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Encounters in nursing homes: Experiences from nurses, residents and relatives
University of Skövde, School of Life Sciences.
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The care of residents in nursing homes (special housing) is a major challenge for the nursing profession, especially as the population of older people has increased in recent decades. One important aim of this care is to promote the wellbeing and security of the residents. Encounters between residents, nurses and relatives are one important and frequent activity in the daily care of the residents. Available knowledge shows that the outcome of these encounters can affect the quality of care both in positive and negative ways. The meaning of these encounters is still a fairly unknown topic. The reason for conducting research on the meaning of encounters in nursing homes is mainly due to the lack of research with this focus and a need to improve understanding and knowledge about nursing home care with an emphasis on the meaning of encounters.

The aim of this thesis was to investigate the experiences of encounters between nurses, residents, their relatives and other significant persons in order to reach a deeper understanding of the meaning of these encounters in nursing homes. A hermeneutic method was used for all four studies in this thesis (I–IV). The hermeneutic method was inspired by Hans George Gadamer and his philosophical hermeneutics. The hermeneutic method provides opportunities to interpret the meaning of human language. All data from participants in this thesis were collected through open-ended interviews with nurses, residents and relatives in four nursing homes in a municipality in Western Sweden in 2004-2005. The interviews were tape-recorded and transcribed verbatim.

The main results of the original papers showed that the meaning of was interpreted and illuminated as the good encounter (I–IV) and the bad encounter (I–IV). In this thesis, encounters between people in nursing homes have been shown to be important for residents’ everyday life in terms of being visible and confirmed but also for nurses’ and relatives’ need to be visible and confirmed as significant persons in the care for the resident. Nurses play an important role in encounters with residents and their relatives in order to make the residents visible and to maintain his/her respect and dignity as a human being in the nursing home. It is therefore important for nurses to establish intentions for being able to contribute to the good encounter. Being present, attentive and open in the encounter with residents and their relatives and listening to their thoughts is the start of a caring action that will result in making the residents visible and confirmed.

 

It is of great importance to realize that there are both good and bad encounters in a nursing home context, which makes certain demands on the nurses’ competence to be able to meet the resident with an open mind as an effort to achieve the good encounter, which means to see the resident as someone belonging somewhere. Accordingly, it is an urgent matter to implement knowledge about the meaning of encounters in this caring context, knowledge that can probably be transferred to nurses working in other forms of long-term care. This thesis can be seen as a contribution to generating knowledge and providing new understanding that can facilitate the development of such nursing competence; knowledge in the art of caring that gives a deeper understanding of how fundamental each encounter can be for making residents and relatives visible and confirmed as an effort to maintain good quality in the care of residents in nursing homes.

Place, publisher, year, edition, pages
Göteborgs universitet , 2008. , 52 p.
Keyword [en]
Nursing Homes, Encounters, Nursing Home Staff, Residents, Relatives, Nurses
National Category
Nursing
Research subject
Medical sciences
Identifiers
URN: urn:nbn:se:his:diva-2710Libris ID: 11206419ISBN: 978-91-628-7591-6 OAI: oai:DiVA.org:his-2710DiVA: diva2:159637
Public defence
2008-11-07, Hörsal 2119, Arvid Wallgrens backe, Göteborg, 13:00 (Swedish)
Opponent
Note

List of Papers: I. Nurses' experiences of caring encounters with people living in Swedish nursing homes. Westin, L. & Danielson, E. International Journal of Older People Nursing (2006), 1, 3-10 II. Encounters in Swedish nursing homes: A hermeneutic study about residents' experiences. Westin, L. & Danielson, E. Journal of Advanced Nursing (2007), 60, 172-180 III. Visiting a nursing home - Relatives' experiences of encounters with nurses. Westin, L., Öhrn, I. & Danielson, E. Submitted IV. Residents' experiences of encounters with relatives and other significant persons in nursing homes. Westin, L., Danielson, E. & Öhrn, I. Submitted

Available from: 2010-04-09 Created: 2009-02-09 Last updated: 2014-03-27Bibliographically approved
List of papers
1. Nurses’ experiences of caring encounters with older people living in Swedish nursing homes
Open this publication in new window or tab >>Nurses’ experiences of caring encounters with older people living in Swedish nursing homes
2006 (English)In: International Journal of Older People Nursing, ISSN 1748-3735, Vol. 1, no 1, 3-10 p.Article in journal (Refereed) Published
Abstract [en]

Aim. The aim of the study was to describe and interpret the meaning of nurses' experiences of caring encounters with residents in nursing homes.

