Patients' experiences of homecare nursing: balancing the duality between obtaining care and to maintain dignity and self-determination.

The aim of this study was to describe patients' experiences and perceptions of receiving nursing care in their private homes. A home is a place of security, independence and an arena for one's own routines. When nurses enter a patient's home, there are expectations from both sides which affect the social interaction. Maintaining patients' dignity demands that the nurse gets to know the patients and shows respect for their autonomy and integrity. A qualitative research method was chosen. Twenty-one patients with homecare nursing were interviewed in open interviews during 2008. Data were analysed according to the principles of interpretive description. The results are described in terms of three main themes: to be a person, to have trust and to have self-esteem. Patients reported experiencing certain events that could pose threats to their dignity, integrity and autonomy, as well as to their trust in nursing care. Patients have to deal with this ambiguity of accepting care while simultaneously maintaining independence and privacy. The nurses were perceived not as a guest but as professionals who would carry out a task in the interest of the patient. For patients, there is a duality in receiving homecare nursing and still exerting independence and self-determination in their homes. The patients developed strategies to balance their own privacy and dignity, despite the inconveniences the nursing treatment and procedures involved. This empowered them in their relationship with the professional caregivers.