Abstract
Objectives: This paper provides a theoretical account of nurses' collaborations with patients' with chronic obstructive pulmonary disease during non-invasive ventilation treatment at the hospital.
Background: Despite strong evidence for the effect of non-invasive ventilation treatment, success remains a huge challenge. Nurse and patient collaboration may be vital for treatment tolerance and success. A better understanding of how nurses and patients collaborate during non-invasive ventilation may therefore contribute to improvement.
Design: A constant comparative classical grounded theory.
Method: The data comprised sessions of qualitative participant observation during the treatment of 21 patients with non-invasive ventilation, which included unstructured conversations with the nurses and semi-structured interviews with 11 patients after treatment completion. Data were collected at three Danish hospitals.
Results: Definition of the situation emerged as the core category in nurse-patient collaborations during non-invasive ventilation treatment. The main concern was resolved by activating of one or more of the following four complex adjusted modalities: (1) joint modality; (2) patient-initiated modality; (3) nurse-initiated modality; or (4) split modality. Modalities 1–3 were characterised by mutual definitions of the situation, whereas the fourth was characterised by divergent definitions of the situation.
Conclusions: This study offers a robust account of nurses' and patients' concerns about their definition of the situation and how they activate different complex adaptive modalities. We offer a theoretical basis for developing complex interventions.
- © 2012 ERS
