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Patients and nurses negotiated home care interactions within 6 interpersonal contexts

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QUESTIONS: In home care nurse-patient interactions, what are the interpersonal contexts and social acts through which negotiation occurs? What are the outcomes of unsuccessful and successful negotiation?


Qualitative ethology for video based research.


A large metropolitan home healthcare agency in the western US.


10 nurse-patient dyads (3 home care nurses and 8 patients; 2 patients were each paired with 2 nurses). Patients were 25–86 years of age and required home care for acute and chronic conditions. Exclusion criterion was inability to communicate verbally because of cognitive or physical impairment. {The 3 home care nurses, who were case managers and had ≥6 years of home care experience, were peer nominated as expert practitioners.}*


31 routine home care visits were videotaped (19 hours of videotape). Nurses and patients participated in separate semistructured interviews before and after the videotaped sessions. The unit of analysis was …

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  • * Information provided by author.

  • Source of funding: no external funding.

  • For correspondence: Dr J A Spiers, Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada. jude.spiers{at}