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Towards a shared understanding: Exploring encounters in hospital care from the perspectives of nurses and patients
Luleå University of Technology, Department of Health Sciences, Nursing Care.
2017 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this licentiate thesis was to describe encounters in hospital care from the perspectives of nurses and patients. It focuses specifically on nurses’ views of shortcomings in patient-care encounters in one hospital (I) and the meanings of participation in hospital care as narrated by patients (II). Three focus group discussions with 15 registered nurses were conducted, and data were analyzed using thematic content analysis (I). Narrative interviews were conducted with 15 patients in hospital care, and the interviews were analyzed with a phenomenological hermeneutic interpretation (II). This licentiate thesis shows that a shared understanding is considered as central for both the nurses and the patients in the hospital-care encounter. The nurses demonstrate the need to understand, to create space, and also to be available for vulnerable patients. The patients describe the need to be understood and to understand their own situations. This thesis suggests that positive encounters in hospital care imply that nurses need to take responsibility for creating a mutual dialogue where the patient experiences himself or herself as a co-creator in a trustful context. When nurses acknowledge and confirm the vulnerability of their patients, it becomes possible to support them to participate in an active manner. A well-functioning team, as well as a coherent environment, is, in this thesis, understood as a precondition for positive hospitalcare encounters.

Place, publisher, year, edition, pages
Luleå: Luleå tekniska universitet, 2017.
Series
Licentiate thesis / Luleå University of Technology, ISSN 1402-1757
Keyword [en]
Encounter, participation, nurses, nursing, patients, hospital care, shared understanding, shortcomings in hospital care, qualitative interviews, thematic analysis, phenomenological-hermeneutic interpreation
National Category
Medical and Health Sciences
Research subject
Nursing
Identifiers
URN: urn:nbn:se:ltu:diva-63355ISBN: 978-91-7583-912-7 (print)ISBN: 978-91-7583-913-4 (electronic)OAI: oai:DiVA.org:ltu-63355DiVA: diva2:1095543
Presentation
2017-06-13, D 770, Luleå, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2017-05-16 Created: 2017-05-15 Last updated: 2017-07-03Bibliographically approved
List of papers
1. Nurses' views of shortcomings in patent care encounters in one hospital in Sweden
Open this publication in new window or tab >>Nurses' views of shortcomings in patent care encounters in one hospital in Sweden
2015 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 19-20, 2807-2814 p.Article in journal (Refereed) Published
Abstract [en]

Aim and objectiveTo describe nurses' views of shortcomings in patient care encounters in one hospital in Sweden.BackgroundShortcomings in encounters in healthcare have increased during recent years. Dissatisfaction with encounters in healthcare can affect patients' experiences of dignity, health and well-being.DesignA qualitative design was used in the study.MethodsThree focus group discussions with 15 nurses were conducted. The nurses worked in five different wards. The focus group discussions were subjected to a thematic content analysis.ResultsThe results are presented in two themes. The first theme, ‘Disregard for the patient's unique nursing needs’, describes that information without consideration of the patient's needs, and nurses not being completely present in the meeting with the patient affected healthcare encounters and experiences of quality of care. In the second theme, ‘Difficulty managing obstacles’, nurses described care situations over which they could not always prevail due to lack of time and/or lack of awareness of the patient's vulnerability.ConclusionThe findings illustrate the importance of nurses and their approaches to patients. The nurse's attitude is important for the patient's experiences of participation, security, dignity, and well-being. The findings also illustrate the importance of routines in the healthcare organisation that support and facilitate positive encounters between patients, their close relatives and the healthcare staff.Relevance to clinical practiceNurses require understanding, presence and commitment in their relationships to every unique patient, and their goal should be to adopt interventions with regard to positive healthcare encounters based on each patient's experiences of good nursing care.

National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-14488 (URN)10.1111/jocn.12886 (DOI)ddbc7983-ab16-4ebd-8cfb-3e597c677b93 (Local ID)ddbc7983-ab16-4ebd-8cfb-3e597c677b93 (Archive number)ddbc7983-ab16-4ebd-8cfb-3e597c677b93 (OAI)
Note
Validerad; 2015; Nivå 2; 20150717 (andbra)Available from: 2016-09-29 Created: 2016-09-29 Last updated: 2017-05-15Bibliographically approved

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