title: Sensitive cooperation: a basis for assisted feeding.
abstract: OBJECTIVE
  To describe sensitive cooperation as a basis for assisted feeding through the experiences of people with high cervical spinal cord injury (hcSCI).
  
  
  BACKGROUND
  People who contract a complete hcSCI will require lifelong assistance from others with all activities of daily living. Initially, they prefer getting help from people they already know and are reluctant to cooperate with personal assistants. Assisted feeding is a situation where the nature of the cooperation between the two parties involved is crucial.
  
  
  METHODS
  Qualitative.
  
  
  METHODS
  Sixteen people with hcSCI were interviewed twice within a period of eighteen months. The second interview was combined with an observation. Transcriptions of interviews and notes from the observations were analysed according to Reflective Lifeworld Research as described by Dahlberg and colleagues.
  
  
  RESULTS
  Sensitive cooperation implies genuine acquaintance and sincere concern for the person receiving help. It takes time to develop and it is not possible for the person who needs help to ask for sensitive cooperation. When a meal has to be based on cooperation with another human being it is no longer adjusted by the inner eating pace and rhythm of the person needing assisted feeding, but has the temporality of the helper as a necessary condition. A particular meal draws on the experiences from all previous meals and is a significant forerunner of future meals.
  
  
  CONCLUSIONS
  Sensitive cooperation implies genuine acquaintance and sincere concern for the person receiving help. It takes time to develop and it is not possible for the person who needs help to ask for sensitive cooperation. When a meal has to be based on cooperation with another human being it is no longer adjusted by the inner eating pace and rhythm of the person needing assisted feeding, but has the temporality of the helper as a necessary condition. A particular meal draws on the experiences from all previous meals and is a significant forerunner of future meals.
  
  
  CONCLUSIONS
  Nurses and other health care professionals working within settings where people with hcSCI are admitted right after the injury have a responsibility to be meticulous when cooperating with the patients during assisted feeding. They create the basis for later cooperation with the personal assistants. Professionals working in institutions must assume that people with hcSCI are vulnerable and that assisted feeding should be carefully scheduled and conducted without interruption. Without this foundation, sensitive cooperation might never happen.
authors.affiliation: Department of Nursing Science, Institute of Public Health, University of Aarhus, Aarhus, Denmark. bm@nursingscience.au.dk
authors.forename: Bente
authors.initials: B
authors.lastname: Martinsen
authors.forename: Ingegerd
authors.initials: I
authors.lastname: Harder
authors.forename: Fin
authors.initials: F
authors.lastname: Biering-Sorensen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017028:Caregivers / Q000145:classification / Q000523:psychology / Q000592:standards; D002574:Cervical Vertebrae; D003299:Cooperative Behavior; D006233:Persons with Disabilities / Q000523:psychology; D005247:Feeding Behavior / Q000523:psychology*; D005248:Feeding Methods / Q000523:psychology* / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D013119:Spinal Cord Injuries / Q000451:nursing*; D055815:Young Adult