The public defense of Jessica Höglander's doctoral thesis in caring science

Doctoral thesis and Licentiate seminars

Datum: 2019-05-10
Tid: 13.15 - 16.00
Plats: Room Beta, Västerås

Welcome to the public defense of Jessica Höglander's doctoral thesis at Mälardalen University in Västerås

Title: Home care communication – moving beyond the surface
The faculty examiner is professor, Bjöörn Fossum, Sophiahemmet university, and the examining committee consists of associate professor Barbro Wadensten Uppsala university, Anneli Mellblom Oslo University and professor emeritus Lene Martin, Mälardalen University.
Reserve: associate professor, Lena Nordgren
Number 288

Summary

Home care is often based on older persons’ physical needs and foremost task-focused. Home care is therefore criticised for being too standardised, not based on older persons’ individual needs. Older persons describe it as important to be perceived as a person and to feel involved in their care. Thus, a more individualised care and communication is important when meeting the individual needs of older people and to uphold their experience of health and wellbeing. 

At present, knowledge about the daily communication within home care is scarce but important if to support the nursing staff in their communication. The overall aim was to explore the naturally occurring communication between nursing staff and older persons in home care visits, with focus on communication of emotional distress and with a person-centred perspective. This thesis is a part of the international research project COMHOME.

Communication between nursing staff and older persons have been explored in 188 audio-recorded home care visits with 31 nursing staff and 81 older persons, aged 65-102 years. In Study I, older persons’ expressions of emotional distress in the home care visits were explored. The results showed that older persons often express their emotional distress in the form of hints of emotional concerns, defined as cues. Explicit expressions of emotional distress, defined as concerns, were rarely expressed. When responding to older persons’ emotional distress, the nursing staff often provided space for further talk about the older person’s experience of emotional distress, than reduced space (Study II). Responses providing space were more often given to older females or to older persons aged 65-84 years and emotional distress was most often expressed by older females and to female nursing staff (Study III). In home care communication between registered nurses and older persons the socio-emotional talk was more common than task-focused talk. The communication also had a high degree of person-centredness, especially in longer than shorter home care visits. 

The results of this thesis conclude that socio-emotional talk is an important part of home care to older persons, in addition to the task- or bio-medical communication. The home care communication also entail important aspects associated with person-centredness. The knowledge drawn from the studies can be used in education, for students and professionals, and in interventions studies regarding provision of emotional support and person-centred communication in home care.