Person‐centred communication research: systematic observation of real life practice.

Key learning: Service user–healthcare provider communication is a core element of person‐centred care. Therefore, service user expressions of worries are important moments in the communication between them and the health provider and can be captured by the VR‐CoDES system in a valid and reliable way. Engaging with emotional aspects introduced by the service user can increase person‐centred interactions by strengthening their relationship with the healthcare provider, gaining insight into what is important for the person and increasing a sympathetic presence from the healthcare provider. Investigating service user concerns may provide knowledge on how communication facilitates or hinders person‐centred care

Older persons’ worries expressed during home care visits : Exploring the content of cues and concerns identified by the Verona coding definitions of emotional sequences

Objective Little is known about how older persons in home care express their concerns. Emotional cues and concerns can be identified by the Verona coding definitions of emotional sequences (VR-CoDES), but the method gives no insight into what causes the distress and the emotions involved. The aims of this study are to explore (1) older persons’ worries and (2) the content of these expressions. Methods An observational exploratory two-step approach was used to investigate audiotaped recordings from 38 Norwegian home care visits with older persons and nurse assistants. First, 206 cues and concerns were identified using VR-CoDES. Second, the content and context of these expressions were analysed inductively. Results Four main categories emerged: worries about relationships with others, worries about health care-related issues, worries about aging and bodily impairment, and life narratives and value issues, with several subcategories showing the causes of worry and emotions involved. Conclusion The two-step approach provides an in-depth knowledge of older persons’ worries, causes of worries, and their related emotions. Practice implications The subcategories described in a language close to the experience can be useful in practice development and communication training for students and health care providers

A cross-sectional study on person-centred communication in the care of older people : the COMHOME study protocol

Introduction: This paper presents an international cross-sectional study on person-centred communication with older people receiving healthcare (COMHOME). Person-centred care relies on effective communication, but few studies have explored this with a specific focus on older people. The main aim of the COMHOME study is to generate knowledge on person-centred communication with older people (>65 years) in home healthcare services, radiographic and optometric practice. Methods and analysis: This study will explore the communication between care providers and older persons in home care services. Home healthcare visits will be audiorecorded (n=500) in Norway, the Netherlands and Sweden. Analyses will be performed with the Verona Coding Definitions for Emotional Sequences (VR-CoDES), the Roter Interaction Analysis System (RIAS) and qualitative methods. The content of the communication, communicative challenging situations as well as empathy, power distance, decision-making, preservation of dignity and respect will be explored. In Norway, an additional 100 encounters, 50 in optometric practice (video recorded) and 50 in radiographic practice (audiorecorded), will be analysed. Furthermore, healthcare providers' self-reported communication skills, empathy, mindfulness and emotional intelligence in relation to observed person-centred communication skills will be assessed using well-established standardised instruments. Ethics and dissemination: Depending on national legislation, approval of either the central ethical committees (eg, nation or university), the national data protection officials or the local ethical committees (eg, units of home healthcare) was obtained. Study findings will be disseminated widely through peer-reviewed publications and conference presentations. The research findings will add knowledge to improve services provided to this vulnerable group of patients. Additionally, the findings will underpin a training programme for healthcare students and care providers focusing on communication with older people.

Emotional communication in home care: a comparison between Norway and Sweden.

Objective Given the free movement of workers across countries, knowledge regarding communicationdifferences between countries is imperative. In this study, we explored and compared the supportiveresponses of nursing staff to older persons’ emotions in home care in Norway and Sweden. Methods The study had an observational, cross-sectional, comparative design, which included 383audio-recorded home-care visits. Communication was coded using Verona Coding Definitions ofEmotional Sequences. Worries and responses were categorised with regard to reference, communicativefunction and level of person-centredness. Standard statistical tests were used to analyse the data. Results The Swedish nursing staff provided space for further disclosure of worry more frequently thanthe Norwegian nursing staff (75.0 % versus 60.2 %, χ2 = 20.758, p < 0.01). In all, 65 % of the responses weresupportive. Multiple logistic regression analyses showed that highly person-centred responses wereindependently associated with worries phrasing an emotion, OR (95 % CI) 3.282 (1.524–7.067). Conclusion The level of person-centredness was associated with the way in which older personsexpressed their distress. The Swedish nursing staff provided opportunities for further disclosure ofworries more frequently than the Norwegian nursing staff. Practice implications Findings of intercultural differences should be incorporated into the training ofnursing staff