Nurse-physician communication concerning artificial nutrition or hydration (ANH) in patients with dementia: a qualitative study
Journal of Clinical Nursing, 06/19/2012
Bryon E et al. – Nurse–physician communication was the most important instrument determining whether nurses succeeded or failed to actively act as a patient’s representative and whether nurses achieved the best possible care in co–operation with physicians.Methods
- Between April 2008 and June 2009, they conducted 21 interviews with nurses from nine different hospitals geographically spread throughout Flanders (Belgium). Interviews were audiotaped and later transcribed.
- Data processing involved (1) simultaneous and systematic data collection and analysis, (2) constant forwards–backwards wave, (3) continuous dialogue with the data and (4) interactive team processes.
- The interviews showed that communication with physicians is the central instrument the nurses used in their attempts to realise their perception of ‘the best possible care’.
- From the nurses’ perspective, they distinguished three mutually connected factors that affected the effectiveness of nurse–physician communication during artificial nutrition or hydration decision-making: the physicians’ attitude towards the nurses, the nurses’ attitude towards the physicians and the forms of communication used by the nurses.
- The complex interaction between these three factors resulted in a range of nurses’ perceptions, varying from positive to negative.
- The direction of their perceptions depended on the extent to which they succeeded or failed to use nurse–physician communication as an instrument to realise the ‘best care’.