This dissertation describes a research project about the communication between communication vulnerable people and health care professionals in long-term care settings. Communication vulnerable people experience functional communication difficulties in particular situations, due to medical conditions. They experience difficulties expressing themselves or understanding professionals, and/or professionals experience difficulties understanding these clients. Dialogue conversations between clients and professionals in healthcare, which for example concern health-related goals, activity and participation choices, diagnostics, treatment options, and treatment evaluation, are, however, crucial for successful client-centred care and shared decision making. Dialogue conversations facilitate essential exchanges between clients and healthcare professionals, and both clients and professionals should play a significant role in the conversation. It is unknown how communication vulnerable people and their healthcare professionals experience dialogue conversations and what can be done to support successful communication in these conversations. The aim of this research is to explore how communication vulnerable clients and professionals experience their communication in dialogue conversations in long-term care and how they can best be supported in improving their communication in these conversations.
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The research presented examines how pervasive technology can support intra-family communication, supporting existing practices and complimenting them by addressing communication needs currently unmet by current communication media like mobile phones, social networking systems, and so forth. Specifically the investigation focused on busy families, understood here to be families with two working parents and at least one child sharing the same roof. The class of technologies the authors consider are awareness systems, defined as communication systems that support individuals to maintain, with low effort, a peripheral awareness of each other's activities and whereabouts. This research combined a variety of research methods including interviews, web surveys, experience sampling, and field testing of functional prototypes of mobile awareness systems. It also involved the development of several applications, which were either seen as research tools in support of the methods applied or as prototypes of awareness systems that embody some of the envisioned characteristics of this emerging class of technologies. The contribution of this research is along two main dimensions. First in identifying intra-family communication needs that drive the adoption of awareness systems and second in providing directions for the design of such systems.
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BACKGROUND: Families are introduced as new partners in interprofessional communication and collaboration during hospitalisation of an adult patient. Their introduction into the healthcare team has consequences for the roles and responsibilities of all healthcare professionals. Role clarification is thus needed to create optimal communication and collaboration with families.AIM: To gain insight into how physicians and nurses view their own roles and each other's roles in communication and collaboration with families in the care of adult patients.METHODS: A qualitative interpretive interview design was used. Fourteen semi-structured interviews, with seven physicians and seven nurses, were conducted. Data were analysed according to the steps of thematic analysis. For the study design and analysis of the results, the guidelines of the consolidated criteria for reporting qualitative studies (COREQ) were followed. The ethical committee of the University Medical Center Groningen approved the study protocol (research number 202100640).FINDINGS: Thematic analysis resulted in three themes, each consisting of two or three code groups. Two themes "building a relationship" and "sharing information" were described as roles that both nurses and physicians share regarding communication and collaboration with families. The role expectations differed between physicians and nurses, but these differences were not discussed with each other. The theme "providing support to family" was regarded a nurse-specific role by both professions.CONCLUSION: Physicians and nurses see a role for themselves and each other in communication and collaboration with families. However, the division of roles and expectations thereof are different, overlapping, and unclear. To optimise the role and position of family during hospital care, clarification and division of the roles between physicians and nurses in this partnership is necessary.
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