title: Collaborative relationship in preventive home visits to older people.
abstract: OBJECTIVE
  To describe what characterizes preventive home visits with collaborative relationships among non-disabled home-dwelling older people in Japan.
  
  
  BACKGROUND
  Preventive home visits have the potential to result in improved health outcomes among older people. Collaboration, mutual understanding and trust between visitor and the visited person seem to work as a vehicle, but little is known about which part of the encounters contributes to a collaborative relationship.
  
  
  METHODS
  We performed a retrospective qualitative analysis of visiting records written by preventive home visitors immediately after the visits were made. A collaborative relationship was predefined as a favourable change in behaviour seen in the visited person during the study period. Visitor characteristics were analysed from 248 records where 37 cases of collaborative relationships were documented.
  
  
  RESULTS
  The three most important elements associated with a collaborative relationship were (i) visitor communication skills i.e. mastering 'enhancing motivation' and 'having patience and coping with frustrations' in difficult and problematic situations, (ii) professionalism, which includes 'professional instruction and guidance' based on documented knowledge in health and social domains combined with an overall 'caring approach' and (iii) practical actions which imply an 'immediate concrete response to identified needs or problems' and 'individually tailored advice' to suit the older person's daily life.
  
  
  CONCLUSIONS
  Preventive home visitor communication skills and professionalism, and practical actions after the visits characterized cases, where favourable changes in behaviour were obtained in non-disabled home-dwelling older people in Japan.
  
  
  CONCLUSIONS
  Education should be emphasized, because preventive home visitor competence may be the most important element of proactive assessment schemes to obtain beneficial outcomes.
authors.affiliation: Department of Social Medicine,Institute of Public Health, University of Copenhagen, Copenhagen, Denmark. yuya@sund.ku.dk
authors.forename: Yukari
authors.initials: Y
authors.lastname: Yamada
authors.forename: Mikkel
authors.initials: M
authors.lastname: Vass
authors.forename: Lotte
authors.initials: L
authors.lastname: Hvas
authors.forename: Ayumi
authors.initials: A
authors.lastname: Igarashi
authors.forename: Carsten
authors.initials: C
authors.lastname: Hendriksen
authors.forename: Kirsten
authors.initials: K
authors.lastname: Avlund
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000451:nursing* / Q000517:prevention & control*; D003142:Communication; D003152:Community Health Nursing / Q000379:methods*; D003299:Cooperative Behavior; D005260:Female; D005851:Geriatric Nursing / Q000379:methods*; D016852:Housing for the Elderly; D006801:Humans; D007564:Japan; D008297:Male; D009723:Nurse-Patient Relations; D011364:Professional Practice; D036301:Qualitative Research; D012189:Retrospective Studies