May J, Ellis-Hill C, Payne S
Health Research Unit, School of Health and Rehabilitation Sciences, University of Southampton, Southampton, UK.
J Adv Nurs. 2001 Nov;36(3):364-75. doi: 10.1046/j.1365-2648.2001.01984.x.
AIM(S) OF THE STUDY: This study explores the relationship between informal carers of older people, and health care workers within the context of a hospital ward. Through an analysis of their language-based encounters the purpose of the study was to identify the discursive processes involved in face-to-face informal carer-health care worker interactions, during the course of carers' visits to one elderly care rehabilitation hospital ward.
An ethnomethodological research design, which encompassed the concerns of conversation analysis and the study of institutional interaction, was used. The study involved videotape recording informal carers naturally occurring spontaneous interactions with a range of health care workers on the ward. Data collection was carried out for between 1 and 3 hours, two to three times a week over a period of 3 months. The data comprised: 30 dyadic and group interactions involving 19 different carers and 25 different health care workers, including nurses (qualified and unqualified), physiotherapists, occupational therapists, dieticians, ambulance personnel, housekeepers and nursing auxiliaries. Detailed transcriptions of the data were produced and analysis was undertaken using a modified conversation analysis approach.
Analysis revealed that a central aspect of the way the relationship between informal carers and health care workers is framed is by the way information and access to information is obtained. This paper examines some of the aspects of informal carer-health care worker discourse, which denote both parties as gatekeepers. In doing so it considers the roles that legitimatization of competence and knowledgeability have in facilitating informal carers interactions with health care workers.
We conclude that the accomplishment of legitimacy is largely a collaborative undertaking on behalf of health care workers and informal carers. The implications of these findings for carers, health care workers, policy and future research are discussed.
本研究探讨在医院病房环境中老年人非正式照料者与医护人员之间的关系。通过对他们基于语言的交流进行分析，本研究的目的是确定在照料者探访一家老年护理康复医院病房期间，面对面的非正式照料者与医护人员互动中所涉及的话语过程。
采用了一种民族方法学研究设计，该设计涵盖了会话分析和机构互动研究的关注点。该研究涉及对非正式照料者与病房中一系列医护人员自然发生的自发互动进行录像。数据收集每周进行两到三次，每次1至3小时，为期3个月。数据包括：30次二元和小组互动，涉及19名不同的照料者和25名不同的医护人员，包括护士（有资质和无资质的）、物理治疗师、职业治疗师、营养师、救护人员、勤杂工和护理辅助人员。对数据进行了详细转录，并采用改良的会话分析方法进行分析。
分析表明，非正式照料者与医护人员之间关系的构建方式的一个核心方面是获取信息和获取信息的方式。本文研究了非正式照料者与医护人员话语的一些方面，这些方面将双方都视为把关人。在此过程中，它考虑了能力和知识的合法化在促进非正式照料者与医护人员互动中所起的作用。
我们得出结论，合法性的实现很大程度上是医护人员和非正式照料者共同的任务。讨论了这些发现对照料者、医护人员、政策和未来研究的影响。
