Advanced

Nurses' experience of collaboration with relatives of frail elderly patients in acute hospital wards: A qualitative study.

Lindhardt, Tove LU ; Rahm Hallberg, Ingalill LU and Poulsen, Ingrid LU (2008) In International Journal of Nursing Studies 45(5). p.668-681
Abstract
Background



Frail elderly people admitted to hospital often receive help from relatives in managing their daily lives. These relatives are likely to continue to feel responsible after admission, and to hold valuable knowledge, which may contribute to decision-making related to care and treatment.



Objective



To illuminate nurses’ experience of collaboration with relatives of frail elderly patients in acute hospital wards, and of the barriers and promoters for collaboration.



Design and setting



The design was descriptive. Three acute units in a large Danish university hospital participated.



Participants



Six... (More)
Background



Frail elderly people admitted to hospital often receive help from relatives in managing their daily lives. These relatives are likely to continue to feel responsible after admission, and to hold valuable knowledge, which may contribute to decision-making related to care and treatment.



Objective



To illuminate nurses’ experience of collaboration with relatives of frail elderly patients in acute hospital wards, and of the barriers and promoters for collaboration.



Design and setting



The design was descriptive. Three acute units in a large Danish university hospital participated.



Participants



Six registered nurses and two auxiliary nurses in charge of discharge planning for the patients were included.



Method



Open interviews using an interview guide. Manifest and latent content analysis was applied.



Result



The main theme Encountering relatives—to be caught between ideals and practice reflected the nurses’ two sets of conflicting attitudes towards collaboration with relatives, one in accordance with professional nursing values, the other reflecting the values of every day practice. The dual attitudes were reflected in two themes The coincidental encounter—the collaboration and Relatives—a demanding resource, which appeared in the text along with a number of sub-themes. Ideally, collaboration was considered important and described as a planned process, but in practice encounters with relatives were coincidental. Relatives were ideally considered a resource but also experienced as demanding, and nurses sometimes even avoided them. The nurses seemed unaware of the conflict of values, and their response pattern of escape-avoidance and labelling of relatives as difficult may be an indication of counter transference as a reaction to moral conflict. Macro level factors, such as organisational and societal values, and micro level factors, such as organisation of care, nurse's competence and communication skills, seemingly governed nurses’ collaboration with relatives.



Conclusion



Although the nurses could be seen as mere victims of conflicting values, there appeared to be potential for improving collaboration practice within the restrictions of macro level factors by interventions at the micro level. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Professional ethics, Nursing, Decision making, Participation, Collaboration, Frail elderly, Family, Aged hospitalised, Content analysis
in
International Journal of Nursing Studies
volume
45
issue
5
pages
668 - 681
publisher
Elsevier
external identifiers
  • wos:000257092900003
  • scopus:43649089680
ISSN
1873-491X
DOI
10.1016/j.ijnurstu.2007.01.010
language
English
LU publication?
yes
id
76b4d80d-1b18-4ec7-b2a1-1feb5c6d9bfb (old id 166528)
date added to LUP
2007-07-23 11:42:02
date last changed
2017-09-17 05:16:35
@article{76b4d80d-1b18-4ec7-b2a1-1feb5c6d9bfb,
  abstract     = {Background<br/><br>
<br/><br>
Frail elderly people admitted to hospital often receive help from relatives in managing their daily lives. These relatives are likely to continue to feel responsible after admission, and to hold valuable knowledge, which may contribute to decision-making related to care and treatment.<br/><br>
<br/><br>
Objective<br/><br>
<br/><br>
To illuminate nurses’ experience of collaboration with relatives of frail elderly patients in acute hospital wards, and of the barriers and promoters for collaboration.<br/><br>
<br/><br>
Design and setting<br/><br>
<br/><br>
The design was descriptive. Three acute units in a large Danish university hospital participated.<br/><br>
<br/><br>
Participants<br/><br>
<br/><br>
Six registered nurses and two auxiliary nurses in charge of discharge planning for the patients were included.<br/><br>
<br/><br>
Method<br/><br>
<br/><br>
Open interviews using an interview guide. Manifest and latent content analysis was applied.<br/><br>
<br/><br>
Result<br/><br>
<br/><br>
The main theme Encountering relatives—to be caught between ideals and practice reflected the nurses’ two sets of conflicting attitudes towards collaboration with relatives, one in accordance with professional nursing values, the other reflecting the values of every day practice. The dual attitudes were reflected in two themes The coincidental encounter—the collaboration and Relatives—a demanding resource, which appeared in the text along with a number of sub-themes. Ideally, collaboration was considered important and described as a planned process, but in practice encounters with relatives were coincidental. Relatives were ideally considered a resource but also experienced as demanding, and nurses sometimes even avoided them. The nurses seemed unaware of the conflict of values, and their response pattern of escape-avoidance and labelling of relatives as difficult may be an indication of counter transference as a reaction to moral conflict. Macro level factors, such as organisational and societal values, and micro level factors, such as organisation of care, nurse's competence and communication skills, seemingly governed nurses’ collaboration with relatives.<br/><br>
<br/><br>
Conclusion<br/><br>
<br/><br>
Although the nurses could be seen as mere victims of conflicting values, there appeared to be potential for improving collaboration practice within the restrictions of macro level factors by interventions at the micro level.},
  author       = {Lindhardt, Tove and Rahm Hallberg, Ingalill and Poulsen, Ingrid},
  issn         = {1873-491X},
  keyword      = {Professional ethics,Nursing,Decision making,Participation,Collaboration,Frail elderly,Family,Aged hospitalised,Content analysis},
  language     = {eng},
  number       = {5},
  pages        = {668--681},
  publisher    = {Elsevier},
  series       = {International Journal of Nursing Studies},
  title        = {Nurses' experience of collaboration with relatives of frail elderly patients in acute hospital wards: A qualitative study.},
  url          = {http://dx.doi.org/10.1016/j.ijnurstu.2007.01.010},
  volume       = {45},
  year         = {2008},
}