Care-planning meetings with stroke survivors: nurses as moderators of the communication

Stroke survivors often have communicative disabilities. They should, however, be involved when decisions are made about their care treatment.

To explore and describe how nurses act as moderators of the communication in cooperative care-planning meetings and what kind of participant status the patients achieve in this type of multi-party talk.

Thirteen care-planning meetings were audio-recorded and transcribed. Nurses, social workers and stroke survivors were the main participants for the meetings. A coding scheme was created and three main categories were used for the analysis: pure utterance types, expert comments (EC) and asymmetries.

The nurses never invited the patients to tell their own versions without possible influence from them. Mostly the nurses gave ECs. The nurses acted as the patients' advocates by talking for or about them. They rarely supported the patients' utterances.

There is an urgent need for nurses to learn how to involve the patients in the communicative process about their treatment. Assessment of the patients' communicative abilities before the care-planning meetings as well as knowledge about how to invite them can improve the patients' participant status.