Holmgren Jessica, Emami Azita, Eriksson Lars E, Eriksson Henrik
Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Scand J Caring Sci. 2013 Sep;27(3):677-85. doi: 10.1111/j.1471-6712.2012.01077.x. Epub 2012 Sep 25.
It is both complex and difficult for relatives when a loved one moves into a nursing home and many relatives are not prepared for the realities these new situations entail. Little attention has been paid to scrutinising the involvement of relatives in patient care, particularly in relation to the structures and routines of nursing homes or to the staff's reasoning concerning their involvement.
To describe, from a gender perspective, how nursing staff's routines and reasoning act to condition the involvement of relatives in nursing homes.
Focused ethnographic fieldwork was conducted in a medium-sized urban community in central Sweden in three different nursing homes.
The nursing staff assigns a certain code of conduct to all relatives they perceived as 'visitors' in their working arena. This code of conduct was related to the routines and subcultures existing among the nursing staff and stemmed from a division of labour; the underlying concept of 'visitor' predetermined the potential for relatives' involvement. This involvement is explicitly related to the general gendered characteristics that exist in the nursing staff's perception of the relatives.
The study's limitations are primarily concerned with shortcomings associated with a research presence during the fieldwork. The discussion focuses on the dimensions of power structures observed in the nursing home routines and the staff's reasoning based on their gendered assumptions. We argue that it is important to develop mechanisms that provide opportunities for nursing staff in elderly care to reflect on these structures without downplaying the excellent care they provide. We stress the importance of further exploring these issues concerning relatives and their involvement in nursing homes to facilitate the transition from informal caregiver to 'visitor'.
当亲人住进养老院时，这对亲属来说既复杂又困难，许多亲属并未对这些新情况所带来的现实做好准备。很少有人关注审视亲属在患者护理中的参与情况，尤其是与养老院的结构和日常安排相关的情况，或者与工作人员关于亲属参与的理由相关的情况。
从性别视角描述养老院工作人员的日常安排和理由如何影响亲属的参与。
在瑞典中部一个中等规模的城市社区的三家不同养老院进行了聚焦民族志实地调查。
养老院工作人员为他们工作场所中所有他们视为“访客”的亲属设定了某种行为准则。这种行为准则与养老院工作人员中存在的日常安排和亚文化相关，并且源于分工；“访客”这一基本概念预先决定了亲属参与的可能性。这种参与与养老院工作人员对亲属的认知中普遍存在的性别特征明确相关。
该研究的局限性主要与实地调查期间研究存在的缺点有关。讨论集中在养老院日常安排中观察到的权力结构维度以及工作人员基于其性别假设的理由。我们认为，重要的是要建立机制，为老年护理中的工作人员提供反思这些结构的机会，同时不贬低他们所提供的优质护理。我们强调进一步探索这些关于亲属及其在养老院参与情况的问题的重要性，以促进从非正式照料者到“访客”的转变。
