1. Nurses' elicitation of patient error as a practice in training end-stage renal patients in automated home peritoneal dialysis
- Author
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Tine Larsen
- Subjects
Health Knowledge, Attitudes, Practice ,Health (social science) ,conversation analysis ,automated home peritoneal dialysis ,Peritoneal Dialysis/methods ,medicine.medical_treatment ,media_common.quotation_subject ,Denmark ,Hemodialysis, Home/nursing ,chronic disease self-management ,Hemodialysis, Home ,Certification ,Disease ,Nurse's Role ,patient education ,Peritoneal dialysis ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,Patient Education as Topic ,Health care ,Medicine ,Humans ,030212 general & internal medicine ,error-elicitation as instructional practice ,media_common ,060201 languages & linguistics ,business.industry ,Health Policy ,Patient Education as Topic/methods ,Self-Management ,Public Health, Environmental and Occupational Health ,Health technology ,06 humanities and the arts ,Home Care Services ,Conversation analysis ,Kidney Failure, Chronic/therapy ,0602 languages and literature ,nurse-patient interaction ,Kidney Failure, Chronic ,business ,Peritoneal Dialysis ,Seriousness ,Patient education - Abstract
As part of a reorganisation of the delivery of health care in Denmark therapies for chronic medical conditions are moved out of hospitals and disease-specific patient education programmes instituted to train patients to assume responsibility for treating their disease at home, that is, perform tasks and functions traditionally done by healthcare professionals. Drawing on video-recordings (90:25h) from a programme for self-management of end-stage renal disease through automated home peritoneal dialysis, the study employs conversation analysis to examine nurses’ instructional practices for providing patients with the necessary knowledge, skill and competences. Showing training to rely on an error-based monitoring strategy, the study demonstrates that rather than solely waiting for random errors to emerge, nurses on occasion steer patients towards specific errors to bring about particular instructional opportunities. Surprising given the seriousness of the therapy, this elicitation of error is shown to reflect a deliberate instructional choice; nurses promote select errors to impart patients with an understanding of the procedural logic behind the therapy and medical technology. The study argues that training patients for chronic disease self-management and providing them with a proficiency level, normally associated with certified professionals, necessitates pushing patients beyond what is strictly accurate and exposing them to medically delicate events.
- Published
- 2018
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