title: How nursing home residents develop relationships with peers and staff: a grounded theory study.
abstract: Social support and social relationships have been repeatedly identified as essential to nursing home resident quality of life. However, little is known about ways residents develop relationships with peers or staff.
  
  
  OBJECTIVE
  This study was conducted to explore the ways resident develop relationships with peers and staff in nursing homes.
  
  
  METHODS
  Fifteen cognitively intact nursing home residents from two facilities were interviewed for this grounded theory study. Sampling, interviewing, and analysis occurred in a cyclical process with results at each stage of the study informing decisions about data collection and analysis in the next. Unstructured interviews and field observations were conducted. Data were analyzed with open, axial, and selective coding.
  
  
  RESULTS
  Residents developed relationships with peers and staff largely as an unintended consequence of trying to have a life in the nursing home. Having a life was a two-step process. First, life motivations (Being Self and Creating a Positive Atmosphere) influenced resident preferences for daily activities and interaction goals and subsequently their strategies for achieving and establishing both. Second, the strategies residents used for achieving their required daily activities (Passing Time and Getting Needs Met) and interaction goals then influenced the nature of interaction and the subsequent peer or staff response to these interactions. Residents defined relationships as friendly or unfriendly depending on whether peers or staff responded positively or negatively. There was considerable overlap in the ways peer and staff relationships developed and the results highlight the role of peer and staff responsiveness in relationship development.
  
  
  CONCLUSIONS
  The results provide possible explanations for the success of interventions in the literature designed to improve staff responsiveness to residents. The results suggest that adapting these kinds of interventions for use with peers may also be successful. The conceptual model also presents a number of opportunities for developing interventions for residents.
authors.affiliation: Geriatric Research Education & Clinical Center (GRECC), William S. Middleton Veteran Affairs Hospital, Madison, WI, United States; University of Wisconsin - Madison, School of Nursing, United States. Electronic address: tjbeal@wisc.edu.
authors.forename: Tonya
authors.initials: T
authors.lastname: Roberts
authors.affiliation: University of Wisconsin - Madison, School of Nursing, United States.
authors.forename: Barbara
authors.initials: B
authors.lastname: Bowers
mesh_terms: D006801:Humans; D007297:Inpatients; D007398:Interpersonal Relations; D009723:Nurse-Patient Relations; D009735:Nursing Homes; D010379:Peer Group; D011788:Quality of Life
keywords: Aged; Grounded theory; Interpersonal relations; Nursing homes