Nilsson Elin, Olaison Anna
Division of Social Work, Department of Culture and Society, Linköping University, SE-601 74 Norrköping, Sweden.
Healthcare (Basel). 2023 Jul 25;11(15):2124. doi: 10.3390/healthcare11152124.
Social workers have a key role in needs assessment meetings with families dealing with dementia, providing information, support, and advocacy, while also assessing needs and making decisions about care services for several parties. These contacts are especially important during the introduction of home care services, where often the person has previously relied on informal support from relatives. The needs assessment process entails the involvement of all present parties, with the aim to reach a mutual agreement, a , regarding which services to apply for.
The aim of this case study is to explore how the participants, by means of different conversational practices, jointly create a working alliance between the different parties in one family. The study provides insights into the process of co-constructing a working alliance in the needs assessment process for elder care services.
This article addresses the process by which social workers build a working alliance in a multi-party conversation with a family living with cognitive decline; a meeting that lasted 50 min. In this case study, we benefit from an inductive and detailed conversation analytic methodology. The theoretical framework of working alliances in institutional interaction has informed the analysis.
The findings illustrate how the social worker in this case study involves all parties in the decision regarding care services and explores the use of the conversational practices of , , and as a "we" achieve mutual agreement toward the end of several sequences.
Drawing on the results of this case study, we argue that multi-party interaction involving relatives enables diversity in role-taking, where the professional, for instance, can pursue a more empathic role. Also, our results indicate that minimal agreement to a proposal is sufficient in a multi-party interaction involving clients with cognitive decline.
在与患有痴呆症的家庭进行需求评估会议时，社会工作者发挥着关键作用，他们提供信息、支持和宣传，同时还评估需求并为多方做出护理服务决策。在引入家庭护理服务时，这些联系尤为重要，因为在此之前，患者通常依赖亲属的非正式支持。需求评估过程需要所有在场方的参与，目的是就申请哪些服务达成共同协议。
本案例研究的目的是探讨参与者如何通过不同的对话方式，在一个家庭的不同方之间共同建立工作联盟。该研究深入了解了老年护理服务需求评估过程中共同构建工作联盟的过程。
本文探讨了社会工作者在与认知能力下降的家庭进行多方对话时建立工作联盟的过程；一次持续了50分钟的会议。在本案例研究中，我们受益于归纳性和详细的对话分析方法。机构互动中工作联盟的理论框架为分析提供了依据。
研究结果表明，在本案例研究中，社会工作者如何让所有各方参与护理服务决策，并探索使用“倾听”“确认”“解释”和“建议”等对话方式，使“我们”在几个环节结束时达成共同协议。
基于本案例研究的结果，我们认为涉及亲属的多方互动能够实现角色转换的多样性，例如专业人员可以扮演更具同理心的角色。此外，我们的结果表明，在涉及认知能力下降客户的多方互动中，对提议的最低限度同意就足够了。
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