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Establishing joint attention in remote talks with the elderly about health: a study of nurses' conversation with elderly persons in teleconsultations
Umeå University, Faculty of Medicine, Department of Nursing.
Umeå University, Faculty of Medicine, Department of Nursing.
2005 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, no 4, 317-24 p.Article in journal (Refereed) Published
Abstract [en]

This study is a contribution to the sparsely studied field of nurses' teleconsultations with frail elderly people. The aim was to describe how talk and interaction are accomplished and by what means problems are handled that emerge from the fact that the communication is conducted via videoconferencing techniques. Recordings were made of 22 sessions of teleconsultation between nurses and elderly nursing home residents aided by enrolled nurses. The data were analysed with a qualitative method inspired by conversation and discourse analysis. The findings indicate that in order to create a joint attention the participants often had to verbally confirm and reconfirm that contact had been established. The triad of participants played a special part in maintaining the joint attention through compensating for the contextual aspect of the medium's limitations and the demented elderly person's communication problems. 'Talks about the communication' and passages of social talk took place when the nurse or the staff member wanted to re-establish and maintain joint attention. The joint attention seemed connected to a special sort of eye contact and gaze and to the type of camera projection that was used. One conclusion was that to create joint attention in nurses' teleconsultations with frail elderly people, the limitations in transferring communication cues and the limitations of what the camera can reveal of the general context could, to some extent, be made up for by verbal communication within the triad of participants. Another conclusion was that these limitations in the context of interaction in some situations also seemed to be an advantage for the demented elderly and contributed to increased attention

Place, publisher, year, edition, pages
2005. Vol. 19, no 4, 317-24 p.
Keyword [en]
Aged, Attention, Communication, Dementia/nursing, Frail Elderly, Humans, Nurse-Patient Relations, Nursing Homes, Remote Consultation, Sweden, Videoconferencing
Identifiers
URN: urn:nbn:se:umu:diva-6756DOI: doi:10.1111/j.1471-6712.2005.00346.xPubMedID: 16324054OAI: oai:DiVA.org:umu-6756DiVA: diva2:146426
Available from: 2007-12-17 Created: 2007-12-17 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Telecare of frail elderly: reflections and experiences among health personnel and family members
Open this publication in new window or tab >>Telecare of frail elderly: reflections and experiences among health personnel and family members
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Telecare has been an approach to care that, internationally, has experienced a generally rapid development during the last ten years. There are many examples of successful pilot projects where ICT applications have been used in the care of elderly: for improved remote consultation with health professionals, to improve the communication and support of the elderly person’s social network, and as intelligent sensors intended to improve the safety of the elderly person. Despite these successes, implementation has been slow. This research project was set up to provide additional knowledge on some of the important questions regarding quality and implementation aspects of the use of ICT application on the care of frail elderly persons. The overall aim of the research project is to illuminate reasoning and experiences of using applications of telecare for frail elderly persons.

The research project comprised five studies that were conducted using qualitative research methods. Four of them were carried out within the framework of three telecare projects. Different qualitative research approaches such as content analysis, phenomenological hermeneutics and conversational and discourse analysis were used, in accordance with the research questions of each study. The experiences revealed in the findings of the studies indicate that it is possible to have communication of good quality via videoconferencing with frail elderly persons, even those that have mild or mid-level dementia, provided the conditions are right. Technical limitations of the videoconferencing media in transferring communication cues and the limitations on what the camera can expose place special demands on those communicating with the frail elderly and on the general setting. On the other hand, these limitations on the context of interaction in some situations also seem to be an advantage for demented elderly persons and contribute to increased attention. One example of meaningful remote communication with frail elderly persons was family members’ videophone conversations with their demented relatives when they were placed in nursing homes or homes for respite services. This communication gave new possibilities of being involved in caring for, and of maintaining a relationship with, their demented relative. An introduction of teleconsultations in the care of frail elderly persons will, according to the experiences recorded, affect the professional role and the practical spheres of involved health professionals. The perceptions and experiences of participating health personnel indicate that in order for ICT applications to become valuable assets in the care of frail elderly persons they have to be part of a care alternative that is viewed by all concerned as the best alternative, as a whole, for all affected parties. Further research is needed in order to confirm or refute the findings of this thesis and in order to further broaden our understanding of the use of ICT applications in the care of frail elderly persons. This could facilitate a development of ICT applications suitable for the care of frail elderly persons and their introduction into regular care activities, to the benefit of both the frail elderly persons and their carers.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, Institutionen för omvårdnad, 2004. 56 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 918
Keyword
Nursing, Telecare, Frail elderly, Nurse-patient interaction, Quality of care, Professional roles, Videoconferensing, Ethical reasoning, Perception of care, Omvårdnad
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-339 (URN)91-7305-733-9 (ISBN)
Public defence
2004-11-05, Vårdvetarhuset, Aulan, Umeå universitet, Umeå, 13:00 (English)
Opponent
Available from: 2004-10-28 Created: 2004-10-28 Last updated: 2010-09-23Bibliographically approved

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