries about relationships with others, b) worries about healthcare-related issues, c) worries about aging and bodily impairment and d) life narratives and value issues [11]. These main categories coincide well with the important features of successful aging at home for frail older people as emphasized in another qualitative study: balancing daily rituals with social engagement in the face of loss and change, in order to retain both capacity and quality of life [12].…”

“…Moreover, the need for someone to keep an eye on them and having someone to talk to were described as central to older people receiving home care. An analysis of Norwegian home care visits by Hafskjold, Eide, Holmstrom, Sundling, van Dulmen and Eide [11] revealed the complexity of underlying emotions in older people’s expressions of personal worries in communication with nursing assistants. Further, a Dutch observational study exploring communication with older people found that their level of socio-emotional interaction may be higher than previously reported, and that nurses provide more affective communication (support, concern and empathy) in home care compared with nurses in institutional care [13].…”