title: Strategies for working with elderly clients: a qualitative analysis of elderly client/nurse practitioner communication.
abstract: OBJECTIVE
  To describe communication between nurse practitioners (NPs) and elderly clients.
  
  
  METHODS
  A qualitative study using a focus group composed of 6 NPs and in-depth interviews of an additional 6 NPs who provide care to elderly clients in a variety of settings.
  
  
  CONCLUSIONS
  The NPs described a framework of critical thinking, termed hypervigilance, which they enter before and during an interaction with an elderly client. Specific communication strategies were identified that increased the likelihood of compliance with or adherence to treatment regimens for elderly clients.
  
  
  CONCLUSIONS
  Hypervigilance is descriptive of actively working to merge nursing practice with traditional medical primary care practice. This finding raises the issue of the difference in practice between physicians and NPs in regards to communication with clients.
authors.affiliation: University of Portland, Portland, Ore., USA. kaakinen@up.edu
authors.forename: J
authors.initials: J
authors.lastname: Kaakinen
authors.forename: E
authors.initials: E
authors.lastname: Shapiro
authors.forename: B M
authors.initials: BM
authors.lastname: Gayle
mesh_terms: D000328:Adult; D000368:Aged; D003142:Communication; D005260:Female; D017144:Focus Groups; D005851:Geriatric Nursing / Q000379:methods*; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D009722:Nurse Practitioners; D009723:Nurse-Patient Relations; D010349:Patient Compliance