title: A Qualitative Inquiry into the Complex Features of Strained Interactions: Analysis and Implications for Health Care Personnel.
abstract: Communication skills are vital for successful relationships between patients and health care professionals. Failure to communicate may lead to a lack of understanding and may result in strained interactions. Our theoretical point of departure was to make use of chaos and complexity theories.
  
  
  
  To examine the features of strained interactions and to discuss their relevance for health care settings.
  
  
  
  A netnography study design was applied. Data were purposefully sampled, and video clips (122 minutes from 30 video clips) from public online venues were used.
  
  
  
  The results are presented in four categories: 1) unpredictability, 2) sensitivity dependence, 3) resistibility, and 4) iteration. They are all features of strained interactions.
  
  
  
  Strained interactions are a complex phenomenon that exists in health care settings. The findings provide health care professionals guidance to understand the complexity and the features of strained interactions.
authors.affiliation: Registered Physiotherapist in the Department of Neurobiology, Care Sciences and Society at the Karolinska Institutet Division of Neurogeriatrics, Center for Alzheimer Research in Huddinge, Sweden. charlotta.thunborg@ki.se.
authors.forename: Charlotta
authors.initials: C
authors.lastname: Thunborg
authors.affiliation: Associate Professor in Nursing of Health and Occupational Studies in the Department of Health and Caring Sciences at the University of Gävle and a Postdoctoral Researcher in the Faculty of Health and Occupational Studies at Gävle University College in Sweden. martin.salzmann@hig.se.
authors.forename: Martin
authors.initials: M
authors.lastname: Salzmann-Erikson
mesh_terms: D001291:Attitude of Health Personnel; D003142:Communication; D005260:Female; D006282:Health Personnel; D006801:Humans; D008297:Male; D011369:Professional-Patient Relations; D036301:Qualitative Research