It takes three to tango: An ethnography of triadic involvement of residents, families and nurses in long-term dementia care.
family participation
identity
qualitative research
relationship-centred care
residential dementia care
roles rights and responsibilities
triad encounters
user involvement
Journal
Health expectations : an international journal of public participation in health care and health policy
ISSN: 1369-7625
Titre abrégé: Health Expect
Pays: England
ID NLM: 9815926
Informations de publication
Date de publication:
02 2022
02 2022
Historique:
revised:
10
02
2021
received:
02
08
2020
accepted:
13
02
2021
pubmed:
22
7
2021
medline:
15
3
2022
entrez:
21
7
2021
Statut:
ppublish
Résumé
Researchers often stress the necessity and challenge of integrating the positionings of residents, family members and nurses in order to realize each actor's involvement in long-term dementia care. Yet most studies approach user and family involvement separately. To explain how productive involvement in care provision is accomplished in triadic relationships between residents, family members and nurses. An ethnographic study of identity work, conducted between 2014 and 2016 in a Dutch nursing home. We identify four ideal-typical identity positionings performed by nurses through daily activities. The findings reveal how their identity positionings were inseparable from those of the residents and family members as they formed triads. Congruent, or 'matching', identity positionings set the stage for productive involvement. Our systematic analysis of participants' identity work shows how-through embedded rights and responsibilities-their positionings inherently shaped and formed the triadic types and degrees of involvement observed within these relationships. This study both unravels and juxtaposes the interrelatedness of, and differences between, the concepts of user and family involvement. Accordingly, our findings display how residents, family members and nurses-while continuously entangled in triadic relationships-can use their identity positionings to accomplish a variety of involvement activities. To mirror and optimize the implementation of user and family involvement, we propose a rights-based and relational framework based on our findings. Conversations with and observations of residents; feedback session with the Clients' Council.
Sections du résumé
BACKGROUND
Researchers often stress the necessity and challenge of integrating the positionings of residents, family members and nurses in order to realize each actor's involvement in long-term dementia care. Yet most studies approach user and family involvement separately.
AIM
To explain how productive involvement in care provision is accomplished in triadic relationships between residents, family members and nurses.
METHODS
An ethnographic study of identity work, conducted between 2014 and 2016 in a Dutch nursing home.
FINDINGS
We identify four ideal-typical identity positionings performed by nurses through daily activities. The findings reveal how their identity positionings were inseparable from those of the residents and family members as they formed triads. Congruent, or 'matching', identity positionings set the stage for productive involvement. Our systematic analysis of participants' identity work shows how-through embedded rights and responsibilities-their positionings inherently shaped and formed the triadic types and degrees of involvement observed within these relationships.
DISCUSSION AND CONCLUSION
This study both unravels and juxtaposes the interrelatedness of, and differences between, the concepts of user and family involvement. Accordingly, our findings display how residents, family members and nurses-while continuously entangled in triadic relationships-can use their identity positionings to accomplish a variety of involvement activities. To mirror and optimize the implementation of user and family involvement, we propose a rights-based and relational framework based on our findings.
PATIENT OR PUBLIC CONTRIBUTION
Conversations with and observations of residents; feedback session with the Clients' Council.
Identifiants
pubmed: 34288293
doi: 10.1111/hex.13224
pmc: PMC8849257
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
80-90Informations de copyright
© 2021 The Authors. Health Expectations published by John Wiley & Sons Ltd.
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