Rebecca Feo

Using holistic interpretive synthesis to create practice-relevant guidance for person-centred fundamental care delivered by nurses.

Nursing policy and healthcare reform are focusing on two, interconnected areas: person-centred care and fundamental care. Each initiative emphasises a positive nurse-patient relationship. For these initiatives to work, nurses require guidance for how they can best develop and maintain relationships with their patients in practice. Although empirical evidence on the nurse-patient relationship is increasing, findings derived from this research are not readily or easily transferable to the complexities and diversities of nursing practice. This study describes a novel methodological approach, called holistic interpretive synthesis (HIS), for interpreting empirical research findings to create practice-relevant recommendations for nurses. Using HIS, umbrella review findings on the nurse-patient relationship are interpreted through the lens of the Fundamentals of Care Framework. The recommendations for the nurse-patient relationship created through this approach can be used by nurses to establish, maintain and evaluate therapeutic relationships with patients to deliver person-centred fundamental care. Future research should evaluate the validity and impact of these recommendations and test the feasibility of using HIS for other areas of nursing practice and further refine the approach.

'I Just Want to Talk': Establishing reason for call on a men's counselling helpline

Abstract Literature on mens health help-seeking suggests that, consistent with hegemonic masculine ideals, men display a general preference for solution-focused interaction. Mens health services routinely orient to this preference, emphasising assistance in the form of practical advice. Little research, however, has examined the nature of actual interactions between men and health professionals. The present paper analyses interaction on a mens telephone relationship-counselling service, focusing on reasons for calling. We demonstrate some recurring interactional patterns relating to the helplines institutional philosophy of solution-focused counselling. Specifically, callers routinely engaged in narrative reporting of relationship troubles rather than indicating that they were seeking advice; counsellors, however, routinely orientated to the role of advice- and information-provider, in addition to that of troubles-talk recipient. We examine the recurring interactional disfluencies around this reason-for-call talk, considering some consequences for institutional help-giving that arise from the assumption of a male preference for solution-focused healthcare.

Developing effective and caring nurse-patient relationships

Establishing positive and trusting therapeutic relationships with patients has long been recognised as an essential component of nursing practice and is important for effective care. There are various challenges in clinical practice that make it increasingly difficult to deliver effective care centred on such relationships. Understanding and addressing these challenges is crucial to ensure a positive experience of care for patients, families, carers and nurses. This article outlines how nurses can use a framework to develop therapeutic relationships with patients and use the best available evidence to deliver effective care. It also explores the challenges in developing effective therapeutic relationships with patients at the healthcare system level, and considers how these challenges can be addressed.

Role of effective nurse-patient relationships in enhancing patient safety

Ensuring and maintaining patient safety is an essential aspect of care provision. Safety is a multidimensional concept, which incorporates interrelated elements such as physical and psychosocial safety. An effective nurse-patient relationship should ensure that these elements are considered when planning and providing care. This article discusses the importance of an effective nurse-patient relationship, as well as healthcare environments and working practices that promote safety, thus ensuring optimal patient care.

Dealing with third-party complaints on a men’s relationship-counselling helpline

This article examines how third-party complaints were responded to by counsellors on a men’s relationship-counselling helpline. Much prior conversation analytic research has shown that third-party complaints in institutional settings are embedded in other activities and treated as secondary to the main interactional business. As such, complaints are routinely responded to with a shift to a new, institutionally relevant activity (e.g. the reason for the call/visit). In the context examined here, however, the third-party complaints constituted callers’ reasons for call. We show that, as in many other institutional contexts, counsellors do not, commonly, affiliate with callers’ complaints in the sense of displaying a similar stance towards a described third party. However, unlike in other settings that have been examined, counsellors’ responses did not result in an immediate shift away from callers’ complaints. This was primarily because, following counsellors’ non-affiliative responses, callers regularly engaged in work to pursue affiliation.