Hovenga Nina, Landeweer Elleke, Lesman-Leegte Ivonne, Van Twillert Sacha, Vinckers Floor, Zuidema Sytse, Leget Carlo
Department of Primary- and Long-Term Care, University of Groningen, Faculty of Medical Sciences, University Medical Center Groningen, Groningen, The Netherlands.
Department of Care Ethics, University of Humanistic Studies, Utrecht, The Netherlands.
J Adv Nurs. 2025 Apr;81(4):2039-2049. doi: 10.1111/jan.16432. Epub 2024 Sep 4.
To explore experiences of nursing home staff in implementing self-designed interventions to foster trusting relationships with family in practice.
This qualitative study used a Participatory Action Research approach.
Data collection included focus groups (n = 15), interviews (n = 28) and observations (n = 5). A holistic narrative approach was used for data analysis, resulting in co-constructed narratives representing experiences of nursing home staff in implementing four different interventions in five Dutch dementia special care units in nursing homes. The data collection period began in August 2021 and ended in April 2022.
Nursing home staff implemented self-designed interventions to foster trusting relationships with family, including initiating informal conversations, sharing residents' 'happy' moments, discussing mutual expectations, and being more aware of families' emotional burdens. Identified facilitators emphasise the importance of reciprocity, familiarity, transparency, realistic goal setting and empathy. Identified barriers are related to moral uncertainty in balancing competing demands, conflicting social norms, prioritising hands-on care tasks over family contact and lack of courage to act.
Nursing home staff conclude that their interventions contribute positively to building and maintaining a trusting relationship with families.
IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Sharing the narratives of nursing home staff with peers would support them in implementing interventions to foster trust. Regular Moral Case Deliberations can be used to address moral uncertainty. Collective dialogue among nursing home staff can be useful in establishing new social norms that prioritise family involvement. Conversation skills training can empower nursing home staff.
Trust between nursing home staff and families can be improved by implementing the conducted interventions.
This report adheres to the standards for reporting qualitative research (COREQ).
No patient or public contribution.
探讨养老院工作人员在实践中实施自行设计的干预措施以促进与家属建立信任关系的经验。
本定性研究采用参与式行动研究方法。
数据收集包括焦点小组（n = 15）、访谈（n = 28）和观察（n = 5）。采用整体叙事方法进行数据分析，得出共同构建的叙事，代表养老院工作人员在荷兰五家养老院的痴呆症特殊护理单元实施四种不同干预措施的经验。数据收集期从2021年8月开始，至2022年4月结束。
养老院工作人员实施自行设计的干预措施以促进与家属建立信任关系，包括开展非正式对话、分享居民的“快乐”时刻、讨论相互期望以及更加关注家属的情感负担。确定的促进因素强调互惠、熟悉、透明、现实目标设定和同理心的重要性。确定的障碍与平衡相互冲突的需求时的道德不确定性、相互冲突的社会规范、将实际护理任务置于与家属联系之上以及缺乏行动勇气有关。
养老院工作人员得出结论，他们的干预措施对与家属建立和维持信任关系有积极贡献。
对专业和/或患者护理的启示：与同行分享养老院工作人员的叙事将支持他们实施促进信任的干预措施。定期进行道德案例审议可用于解决道德不确定性。养老院工作人员之间的集体对话有助于建立优先考虑家属参与的新社会规范。沟通技巧培训可增强养老院工作人员的能力。
通过实施所开展的干预措施可改善养老院工作人员与家属之间的信任。
本报告遵循定性研究报告标准（COREQ）。
无患者或公众贡献。
