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Homecare nurses’ perceptions of the impact of nursing behaviors on family communication in families with an adult palliative member : a pilot study Miller, Rona

Abstract

An interpretative descriptive approach was used in this pilot study to lay the foundations for a full-scale study to explore how homecare nurses influence family communication and their perception of the impact of their nursing strategies on family communication in families with an adult palliative member. A convenience sample of eight experienced, diploma-prepared homecare nurses was recruited following the presentation of the study at a staff meeting and the distribution of information letters that detailed the study and invited homecare nurses to participate in the study. In-depth participant interviews were the primary method of data collection. Data analysis involved constant comparative analysis of the interview transcripts to identify emerging data themes. While the findings mainly related to limitations in the research process, such as participant recruitment and a single data collection method, some preliminary codes identified from the data were: "creating a family circle," "speaking for," "bringing it out into the open," "family rules," and "taking the time." These preliminary codes reflected strategies that the homecare nurses used to influence family communication and while some, such as creating a family circle and bringing it out into the open, are strategies that are supported in the communication and family literature, others such as, speaking for, are not supported in this literature. Creating a family circle referred to how the homecare nurses interacted with families by creating a circle around the palliative individual, and this strategy perhaps reflected the focus on the individual rather than family-focused nursing care. Speaking for referred to the situations in which the nurses spoke on behalf of individuals in the family. The nurses tended to speak for individuals when they perceived a benefit to the palliative individual's care. Bringing it out into the open reflected the strategies used by the nurses to ensure open family communication. The data for the code taking the time referred to how the nurses structured their workload to make time for the palliative individual and family, to workplace support, and to the nurses' knowledge, skills, and energy in assessing and intervening in family communication. Recommendations for a future study include more active recruitment strategies, the triangulation of data collection methods, such as nonparticipant and videotaped observations, a focus group, and the inclusion of methods, such as nonparticipant and videotaped observations, a focus group, and the inclusion of family interviews to provide data on the families' perspectives of nurses' interventions in family communication. The findings from this study have implications for nursing practice and education. The palliative tenet of family-focused care was not clearly reflected in the data suggesting that nurses may benefit from education and supportive work environments to shift from the individual to family-focused nursing care.

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