Trauma patients’ encounters with the team in the emergency department—A qualitative study
Section snippets
What is already known about this topic?
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Patient satisfaction in emergency medicine is related to interpersonal skills/staff attitude, provision of information, and waiting times.
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ED patients’ complaints are related to communication problems, treatment, diagnosis and discharge arrangements.
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Communication skills are a prerequisite for a good relationship between nurses and patients.
What this paper adds
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More varied view of trauma victims’ encounter with the ED team concerning the team's behaviour throughout the care.
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The team members changed their behaviour towards the patients whereupon the care activities advanced and they showed three modes of being with the trauma patient: instrumental, attentive and uncommitted.
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A high-quality encounter in the ED requires team members who have the ability to vary their mode between the instrumental and the attentive modes of being.
Aim
The aim of this study was to explore trauma patients’ conceptions of their encounter with the ED team.
Phenomenographic research tradition
A qualitative study that takes a phenomenographic approach was designed. During the early 1970s, phenomenography was developed in Sweden in the area of pedagogic research. Phenomenography describes a distinction between the first-order perspective, explaining how things are, and the second-order perspective, describing how people perceive the world (Marton, 1981). Phenomenography uses the
Discussion
By relating the discerned aspects and components, the categories emerged as three definite modes of being with the trauma patients. The modes that emerged, instrumental, attentive and uncommitted, vary in content. There are close points of similarity between the instrumental mode and the attentive mode with regard to the outcome for the patients. These two modes of being generated positive feelings, whereas the uncommitted mode gave rise to negative feelings. It was interesting to observe how
Conclusion
One prerequisite for a high-quality encounter in the ED is team members who can change their mode of being with the patient between the instrumental and the attentive mode. Thus, flexibility with regard to the timing of physical and psychosocial care is necessary.
Implications
The quality of care can be improved by developing proper routines at discharge. The nurse must check the patients’ understanding of advice and prescriptions, etc., and make a note about this in the patient record. If such work assignments are not practicable for the responsible nurse, a post for a discharge coordinator could be created.
Recurrent measurement of patient satisfaction could help caregivers become aware of the patient perspective on trauma care. Instruments measuring patient
Acknowledgements
The study received financial support from The Health Research Council in south-east of Sweden (FORSS).
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