Encounters in primary healthcare from the perspectives of people with long-term illness, their close relatives and district nurses

People with a long-term illness and their close relatives regard encounters as the foundation of their relationshipwith the district nurses within the primary healthcare setting. The overall aim of this doctoral thesis was todescribe and elucidate the experiences of encounters for people with long-term illness, their close relatives anddistrict nurses within a primary healthcare setting. From the overall aim, specific aims were formulated asfollows: to describe district nurses’ views on quality of healthcare encounters in primary healthcare (I), toelucidate meanings of encounters for patients with long-term illness within the primary healthcare setting (II), toelucidate meanings of encounters for close relatives of people with a long-term illness within a primaryhealthcare setting (III) and to describe the experiences of dignity encounters from the perspective of people withlong-term illness and their close relatives within a primary healthcare setting (IV). Data were collected fromfocus group interviews (I), narrative interviews (II, III), and semi-structured interviews (IV). The interviewswere analysed using thematic content analysis (I, IV) and phenomenological hermeneutics (II, III). The findingsshow that encounters are given great importance among people who have a long-term illness, their closerelatives, and district nurses in the setting of primary healthcare. The manner in which the encounter wasexperienced in the relationship with healthcare personnel was, at many times, crucial for the whole careexperience to be viewed as beneficial or not. The findings show that district nurses described that the encountersformed the basis of their work as an important aspect and that many times they were difficult because of stressand lack of time. The first meeting with the patient was important since it was unique and unrepeatable. Districtnurses considered themselves as being the patients ‘advocate’ who helped them and protected their interests.They indicated the importance of confirming the patient as a person deserving of respect, and if a meeting turnedout poorly, it was their duty to give the patient an apology (I). The findings also show that patients with a longtermillness experienced that good encounters had health-promoting effects on their health and recovery. Patientsfelt well when they were welcomed as a person with respect, interest, and attention by the healthcare personnel.They wanted to participate in their own care by receiving regular information and follow-up dialogues abouttheir status with the healthcare personnel. Continuity with the healthcare personnel laid the foundation for apersonal and a trustful relationship (II). Close relatives of people with a long-term illness wanted to beencountered as part of the ill person’s family as they accompanied him or her to the healthcare centre. To beconfirmed as a family was important, as it gave meaning to their lives and strengthened their well-being. A goodencounter was characterised by aspects of being involved in the care of the ill person and being respected as avaluable person (III). The findings show that people with a long-term illness and their close relatives experienceddignity in the encounter when they had access to care. They experienced that it was important to be encounteredwith dignity, as it meant receiving help with their needs from the healthcare personnel. To be confirmed by beingseen and listened to was important. When the couples experienced dignity in the encounter, they felt satisfiedwith the care they received. To be encountered with dignity made they feel valuable; this facilitated their healthand well-being, and it contributed to a good impression of the healthcare personnel within primary healthcare(IV). In conclusion, the findings of this thesis show that healthcare encounters are more than just meetings; theyalso mean being confirmed as a human being by being treated with respect, engagement and dignity. Healthcarepersonnel should promote encounters for people with long-term illness and their close relatives in order tosupport their feelings of being regarded as persons and to feel that they are welcomed to primary healthcare withtheir needs, which can empower their health and well-being