Pedagogical encounters between nurses and patients in a medical ward—a field study

F Friberg, E Pilhammar Andersson, J Bengtsson
International Journal of Nursing Studies 2007, 44 (4): 534-44

BACKGROUND: Patient teaching is regarded as an important aspect of nursing care as well as an essential part of the nursing profession. In nursing practice, a distinction can be made between formal (planned) and informal (spontaneous) patient teaching. The major part of patient teaching research is within the area of formal teaching. In spite of the fact that spontaneous teaching occurs in everyday nursing practice, there is a lack of knowledge in this area.

OBJECTIVES: The aim was to illuminate pedagogical dimensions in nursing situations and informal teaching.

DESIGN: The study is a fieldwork study within the frames of a life-world phenomenological tradition.

PARTICIPANTS AND SETTING: Fifteen registered nurses in a general medical ward of a university hospital in Sweden were followed in their daily work with patients. Twelve patients suffering from various chronic diseases were interviewed.

METHODS: The observations comprised a total of 173 h on 34 separate occasions. Informal dialogues with nurses were carried through. Further, formal interviews were conducted with 12 of the observed patients. The data were analysed by means of a life-world phenomenological approach.

RESULTS: Two different pedagogical encounters are presented: "Players in different field pedagogical encounters", in which there is a breakdown in the pedagogical dialogue, and "Players in same field pedagogical encounters", in which the pedagogical dialogue develops. Patients' experiences of seeking and acquiring knowledge within these two types of encounter are characterised as "worry" versus "preparedness". Patients' dignity is either threatened or supported, depending on the type of encounter.

CONCLUSIONS: Health care organisations have to create a pedagogical climate where "Same field pedagogical encounters" can be created. The nurse has to view the patient as a learning person in order to help the patient to achieve "preparedness". "Preparedness" is described as a cognitive-emotive-existential state and emphasised as an important goal of patient teaching.

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