Compliance re-examined : a study of nurses' perceptions of and responses to in-hospital maintenance hemodialysis patients whom nurses perceived to be noncompliant

Denise Marie Gaudet
The respective rights and responsibilities of the nurse and the patient may be a source of conflict as nurses and patients do not always agree on behaviors and attitudes necessary for adjustment to life on hemodialysis. The investigator had observed that hemodialysis nurses' responses to patients who deviate from the recommended medical regime varied significantly. The question arose as to why there are differences in nurses' responses to perceived noncompliant patient behaviors. Only one study
more » ... was found which examined emotional reactions and behaviors of nurses as part of a multidisciplinary hemodialysis team, toward their patients (Kaplan De-Nour & Czackes, 1968). The purpose of this study was to investigate specifically hemodialysis nurses' perceptions of noncompliant in-hospital maintenance hemodialysis patient behaviors and their responses to such patient behaviors. A phenomenological research method was used to explore nurses' lived experience of caring for hemodialysis patients. Eight nurses were selected as participants for the study from hemodialysis units in two hospitals from the Lower Vancouver Mainland area. These nurses participated in one to three audiotaped interviews using open-ended questions. Data collection and analysis occurred concurrently following Colaizzi's (1978) method of analysis. Field notes and verbatim transcriptions of the audiotapes interviews were used as data for analysis. The process of labelling and judging compliant or noncompliant patients was unique to each nurse and was linked with the degree of congruence between nurses' and patients' expectations and the nurses' sense of empowerment or powerlessness. There were two sources of empowerment or powerlessness: nurse-patient relationships and the workplace. The key factor which seemed to determine the nature of nurse-patient relationships the notion of reciprocity was based on shared responsibility with patients and mutual respect. In terms of the work environment, mutual concern and support from peers and colleagues co [...]
doi:10.14288/1.0086224 fatcat:rd3fdquxsnhstcgvq3i2ceg7za