Background. Life for residents in nursing homes can be characterized as a process of decreased physical and psychological resources. Therefore, encounters with nurses are important activities for providing meaning and security for the residents. Research in this field has previously focused on communication, attitudes and job satisfaction, but gives limited knowledge about what the human encounters in this context mean for the nurses.

Method. A hermeneutic method was used in this study. Interviews were conducted with 14 nurses from two nursing homes about their experiences of caring encounters. The transcribed interview texts were interpreted as a whole.

Results. In the interpretation of the text concerning the meaning of nurses' experiences of encounters with resident's four themes and 11 subthemes emerged. The comprehensive interpretation mainly showed possible ways available being present, being significant and being aware of opportunities for the nurse to find meaning in the encounter with the resident, but impossible ways as being inadequately were also revealed.

Conclusion. This study shows the importance of caring encounters between nurses and residents in nursing homes. The good encounters provide various possible ways for nurses to find meaning and a sense of communion with residents. However, bad encounters, described as being inadequate, were found to inhibit nurses from finding meaning in their encounters with residents.

Relevance to clinical practice. Meeting the needs of older people in nursing homes requires special knowledge about the importance of the caring encounter. Therefore, nurses in this care context need supervision and continuous education in order to gain relevant knowledge about the meaning of caring encounters for themselves and residents.

Place, publisher, year, edition, pages
John Wiley & Sons, 2006
National Category
Medical and Health Sciences
Research subject
Medical sciences
Identifiers
urn:nbn:se:his:diva-1789 (URN)10.1111/j.1748-3743.2006.00003.x (DOI)20925722 (PubMedID)
Available from: 2007-08-31 Created: 2007-08-31 Last updated: 2014-03-27Bibliographically approved
2. Encounters in Swedish nursing homes: a hermeneutic study of residents' experiences
Open this publication in new window or tab >>Encounters in Swedish nursing homes: a hermeneutic study of residents' experiences
2007 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 60, no 2, 172-180 p.Article in journal (Refereed) Published
Abstract [en]

Aim. This paper is a report of a study to illuminate and interpret the meaning of residents' experiences of encounters with nurses in nursing homes.

Background. A large number of older people suffer from illness and become dependent on other people in their daily living. These people are often in need of care in nursing homes. It is assumed that encounters between nurses and residents are of importance in how residents experience care in nursing homes.

Method. Twelve residents from three nursing homes in Sweden were interviewed in 2004–2005 about their experiences in encounters with nurses. The interviews were tape-recorded and transcribed verbatim. A hermeneutic method was used to describe and interpret the meaning of residents' experiences.

Findings. Three themes emerged: 'being somebody', 'being nobody' and 'being in a community'. The encounters had both positive and negative influences on residents, expressed as being somebody and belonging somewhere or being nobody and not being seen as a person or simply being left out of things. Encounters between residents and nurses have a mutual dependency where residents certainly have some influence on the relationship. The nurses have both an influence on the relationship and a professional responsibility for the outcome of encounters with residents.

Conclusion. The insights gained from the study can guide nurses in their encounters with residents in nursing homes so that they feel respected as unique human beings and part of a community.

Place, publisher, year, edition, pages
Blackwell Publishing, 2007
Keyword
caring, empirical research report, hermeneutics, interviews, nursing, nursing homes, older people
National Category
Clinical Science
Research subject
Medical sciences
Identifiers
urn:nbn:se:his:diva-1434 (URN)10.1111/j.1365-2648.2007.04396.x (DOI)000249488100007 ()17877564 (PubMedID)2-s2.0-34548665709 (Scopus ID)
Available from: 2008-09-24 Created: 2008-09-24 Last updated: 2014-03-27Bibliographically approved

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