Humanising communication between stroke unit practitioners (SUP) and patients with communication impairment (CI) to support therapeutic relationships.

Abstract

Introduction Research into the lived experience of CI describes discomfort, feeling isolated and ignored when interacting with SUP. Negative feelings are also described by SUP and relatives when attempting to communicate with patients with CI. Study Aim: To explore a humanising relationship-centred approach to support the development of positive relationships between patients, relatives and SUP. This abstract will present data specific to patients with CI. Methods A two-phase action research study with two stroke units over 20 months. Phase 1 explored the experiences of positive relationships with SUP, patients and relatives, and collaborated with SUP to develop and evaluate practices that supported relationships. Phase 2 used the practices developed in Phase 1 to explore translation to a second setting. Methods were participant observation, interviews, story-telling and group discussions. Processes of sense-making and immersion crystallisation were used to analyse data with staff as co-analysts. Results Three themes described the processes in clinical practice to support positive relationships: 1. Intentions by SUP or relatives to reach out towards, to try and connect with those with CI, was most meaningful for patients with CI. Successful transaction of information was less important. 2. Relatives and SUP used vicarious storytelling to share and maintain the uniqueness of the patient with CI. 3. Increasing SUP sensitivity to communicating beyond words – drawing on their emotional or tacit response during encounters. Conclusion This study has shown SUP using a humanising relationship-centred focus and wordless narratives support positive, therapeutic relationships. It offers new insights into practice developments beyond conventional supportive communication strategies.