Fostering a Trusting Relationship With Family in Dementia Special Care Units: A Participatory Action Research Project

Author:

Hovenga Nina1ORCID,Landeweer Elleke12,Lesman‐Leegte Ivonne1,Van Twillert Sacha3,Vinckers Floor1ORCID,Zuidema Sytse1,Leget Carlo2

Affiliation:

1. Department of Primary‐ and Long‐Term Care University of Groningen, Faculty of Medical Sciences, University Medical Center Groningen Groningen The Netherlands

2. Department of Care Ethics University of Humanistic Studies Utrecht The Netherlands

3. UMC Staff Policy and Management Support University of Groningen, University Medical Center Groningen Groningen The Netherlands

Abstract

ABSTRACTAimTo explore experiences of nursing home staff in implementing self‐designed interventions to foster trusting relationships with family in practice.DesignThis qualitative study used a Participatory Action Research approach.MethodsData collection included focus groups (n = 15), interviews (n = 28) and observations (n = 5). A holistic narrative approach was used for data analysis, resulting in co‐constructed narratives representing experiences of nursing home staff in implementing four different interventions in five Dutch dementia special care units in nursing homes. The data collection period began in August 2021 and ended in April 2022.ResultsNursing home staff implemented self‐designed interventions to foster trusting relationships with family, including initiating informal conversations, sharing residents’ ‘happy’ moments, discussing mutual expectations, and being more aware of families’ emotional burdens. Identified facilitators emphasise the importance of reciprocity, familiarity, transparency, realistic goal setting and empathy. Identified barriers are related to moral uncertainty in balancing competing demands, conflicting social norms, prioritising hands‐on care tasks over family contact and lack of courage to act.ConclusionNursing home staff conclude that their interventions contribute positively to building and maintaining a trusting relationship with families.Implications for the Profession and/or Patient CareSharing the narratives of nursing home staff with peers would support them in implementing interventions to foster trust. Regular Moral Case Deliberations can be used to address moral uncertainty. Collective dialogue among nursing home staff can be useful in establishing new social norms that prioritise family involvement. Conversation skills training can empower nursing home staff.ImpactTrust between nursing home staff and families can be improved by implementing the conducted interventions.Reporting MethodThis report adheres to the standards for reporting qualitative research (COREQ).Patient or Public ContributionNo patient or public contribution.

Funder

ZonMw

Publisher

Wiley

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