Eleni Siouta1, Carole Farrell2, E Angela Chan3, Catherine Walshe4, Alex Molassiotis5. 1. Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Stockholm, Sweden; Sophiahemmet University College, Stockholm, Sweden. Electronic address: eleni.siouta@shh.se. 2. Christie Patient Centred Research Group, The Christie NHS Foundation Trust, Wilmslow Road, Withington, Manchester, United Kingdom. Electronic address: c.farrell@bolton.ac.uk. 3. School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China. Electronic address: e.angela.chan@polyu.edu.hk. 4. Department of Health Research, University of Lancaster, Lancaster, United Kingdom. Electronic address: c.walshe@lancaster.ac.uk. 5. School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China. Electronic address: alex.molasiotis@polyu.edu.hk.
Abstract
PURPOSE: Nursing is theorised to be a component of person-centred care. Communicative constructions of person-centred caring are a topic that needs to be studied in consultations. The study aimed to explore how person-centred caring and non-person- centred caring are verbally constructed in consultations between patients and nurse. METHOD: This study was qualitative using audio-recorded observations from consultations with advanced nurse practitioners in nurse-led chemotherapy clinics from four hospitals in the UK through purposive sampling. Discourse analysis was used to identify communicative patterns in 45 non-participant observations of nurse consultations. RESULTS: The dominant discourse was a non-person-centred oriented discourse framed by the biomedical model. It was also possible to identify fragments of an alternative discourse-a person-oriented discourse localising health problems within the patient's personal and sociocultural context. CONCLUSIONS: The prominent use of a non-person-oriented discourse focusing on the medical/technical aspects of a patient's assessment/evaluation in consultations may make it difficult for patients to raise questions and concerns from their daily lives during consultations. However, fragments of a person-oriented discourse show that it is possible for nurses to allow a person-centred approach to the consultation. The pedagogical implications have to do with raising nurses' awareness of the role of evaluative language in enhancing person-centred communication with patients in clinical interactions.
PURPOSE: Nursing is theorised to be a component of person-centred care. Communicative constructions of person-centred caring are a topic that needs to be studied in consultations. The study aimed to explore how person-centred caring and non-person- centred caring are verbally constructed in consultations between patients and nurse. METHOD: This study was qualitative using audio-recorded observations from consultations with advanced nurse practitioners in nurse-led chemotherapy clinics from four hospitals in the UK through purposive sampling. Discourse analysis was used to identify communicative patterns in 45 non-participant observations of nurse consultations. RESULTS: The dominant discourse was a non-person-centred oriented discourse framed by the biomedical model. It was also possible to identify fragments of an alternative discourse-a person-oriented discourse localising health problems within the patient's personal and sociocultural context. CONCLUSIONS: The prominent use of a non-person-oriented discourse focusing on the medical/technical aspects of a patient's assessment/evaluation in consultations may make it difficult for patients to raise questions and concerns from their daily lives during consultations. However, fragments of a person-oriented discourse show that it is possible for nurses to allow a person-centred approach to the consultation. The pedagogical implications have to do with raising nurses' awareness of the role of evaluative language in enhancing person-centred communication with patients in clinical interactions.