Hedberg Berith, Cederborg Ann-Christin, Johanson Marita
Institute of Health Care Pedagogics, The Sahlgrenska Academy at Göteborg University, Sweden.
J Nurs Manag. 2007 Mar;15(2):214-21. doi: 10.1111/j.1365-2834.2007.00619.x.
Stroke survivors often have communicative disabilities. They should, however, be involved when decisions are made about their care treatment.
To explore and describe how nurses act as moderators of the communication in cooperative care-planning meetings and what kind of participant status the patients achieve in this type of multi-party talk.
Thirteen care-planning meetings were audio-recorded and transcribed. Nurses, social workers and stroke survivors were the main participants for the meetings. A coding scheme was created and three main categories were used for the analysis: pure utterance types, expert comments (EC) and asymmetries.
The nurses never invited the patients to tell their own versions without possible influence from them. Mostly the nurses gave ECs. The nurses acted as the patients' advocates by talking for or about them. They rarely supported the patients' utterances.
There is an urgent need for nurses to learn how to involve the patients in the communicative process about their treatment. Assessment of the patients' communicative abilities before the care-planning meetings as well as knowledge about how to invite them can improve the patients' participant status.
中风幸存者常常存在沟通障碍。然而,在对其护理治疗做出决策时,应让他们参与其中。
探讨并描述护士在合作护理计划会议中如何充当沟通调解人,以及患者在这种多方交谈中获得何种参与地位。
对13次护理计划会议进行录音和转录。护士、社会工作者和中风幸存者是会议的主要参与者。创建了一个编码方案,并使用三个主要类别进行分析:纯粹的话语类型、专家评论(EC)和不对称性。
在没有患者可能的影响时,护士从不邀请患者讲述他们自己的情况。大多数情况下,护士给出专家评论。护士通过为患者代言或谈论患者来充当患者的代言人。他们很少支持患者的话语。
护士迫切需要学习如何让患者参与到关于其治疗的沟通进程中。在护理计划会议之前评估患者的沟通能力以及了解如何邀请患者,可以提高患者的参与地位。