The social construction of risk by community psychiatric nurses and family carers for people with dementia

Abstract

This paper examines the conversational and discursive processes through which situations are constructed as a risk by informal carers and community psychiatric nurses working with people who have dementia. The data were taken from 24 tape recordings of domiciliary meetings between primary informal carers for people with dementia and their community psychiatric nurse (CPN). Data were analysed using techniques developed from conversation analysis and discourse analysis. The analysis identi es four stages associated with the construction of risk by informal carers and CPNs. These stages are fully discussed in relation to the provision of care.

Ethnomethodological studies of nurse-patient and nurse-relative interactions: A scoping review

“…Reciprocal (vs non-reciprocal) interaction styles promote patient participation in health counseling sessions, i.e., rigidly following a procedure reduces patients' participation (Poskiparta et al, 2000;Kettunen et al, 2003). With regards to nurse-relative interactions, studies have shown the active role of relatives in risk assessments (Adams, 2001b). Patient relatives are reticent accepting nurses' contributions on non-medical issues (Plumridge et al, 2008).…”

“…Horizontal interactional styles between nurses and patients' relatives facilitate the collaborative identification of risk in psychiatric patients (Adams, 2001b), and parents' progressive understanding of their child's diabetes symptoms (Adams, 2001a).…”

“…This happens when they initiate discussions about death to inform and provide emotional support (Wilainuch, 2013), when they use humor to reduce patients' anxiety (Mallett and A'hern, 1996) and foster optimism in cancer patients (Jarrett and Payne, 2000). Nurses readily display empathy at the patients' home (Adams, 2001b). But they can also display a lack of emotional availability towards patient's requests in palliative care (Haraldsdottir, 2011).…”

Developing an inclusive approach to dementia care

“…Within this approach, the identity of triad members occurs through social practices such as language (Adams, 2000;2001b;Burr, 1996 (Adams, 2000).…”

“…Evidence of this comes from a study of how DCPs organise and manage what they say when they are talking to carers with respect to the construction of identity and risk within dementia care 2001a;2001b).…”