Speaking with care: a qualitative study on communication styles in everyday nursing conversations with older persons

TL;DR

This study explores how nursing assistants communicate with older people during home visits, identifying styles that affect person-centered care.

Contribution

The study identifies four distinct communication styles used by nursing assistants in home care settings, highlighting their impact on person-centered care.

Findings

Four communication styles were identified: doing more, doing with, doing for, and doing tasks.

Communication styles ranged from relational and collaborative to task-oriented interactions.

The emotional demands of home care work require more recognition and support.

Abstract

Enhancing communication in everyday nursing conversations is essential for promoting person-centred care and preserving the dignity of older persons. This qualitative study was performed to gain an in-depth understanding of the nursing assistants’ person-centred communication skills and their communication style. The aim was to explore the communication styles of nursing assistants during home care visits to older persons.

This deductive qualitative study was based on observational data gathered with audio recordings of naturally occurring communication between nursing assistants and older persons during home care visits. Data collection was part of an educational intervention study for in-home nursing assistants and took place from March to December 2022. Data were analysed with a method for deductive qualitative content analysis. The deductive analysis was guided by the framework developed by Bottorff and Morse, and the communication styles identified in the current study, doing more, doing with, doing for, and doing tasks.

A total of 70 audio recording home care visits, including 39 nursing assistants and 37 older persons were included. Based on conversations during these visits, four distinct communication styles employed by NAs in their everyday interactions with older persons were described in depth with focus on communication patterns observed. The different styles included nuances of communication ranging from being more relational and collaborative to more task-oriented interactions. A pattern of doing too much was also observed.

The communication styles used influenced the degree of person-centredness. Nurse assistants’ communication styles can vary during conversations and appear to reflect individual traits. The emotional demands of home care work may require more recognition and support from policymakers and managers. Strengthening person-centred communication and care for older persons requires both training and organizational support.