Characteristics of communication with older people in home care: A qualitative analysis of audio recordings of home care visits

Kristensen, Dorte Vesterager; Sundler, Annelie Johansson; Eide, Hilde; Hafskjold, Linda; Ruud, Iren; Holmström, Inger

doi:10.1111/jocn.13807

Cited by 22 publications

(27 citation statements)

References 39 publications

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“…This paper is based on an international research project, the COMHOME study, which focus on how older persons communicate with their care providers [ 25 ]. Qualitative studies from COMHOME show that communication in home care mainly is instrumental, focusing on the task at hand [ 26 , 27 ], similar to reported findings 20 years ago [ 28 ]. A study, from Sweden and Denmark found that in home help visits, task completion aims at being “good enough” rather than “brilliant” and that older persons rarely dispute the home help provider’s assessment of the task performed [ 29 ].…”

Section: Introductionsupporting

confidence: 70%

“…What type of responses older persons prefer and perceive as supportive in different situations are yet to be explored. However, increased communication skills may have the potential to enhance the experienced quality of care [ 7 , 8 ], prevent unnecessary suffering [ 65 ] and increase the nursing staff’s perception of being competent when facing challenging communication in home care [ 26 , 27 , 62 ].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, we expected these themes to be frequently observed. One reason for our findings could be that the care setting is characterised by task focused communication [ 27 ] that places the care tasks and related issues in focus. Therefore, the patients may by nature experience the company of the nursing staff as supportive and thereby drawn the attention away from potentially worrying relational issues or important life events.…”

Section: Discussionmentioning

confidence: 99%

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Nursing staff’s responses to thematic content of patients’ expressed worries: observing communication in home care visits

Hafskjold

Sundling

Eide

2018

BMC Health Serv Res

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BackgroundThe aim of the study was to explore the thematic content of older persons’ expressed worries in home care visits, and how nursing staff respond to different thematic contents.MethodsThe study had a descriptive, observational design, including 195 audio-recorded Norwegian home care visits with 33 nursing staff and 48 older persons. In all, 638 patient cues/concerns (worries) and subsequent nursing staff’s responses were identified using Verona Coding Definitions of Emotional Sequences. A novel thematic coding scheme was used to label the thematic content of the cues/concerns. The nursing staff’s responses were grouped based on communicative function as emotion-focused, content-focused or ignoring/blocking the cue/concern. Group difference was analysed using Pearson’s chi-squared test, Fisher’s exact test, and adjusted residuals.ResultsThe theme of worries was associated with elicitation of the cue/concern, either elicited by the nursing staff or spontaneously expressed by the patient (Chi-square, p< 0.001). “Ageing and bodily impairment” was the most common theme (66%) and was equally elicited by patients and nursing staff. Worries about “Relationships with others” (9%), “Health care-related issues” (15%) and “Life narratives and value issues” (9%) were mainly elicited by nursing staff. The nursing staff response was associated with the theme of worries (p˂0.001). For the sub-themes of “Ageing and bodily impairment”, Coping with existential challenges received more frequently emotion-focused responses (adjusted residuals: 3.2) and Expression of pain felt in the moment were more frequently ignored/blocked (adjusted residuals: 4.0, Fisher’s exact test, p< 0.001). For the sub-themes of “Relationships with others”, Being a burden more frequently received a content-focused response (adjusted residuals: 2.8), while Losing social ties more frequently received an emotion-focused response (adjusted residuals: 3.1, Fisher’s exact test, p = 0.009).Conclusion“Ageing and bodily impairment” was the most common theme and more frequently elicited by the older persons than other themes. Emotionally focused nursing staff responses were most common when addressing existential challenges and fear of losing social ties. Whereas nursing staff showed a tendency to ignore patients’ spontaneous expressions of pain. Further research should explore the influence of nursing staff’s responses on quality of care and patient satisfaction.

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Section: Introductionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Nursing staff’s responses to thematic content of patients’ expressed worries: observing communication in home care visits

Hafskjold

Sundling

Eide

2018

BMC Health Serv Res

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“…The authors found it important to refrain from trying to "solve" a problem and instead maintain a presence and confirming attitude. The importance of existential dialogue was also demonstrated by Kristensen et al [41] who stated that dialogue often breaks down between caregivers and older patients. When older adults want to talk about the end of life, they take initiative to talk about it.…”

Section: Involvement In Social Relationshipsmentioning

confidence: 89%

Life without professional work-perceptions about one’s self, interpersonal relations and social life after retirement

Dalheim-Englund¹,

Carlsson²,

Nyström³

et al. 2019

HAR

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The aim of this study is to understand how healthy, older adults in Sweden perceive their life situation after retirement. The study is based on a lifeworld approach, and a phenomenographic method was used. Eighteen participants were interviewed, and data were analysed according to the phenomenographic principle of qualitatively different categories. Two categories were developed. The first category, "perceptions that draw attention inward, towards one's self", was further described in three subcategories: Sense of decreased status in society, the desire to keep aging at a distance, and contemplation of one's own existence. The second category, "perceptions that draw attention outward, away from one's self" was further described in the following four subcategories: caretaking of family members, involvement in social relationships, finding of deep meaning in animals and nature and engagement with society. In the discussion, the findings are further illuminated through comparisons with concepts such as maturity, wisdom and gerotranscendence, and reflections on the findings' relevance to a caring context follow. The conclusion suggests this study can provide knowledge that will allow healthcare providers to bridge the gap between generations in order to provide high-quality care. However, for a more profound caring dialogue, for example, about the end of life, a deeper analysis is required.

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“…During home care visits, older people reveal essential information about their well‐being and health, such as worries and needs (Kristensen et al, ; Sundler, Höglander, Eklund, Eide, & Holmström, ). These issues can then be listened to and solved by the nursing staff (Höglander, Eklund, Eide, Holmström, & Sundler, ).…”

Section: Introductionmentioning

confidence: 99%

Emotional communication with older people: A cross‐sectional study of home care

Höglander

Sundler

Spreeuwenberg

et al. 2019

Nursing & Health Sciences

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The aim of this study was to explore the influence of characteristics of nurses and older people on emotional communication in home care settings. A generalized, linear, mixed model was used to analyze 188 audio‐recorded home care visits coded with Verona Coding Definitions of Emotional Sequences. The results showed that most emotional distress was expressed by older females or with female nurses. The elicitation of an expression of emotional distress was influenced by the nurses' native language and profession. Older women aged 65–84 years were given the most space for emotional expression. We found that emotional communication was primarily influenced by sex for nurses and older people, with an impact on the frequency of expressions of and responses to emotional distress. Expressions of emotional distress by older males were less common and could risk being missed in communication. The results have implications for students' and health professionals' education in increasing their knowledge of and attentiveness to the impacts of their and others' characteristics and stereotypes on emotional communication with older people.

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Characteristics of communication with older people in home care: A qualitative analysis of audio recordings of home care visits

Cited by 22 publications

References 39 publications

Nursing staff’s responses to thematic content of patients’ expressed worries: observing communication in home care visits

Nursing staff’s responses to thematic content of patients’ expressed worries: observing communication in home care visits

Life without professional work-perceptions about one’s self, interpersonal relations and social life after retirement

Emotional communication with older people: A cross‐sectional study of home care

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