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dc.contributor.advisorNancy Morris
dc.contributor.authorFalkenstrom, Mary Kate
dc.date2022-08-11T08:09:03.000
dc.date.accessioned2022-08-23T16:16:42Z
dc.date.available2022-08-23T16:16:42Z
dc.date.issued2016-04-28
dc.date.submitted2016-11-09
dc.identifier.doi10.13028/62e1-3p47
dc.identifier.urihttp://hdl.handle.net/20.500.14038/34392
dc.description<p>Material from this dissertation has been published in: Falkenstrom MK. A Qualitative Study of Difficult Nurse-Patient Encounters in Home Health Care. ANS Adv Nurs Sci. 2016 Oct 28. [Epub ahead of print] PubMed PMID: 27798435.</p>
dc.description.abstractThe purpose of this study was to explore nurse-patient encounters from the perspective of the Home Healthcare Registered Nurse. A qualitative descriptive design was used to collect data from a purposive sample of 20 home healthcare registered nurses from Connecticut, Massachusetts, and Rhode Island currently or previously employed as a home healthcare nurse. Four themes and one interconnecting theme emerged from the data: Objective Language; Navigating the Unknown; Mitigating Risk; Looking for Reciprocality in the Encounter; and the interconnecting theme of Acknowledging Not All Nurse-Patient Encounters Go Well. One goal of the study was to propose an empirically informed definition of what constituted a difficult encounter. An important early finding was that the terms difficult patient and difficult encounter were not generally used by study participants. HHC RNs voiced a preference for objective and nonjudgmental language to communicate outcomes of nurse-patient encounters. Three types of HHC RN-patient interactions emerged from the data, with constructive encounters the norm and non-constructive or destructive encounters less frequent. A constructive encounter is when two or more human beings, the nurse on the one side, and the patient, caregiver, or both on the other, interact to achieve a mutually agreed upon outcome. A nonconstructive encounter is when one or more human beings obstruct efforts to achieve at least one positive outcome. A destructive encounter is when one or more human beings direct anger at or physically aggress toward another human being. Strategies to promote reciprocality are routinely employed during HHC RN-patient encounters, but HHC RNs who miss cues that a strategy is ineffective or failed may be at risk in the home. Study data lend support to key concepts, assumptions, and propositions of Travelbee’s (1971) Human-to-Human Relationship Model. Study results provide a foundation for further research to increase the understanding, recognition, and development of empirically derived responses to non-constructive or destructive encounters such that HHC RNs are safe and best able to meet patients’ healthcare needs.
dc.language.isoen_US
dc.relation<p><a href="http://escholarship.umassmed.edu/gsn_pp/51/">Published article based on this dissertation</a></p>
dc.rightsCopyright is held by the author, with all rights reserved.
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectconstructive encounters
dc.subjectdifficult encounters
dc.subjecthome care
dc.subjecthome health care
dc.subjecthuman-to-human relationship
dc.subjectmitigating risk
dc.subjectnonconstructive encounters
dc.subjectnurse-patient encounters
dc.subjectreciprocality
dc.subjectreciprocity
dc.subjectNurse-Patient Relations
dc.subjectHome Care Services
dc.subjectHome Health Nursing
dc.subjectHome Nursing
dc.subjectNurses
dc.subjectCommunity Health
dc.subjectHealth Services Administration
dc.subjectNursing
dc.titleExploratory Study of Nurse-Patient Encounters in Home Healthcare: A Dissertation
dc.typeDoctoral Dissertation
dc.identifier.legacyfulltexthttps://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=1058&amp;context=gsn_diss&amp;unstamped=1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/gsn_diss/45
dc.identifier.contextkey9361010
refterms.dateFOA2022-08-24T04:18:14Z
html.description.abstract<p>The purpose of this study was to explore nurse-patient encounters from the perspective of the Home Healthcare Registered Nurse. A qualitative descriptive design was used to collect data from a purposive sample of 20 home healthcare registered nurses from Connecticut, Massachusetts, and Rhode Island currently or previously employed as a home healthcare nurse. Four themes and one interconnecting theme emerged from the data: Objective Language; Navigating the Unknown; Mitigating Risk; Looking for Reciprocality in the Encounter; and the interconnecting theme of Acknowledging Not All Nurse-Patient Encounters Go Well. One goal of the study was to propose an empirically informed definition of what constituted a difficult encounter. An important early finding was that the terms difficult patient and difficult encounter were not generally used by study participants. HHC RNs voiced a preference for objective and nonjudgmental language to communicate outcomes of nurse-patient encounters. Three types of HHC RN-patient interactions emerged from the data, with constructive encounters the norm and non-constructive or destructive encounters less frequent. A constructive encounter is when two or more human beings, the nurse on the one side, and the patient, caregiver, or both on the other, interact to achieve a mutually agreed upon outcome. A nonconstructive encounter is when one or more human beings obstruct efforts to achieve at least one positive outcome. A destructive encounter is when one or more human beings direct anger at or physically aggress toward another human being. Strategies to promote reciprocality are routinely employed during HHC RN-patient encounters, but HHC RNs who miss cues that a strategy is ineffective or failed may be at risk in the home. Study data lend support to key concepts, assumptions, and propositions of Travelbee’s (1971) Human-to-Human Relationship Model. Study results provide a foundation for further research to increase the understanding, recognition, and development of empirically derived responses to non-constructive or destructive encounters such that HHC RNs are safe and best able to meet patients’ healthcare needs.</p>
dc.identifier.submissionpathgsn_diss/45
dc.contributor.departmentGraduate School of Nursing


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