The purpose of this study was to develop a substantive theory or at least a set of theoretical propositions explaining the process of nurse-patient interaction in the presence of technology. This study was undertaken in Perth, Western Australia. The grounded theory method was chosen to undertake this research.The study's informants consisted of nurses. Theoretical sampling led to the inclusion of patients and patients' relatives. Purposive and theoretical sampling were used to choose the informants. Data were obtained using field observations and formal and informal interviews with nurses and post-discharge patients. Data analysis was conducted using the constant comparative method (Glaser and Strauss, 1967), writing memos and drawing a schema. The Ethnograph software package (Seidel, 1988) was used to organize and manage the data.The findings of the study indicated that nurses were stymied in their person-centered interactions with patients in the presence of technology. Nurses used the process of navigating the course of interaction to deal with this problem. The process of navigating the course of interaction consisted of three phases. These were the phases of embarking, steering and veering and disembarking. The action/interaction of the process occurred during the steering and veering phase and four specific strategies of interaction became evident in this research. These strategies of interaction were steadying, demurring, coasting and maximizing. The strategies of interaction used by nurses did not center on one type. There was rather a movement between strategies during and between interactions with patients in the presence of technology. This movement was termed oscillating connections. Conditions that modified the core process of navigating the course of interaction were also identified. The findings of the study provide an understanding of the problem ++ / encountered by nurses in their interaction with patients in the presence of technology and the process used by the nurses to deal with this problem.

This research evaluates whether nurses working in general hospital settings utilise the counselling skills they are taught during their initial nurse training when they practice as qualified nurses. A narrative enquiry methodology was used to gather stories about everyday nurse patient interactions from eight nurses working in a variety of general hospital settings. The stories were tape recorded and transcribed before being subjected to qualitative descriptive analysis, a variant of content analysis, which yielded a number of themes. The analytical process incorporated the use of a hermeneutic circle to reinforce the reliability of the analysis and three types of skill were identified within the narratives. The narratives suggest that nurses do use counselling skills regularly when interacting with patients and carers, in particular the skills of information giving and empathy. These skills are inter-related in nursing practice and their usage stems from the personal experiences of the nurses involved rather than any training received prior to their qualifying as registered practitioners. While the sample size is relatively small the findings might suggest there could be some worth in further research to determine the relational skills possessed by those wishing to enter nurse training. This type of investigation has a resonance with current calls for reform of nurse education and might allow for training in the area of interpersonal skills to become more personalised. Ethical permissions were obtained from NRES, the Ethics committee of the United Lincolnshire Hospitals Trust and the University of Manchester.

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.

Bakgrund: Anestesisjuksköterskan skall kunna skapa en god individuell relation till sin patient i en miljö som är både högteknologisk och ofta långt utanför patientens normala omgivningar. I den perioperativa vården är mötet med patienten dessutom ofta kort och intensivt med många moment som pågår samtidigt, detta ställer därför höga krav på anestesisjuksköterskans kompetens i omvårdnadsarbetet. Syfte: att belysa vad som kännetecknar en god interaktion mellan patient och anestesisjuksköterska pre- och perioperativt. Metod: En systematisk litteraturstudie med kvalitativ ansats där resultaten analyserats med hjälp av manifest och latent innehållsanalys. Totalt analyserades 11 artiklar. Resultat: Analysen resulterade i temat se-lyssna-känn vilket byggde på de två kategorierna; mellanmänskliga faktorer och yttre faktorer. Dessa byggde i sin tur på åtta underkategorier; kommunikation, inom synhåll och räckhåll, förberedelse och personkännedom, delaktighet, ansvar, förtroende, ha tid och vårda i teknisk miljö. Slutsats: Anestesisjuksköterskan måste arbeta utifrån ett personcentrerat arbetssätt där vården anpassas efter varje unik patient. Detta görs genom att se sin patient och dennes behov, lyssna till dess önskemål och lära känna sin patients personlighet och önskemål. Det krävs dessutom att anestesisjuksköterskan kan se bortom den tekniska miljön hon befinner sig i och dela sin uppmärksamhet mellan de medicinska arbetsuppgifter hon har och interaktionen som patienten behöver för att känna sig bekräftad och trygg under den perioperativa vårdtiden. / Background: A nurse anesthetist has to be able to create a good individual relationship with their patient, in an environment that is both highly technological and often far beyond what the patient is used to. In the perioperative care, the meeting with the patient and the nurse is often short and intense, with a lot of things happening at once. This place high demands on the nurse´s competence in anesthetic caring. Purpose: To illustrate what characterizes a good interaction between patient and nurse anesthetist pre- and intraoperatively. Method: A systematic literature review with qualitative approach where the results were analyzed using manifest and latent content analysis. A total of 11 articles were analyzed. Results: The analysis resulted in the theme see-listen-feel, that was built upon the two categories interpersonal factors, inner factors and outer factors. These, in turn built on eight subcategories; communication, within sight and reach, preparation and personal knowledge, participation, responsibility, trust, having time and caring in a technological environment. Conclusion: The nurse anesthetist must work from a person-centered approach where the care is adapted to each unique patient. This is done by seeing the patient´s needs, listening to their wishes and getting to know their patient´s personality and desires. It also requires the nurse anesthetist to be able to see beyond the technological environment she is working in and share her attention between the medical tasks that has to be done and the interaction the patient needs to feel safe and confirmed during the perioperative period.