Patients' perceptions of transgressive behaviour in care relationships with nurses: a qualitative study.
OBJECTIVE
To gain insight in the onset and meaning of transgressive behaviour in care relationships with nurses, from the perspective of patients.


BACKGROUND
Aggression and transgressive behaviour in health care have been a focus of research over the last decades. Most studies describe staff experiences on patient aggression. Patient' perspectives on aggression and transgressive behaviour in interactions with nurses are rarely sought.


METHODS
Qualitative interview study.


METHODS
Twenty patients were purposefully sampled from six wards of two general hospitals. Semi-structured interviews were carried out in 2011. Data were analysed using the constant comparative method influenced by the grounded theory approach.


RESULTS
On elaborating on what constitutes experiences of transgressive behaviour, patients employ a framework of suppositions towards hospital care and nurse-patient relationships. This framework leads to implicit ideas on how competent professional caregivers will be and on how relationships with nurses will be characterized as normal human interactions. When these anticipated ideas are not met, patients feel obliged to address this discrepancy by adjusting their expectations or behaviour. Patients become more vigilant with regard to care given by nurses; search for own solutions; make excuses for nurses or reprioritize their expectations. Because of this adjustment, perceptions of transgressive behaviour are reinforced, mitigated or put into perspective.


CONCLUSIONS
Patients adjust their behaviour based on what they experience in care relationships with nurses or the hospital care. It is crucial that patients feel free to discuss their assumptions or untoward needs and nurses learn to understand and reflect on those experiences.
Department of Public Health, Faculty of Medicine and Health Sciences, University Centre for Nursing & Midwifery, Ghent University, Belgium.|VIVES University College - Department Health Care, Roeselare, Belgium.
Tina
T
Vandecasteele
VIVES University College - Department Health Care, Roeselare, Belgium.
Bart
B
Debyser
Department of Public Health, Faculty of Medicine and Health Sciences, University Centre for Nursing & Midwifery, Ghent University, Belgium.|University Hospital Ghent, Belgium.
Ann
A
Van Hecke
VIVES University College - Department Health Care, Roeselare, Belgium.
Tineke
T
De Backer
Department of Public Health, Faculty of Medicine and Health Sciences, University Centre for Nursing & Midwifery, Ghent University, Belgium.
Dimitri
D
Beeckman
Department of Public Health, Faculty of Medicine and Health Sciences, University Centre for Nursing & Midwifery, Ghent University, Belgium.|VIVES University College - Department Health Care, Roeselare, Belgium.
Sofie
S
Verhaeghe
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000374:Aggression / Q000523:psychology*; D001530:Belgium; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role / Q000523:psychology*; D009723:Nurse-Patient Relations; D009741:Nursing Staff, Hospital / Q000523:psychology*; D010361:Patients / Q000523:psychology*; D036301:Qualitative Research; D012424:Rural Population; D014505:Urban Population
aggression; general hospital; nurse-patient relationship; nurses; nursing; patient; patients' experiences; qualitative research; transgressive behaviour; violence