title: The 'difficult' elderly patient: adjustment or maladjustment?
abstract: In this study, simultaneous triangulation was used to explore the problem of the 'difficult' patient. Ethnoscience was used to describe the perceptions of nurses about the types of difficult patients, ethnographic interviews with difficult patients were used to elicit information about the patients' perspective of the hospitalization experience, and a content analysis of 42 vignettes published in nursing magazines describing difficult patients and the resolution of the problem provided the third perspective. Data from these three sources were integrated to develop an explanatory model for the difficult behaviour. The antecedent is patients' unmet expectations; the patients' behavioural response is an attempt to maintain personal control of the experience of hospitalization; and, frequently, the nurses' response to regain control exacerbates the situation.
authors: Emergency Service, Royal Jubilee Hospital, Victoria, British Columbia, Canada.
authors: J
authors: J
authors: English
authors: J M
authors: JM
authors: Morse
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged / Q000523:psychology*; D000369:Aged, 80 and over; D001519:Behavior; D003142:Communication; D006760:Hospitalization; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008960:Models, Psychological; D009723:Nurse-Patient Relations; D010361:Patients / Q000523:psychology*