Communicative constructions of person-centred and non-person-centred caring in nurse-led consultations

• Published in: European journal of oncology nursing : the official journal of European Oncology Nursing Society Vol. 40; pp. 10 - 21
• Main Authors: Siouta, Eleni, Farrell, Carole, Chan, E. Angela, Walshe, Catherine, Molassiotis, Alex
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01.06.2019
• Subjects: Cancer care; Communication; Consultation; Discourse analysis; Medicin och hälsovetenskap; Nurse; Person-centred; Cancer care; Discourse analysis; Person-centred; Consultation; Communication; Nurse
• ISSN: 1462-3889; 1532-2122; 1532-2122
• DOI: 10.1016/j.ejon.2019.02.008

Nursing is theorised to be a component of person-centred care. Communicative constructions of person-centred caring are a topic that needs to be studied in consultations. The study aimed to explore how person-centred caring and non-person- centred caring are verbally constructed in consultations between patients and nurse. This study was qualitative using audio-recorded observations from consultations with advanced nurse practitioners in nurse-led chemotherapy clinics from four hospitals in the UK through purposive sampling. Discourse analysis was used to identify communicative patterns in 45 non-participant observations of nurse consultations. The dominant discourse was a non-person-centred oriented discourse framed by the biomedical model. It was also possible to identify fragments of an alternative discourse—a person-oriented discourse localising health problems within the patient's personal and sociocultural context. The prominent use of a non-person-oriented discourse focusing on the medical/technical aspects of a patient's assessment/evaluation in consultations may make it difficult for patients to raise questions and concerns from their daily lives during consultations. However, fragments of a person-oriented discourse show that it is possible for nurses to allow a person-centred approach to the consultation. The pedagogical implications have to do with raising nurses' awareness of the role of evaluative language in enhancing person-centred communication with patients in clinical interactions. •Nursing is theorised as a component of person-centred care.•We conducted a discourse analysis to identify communicative patterns in nurse consultations at chemotherapy outpatient clinics.•The nurses focus to far too great an extent on biological markers and a non-person-centred approach in communication.•Fragments of a person-oriented discourse show that it is possible to permit a person-centred approach to the consultation.