title: Work in an intermediate unit: balancing between relational, practical and moral care.
abstract: OBJECTIVE
  To explore the activities carried out and the conditions required to enable satisfactory work in an intermediate unit for patients aged 60 and older.
  
  
  BACKGROUND
  In recent years, several intermediate units have been established to improve the clinical pathway from hospital to home for older patients.
  
  
  METHODS
  Qualitative study.
  
  
  METHODS
  Data were obtained from interviews with eight patients and 16 healthcare providers working in the unit and from observations in six multidisciplinary meetings and six report meetings in the unit. Transcripts of interviews and field notes were analysed using a method for systematic text condensation.
  
  
  RESULTS
  Care performed as a balance between relational, practical and moral aspects seems to be important to render good service to patients and to ensure the providers' job satisfaction. Most patients experienced their stay in the unit as positive. The providers highlighted 'suitable patients', an appropriate physical environment and communicating computer systems as significant factors for performing treatment and for providing nursing and rehabilitation in a caring manner.
  
  
  CONCLUSIONS
  When environmental and organisational conditions exert pressure on the working situation, care as a practical activity seems to be prioritised at the expense of the two other aspects. The findings indicate that unfavourable environmental and organisational conditions impede patients' recovery process and thereby a good clinical pathway.
  
  
  CONCLUSIONS
  To recruit, support and retain a multidisciplinary staff to the best interest of patients, it seems to be important to perform care work as a balance between relational, practical and moral activities.
authors: Health Services Research Centre, Akershus University Hospital, Lørenskog, Norway.
authors: Anne-Kari
authors: AK
authors: Johannessen
authors: Anne
authors: A
authors: Werner
authors: Sissel
authors: S
authors: Steihaug
mesh_terms: D000368:Aged; D006801:Humans; D007380:Intermediate Care Facilities / Q000458:organization & administration*; D008875:Middle Aged; D009014:Morals
keywords: balanced care; intermediate unit; older; qualitative research; structural conditions