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‘No problems when you drive?’ nurses balancing conflicting roles as coaches and state agents when they ask sleepy patients about traffic risk
Uppsala University, Department of Sociology, Uppsala, Sweden.
Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.ORCID-id: 0000-0003-1884-5696
Linkoping University Hospital, Department of Clinical Neurophysiology, Linkoping, Sweden.
2017 (Engelska)Ingår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, nr Suppl. 1, s. S85-S85Artikel i tidskrift, Meeting abstract (Refereegranskat) Published
Abstract [en]

Background: Communication in traffic risk assessment is an understudied area in nursing research. Specifically, no research exists of how clinicians formulate their risk assessment questions in actual practice. Because obstructive sleep apnea (OSA) is associated with an increased risk of traffic accidents, traffic safety authorities demand adherent Continuous Positive Airway Pressure (CPAP) use. Nurses have a key role in both treatment initiation and traffic risk assessment. They act as coaches to achieve treatment adherence, but they are also obliged to act as state agents by asking OSA patients about drowsy driving.

Aim: We examined how nurses and OSA patients manage traffic risk assessment questions in the relation-building context of treatment initiation consultations.

Methods: We studied the actual practice of risk assessment questioning in 19 video-recorded initial CPAP treatment consultations with nurses and recently diagnosed OSA patients. To explicate the details of the interactions, we used conversation analysis.

Results: Nurses ask traffic risk questions in a way that assumes that driving is unproblematic if OSA patients have not previously indicated problems in relation to general daytime sleepiness. Accordingly, by taking a stance to daytime sleepiness prior to the risk question, patients influence how nurses phrase questions about traffic risk. In this sense, traffic risk assessment questioning is coconstructed between nurses and patients.

Conclusion: It poses a safety problem when nurses, by accepting OSA patients’ prior stance when asking about traffic risk, orient to relationship building rather than task focus. To clarify the difference between their potentially conflicting roles, nurses can refer to legislation when they raise the issue of risk in treatment initiation consultations. Nurses should also ask risk assessment questions in a problem-oriented communicative environment. However, our study suggests that there is a need to develop legislation to acknowledge different clinicians’responsibilities in traffic risk assessment. Furthermore, guidelines and risk assessment tools should be developed to help clinicians manage their different roles with regard to coaching CPAP treatment and assessing traffic risk.Traffic risk assessment is communicatively sensitive but clinically important, as obstructive sleep apnea is a highly prevalent and increasing problem causing excessive sleepiness.

Ort, förlag, år, upplaga, sidor
Sage Publications, 2017. Vol. 16, nr Suppl. 1, s. S85-S85
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Identifikatorer
URN: urn:nbn:se:hj:diva-35916ISI: 000401775600145OAI: oai:DiVA.org:hj-35916DiVA, id: diva2:1106941
Konferens
EuroHeartCare 2017, 18-20 May 2017, Jönköping, Sweden
Tillgänglig från: 2017-06-08 Skapad: 2017-06-08 Senast uppdaterad: 2017-06-08Bibliografiskt granskad

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