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Balancing task focus and relationship building: asking sleepy patients about traffic risk in treatment initiation consultations
Uppsala University, Sweden.
Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Clinical Neurophysiology. Jonköping University, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Clinical Neurophysiology.
2017 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 31, no 4, p. 895-903Article in journal (Refereed) Published
Abstract [en]

BackgroundThe use of traffic risk assessment questions is an understudied area in nursing research. Obstructive sleep apnoea is associated with an increased risk of traffic accidents. Therefore, traffic safety authorities demand adherent continuous positive airway pressure use. Nurses act as coaches to achieve treatment adherence, but they are also obliged to act as state agents by prohibiting obstructive sleep apnoea patients from drowsy driving. ObjectiveTo examine how nurses and obstructive sleep apnoea patients manage traffic risk assessment questions in the relation-building context of treatment initiation consultations. MethodsTo study, in detail, the actual practice of risk assessment, we used conversation analysis of 19 video-recorded initial treatment consultations with nurses and recently diagnosed obstructive sleep apnoea patients. EthicsThe study received ethical approval from the Central Ethical Review Board in Linkoping (registration number 214/231-32) and follows the ethical guidelines for qualitative research. ResultsPatients influence how nurses phrase questions about traffic risk by taking a stance to daytime sleepiness prior to the risk question. Nurses ask traffic risk questions in a way that assumes that driving is unproblematic if patients have not previously indicated problems. It may pose a significant problem when nurses, by accepting patients prior stance when asking about traffic risk, orient to relationship building rather than task focus. ConclusionTo clarify the difference between their two potentially conflicting roles, nurses need to refer to existing laws and official guidelines when they raise the issue of risk in treatment initiation consultations. Nurses should also ask risk assessment questions in a problem-oriented communicative environment. Traffic risk assessment is sensitive yet important, as obstructive sleep apnoea is a highly prevalent problem causing excessive sleepiness. It is essential to acknowledge nurses double roles with regard to coaching continuous positive airway pressure treatment and assessing traffic risk.

Place, publisher, year, edition, pages
WILEY , 2017. Vol. 31, no 4, p. 895-903
Keyword [en]
communication; conversation analysis; long-term care; nurse-patient interaction; nurse roles; obstructive sleep apnoea; patient participation; qualitative approaches; risk assessment; sleep
National Category
General Practice
Identifiers
URN: urn:nbn:se:liu:diva-144154DOI: 10.1111/scs.12411ISI: 000416413000028PubMedID: 28439962OAI: oai:DiVA.org:liu-144154DiVA: diva2:1171911
Note

Funding Agencies|European Research Council [CEV 263699]; FORSS (Medical Research Council of Southeast Sweden) [DNR.566401, 376541]

Available from: 2018-01-08 Created: 2018-01-08 Last updated: 2018-01-13

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Broström, AndersUlander, Martin
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Division of Nursing ScienceFaculty of Medicine and Health SciencesDepartment of Clinical NeurophysiologyDivision of Neuro and Inflammation Science
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