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How to get one's voice heard: the problems of the discharge planning conference.
Umeå University, Faculty of Medicine, Nursing.
Umeå University, Faculty of Medicine, Nursing.
Umeå University, Faculty of Medicine, Nursing.
2006 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, Vol. 53, no 6, 646-655 p.Article in journal (Refereed) Published
Abstract [en]

AIMS: This paper reports a study describing how patients, relatives and healthcare professionals dealt with the variety of problems and responsibilities that occur in discharge planning conferences and especially how they managed to do this given the institutional frame that surrounded the meeting. BACKGROUND: In Sweden, the aim of a discharge planning conference is to co-ordinate social and healthcare resources as patients are discharged from hospitals. Patients, relatives and hospital staff, along with healthcare professionals responsible for outpatient care, assemble to achieve an individual care plan. One of the explicit principles informing the discharge planning conference is to increase patients' influence on decision-making. However, research points at shortcomings in this respect. METHOD: A discourse analysis was conducted using transcriptions of eight video-recorded discharge planning conferences. The selected patients were eight older women expected to be discharged from hospital. Other participants were staff nurses, social workers and occasionally relatives, an occupational therapist, district nurse or home care aide. FINDINGS: Participants adopted different roles as persons/patients, relative/next of kin and healthcare professionals/institutional representatives during the discharge planning conference, which they simultaneously struggled to act upon. The findings are presented under the categories 'Clashing roles and perspectives' and 'Facing the institutional frame'. CONCLUSIONS: The performance of the discharge planning conference in its present form interferes with a caring perspective that protects patients' integrity and gives prominence to their life worlds. Moreover, it does not satisfy patients' and relatives' right to expect proceedings that enhance their possibility to express their personal wishes in a dignified manner.

Place, publisher, year, edition, pages
2006. Vol. 53, no 6, 646-655 p.
Keyword [en]
Aftercare, Aged, Communication, Decision Making, Family, Female, Humans, Patient Care Team, Patient Discharge, Patient Participation, Power (Psychology), Sweden
URN: urn:nbn:se:umu:diva-6764DOI: 10.1111/j.1365-2648.2006.03771.xPubMedID: 16553673OAI: diva2:146434
Available from: 2007-12-17 Created: 2007-12-17 Last updated: 2009-11-11Bibliographically approved
In thesis
1. Vårdplaneringsmötet.: En studie av det institutionella samtalet mellan äldre kvinnor, närstående och vårdare
Open this publication in new window or tab >>Vårdplaneringsmötet.: En studie av det institutionella samtalet mellan äldre kvinnor, närstående och vårdare
2005 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis is to describe how elderly women’s encounters with an institutionalised world of health care manifest itself in a discharge planning conference (DPC). The thesis is based on eight video recorded DPCs and follow-up interviews with the women who took part in the conferences.

The result of study I, a case study, showed that the woman’s experience of taking part in the DPC was characterised as a feeling of powerlessness. The women’s possibility to have influence on the care planning was small (Study II). Study III revealed that the participants adopted or were assigned to different roles during the DPC. As these roles collided dilemmatic situations occurred. Simultaneously the women and family members struggled to manage the institutional frame that surrounded the meeting by trying to find room within it or by challenging it. Study IV revealed that the women found themselves to be in a vulnerable situation. Their body had failed them, their future was insecure and they felt unprepared as they took part in the DPC. They felt as if they were being affiliated with the other participants in a joint project, as if they were standing outside the event or as if they were in focus for the conversation which. The last was a double edged experience: getting confirmative attention but also being exposed as dependent. Four themes characterise the care that was jointly constructed by all participants during the DPC. These themes are “Care as spirit of community and confirmation”, ”Care as alienation”, ”The incomprehensible care” and “The inflexible and betraitful care”.The result gives rise to questions about the relevance of DPCs in their present shape. Further research and developmental projects requested to achieve dicharge planning conferences that are corresponding better to official caring ideals and the patients needs.

Place, publisher, year, edition, pages
Umeå: Omvårdnad, 2005. 89 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 967
Nursing, Discharge planning, Omvårdnad
National Category
Research subject
Caring Sciences
urn:nbn:se:umu:diva-590 (URN)91-7305-883-1 (ISBN)
Public defence
2005-09-30, Aulan, Vårdvetarhuset, Institutionen för omvårdnad, 901 87Umeå, 13:00 (English)
Available from: 2005-09-19 Created: 2005-09-19 Last updated: 2009-11-11Bibliographically approved

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