GROUNDED THEORY STUDY OF NURSE/CLIENT MUTUALITY IN HEALTH CARE PLANNING.
Contributors: University of Colorado Health Sciences Center.
Published: 1995
Number of pages: 183
Subjects: Health Sciences, Nursing.; Health Sciences, Health Care Management.
Description: Changes in the health care system are requiring increased professional accountability for outcomes and increased client accountability for self-care. Mutuality in provider/client interactions is offered as a prototype of relationships that facilitate the shift needed for increased accountability. A grounded theory study of the presence of mutuality as an adjunct to health care planning between nurse and client was carried out. Observation of the planning process occurred in the home health setting between eight nurse/client dyads. Each participant was interviewed after the observation to determine the values and beliefs underlying the observed behaviors. A well functioning formal planning structure was identified which defined anticipated standardized care to be delivered. After the introduction of this formal planning on admission, future planning for both nurse and client was spontaneous, episodic or immediate need based, and unilateral rather than integrated, mutually planned, and moving clearly toward self or family care. Mutually identified plans with short-term formative goals were essentially absent. Mutuality was found in the relationship building phase and in the terminal care phase. Interactions in the working phase showed unilateral agendas and a task orientation. While both nurse and client said they valued open communication and mutual participation, overt mutual planning and goal setting with bilateral accountability was in fact an unfamiliar concept requiring unrefined skills. Instead, interactions called forth child-authority roles which were based on earlier life experiences and personal characteristics. Nurse participants did not feel their formal education and socialization included the skills for mutual planning. The nursing profession is challenged to make changes that would facilitate the development of behaviors of mutuality in practice. Such behaviors of bilateral accountability would relieve some strain from the health care system.
Notes: Source: Dissertation Abstracts International, Volume: 57-01, Section: B, page: 0238.

Thesis (PH.D.)--UNIVERSITY OF COLORADO HEALTH SCIENCES CENTER, 1995.

School code: 0831.