Background: The patient is observed to acquire a passive role and the nurse an expert role with a maternalistic attitude. This relationship among others determines the capacity for autonomy in the decision making of patients. Objectives: The aim of this study is to analyse the nurse-patient relationship and explore their implications for clinical practice, the impact on quality of care, and the decision-making capacity of patients. Design: A phenomenological qualitative study was conducted. Settings and participants: Thirteen in-depth interviews with nurses and 61,484 nursing records from internal medicine and specialties departments in a general hospital from 2015–2016. Methods: A discourse analysis and triangulation for these sources were conducted. Results: The category elaborated from nursing records was defined according to the following codes: Good Patient, Bad patient, and Social Problem. Analysis of the interviews resulted in a category defined as Patient as a passive object. Discussion: A good nurse-patient relationship reduces the days of hospital stay and improves the quality and satisfaction of both. However, in contrast, the good relationship is conditioned by the patient’s submissive role. Conclusion: An equal distribution of power allows decisions about health and disease processes to be acquired by patients, autonomously, with the advice of professionals. The nurse-patient relationship should not pursue the change in values and customs of the patient, but position the professional as a witness of the experience of the health and illness process in the patient and family.

It is currently acknowledged that older people prefer to live in their own home, even if they are lonely or disabled in some way. The factors that condition aging among older people members of the population living alone include the following: the existence or absence of a social network, gender, the home or place where they live, their capacity to function, and welfare and health resources. The main goal of this study was to explore the perceptions of older peoples over 75 years old about adaptation strategies and the social, gender, physical autonomy, and socio-health resource factors that determine their permanence at home. The authors used a qualitative methodology, within a critical social framework, based on the theories of Pierre Bourdieu. When the interviewees’ discourse was analyzed, four main categories were evident: (a) “A desire to stay at home”, (b) “Changes and every-day aspects of domestic life”, (c) “Reliance on social and family assistance”, and (d) “The use of social services and resources”. In synthesis, the participants questioned the benefits of the type of home life offered by members of the family. They believed that, in some cases, this option did not overcome the problem of loneliness or the need to hire assistance. The findings of the study revealed that one needs to dispel the notion of geriatric care as a form of charity, and to distinguish between the activities of caring, providing support, and offering companionship to someone. It is important to identify products designed for older people who might live for a long time.

Interprofessional relationships may impact the decision making of patients in a clinical setting. The objective of this study was to analyse the decision-making capabilities of patients from nurses’ perspectives of interprofessional relationships using Foucauldian ethics. This qualitative study was based on poststructuralist Foucault references with in-depth interviews of nurses working in internal medicine and specialties in a general hospital. The patients constantly appeared in the definition of teamwork, but also as a passive element used by every professional to communicate with others. Nurses continue modelling a type of patient passivity, or what Foucault called passive subjectivity in relation to oneself, because the patient is guided and directed to take charge of a truth provided by professionals. Nurses must break the rigid design of sections or professional skills, and adopt a model of teamwork that meets the needs of the patient and increases their decision-making power. The quality of care will increase to the extent that professionals establish a relationship of equality with the patient, allowing the patient to make real decisions about their care. An egalitarian model of teamwork is beneficial to the patient, abandoning the idea of a team where the patient and family are constantly excluded from decisions about their care.

Los cambios en el envejecimiento hacen una llamada a trasformar los cuidados dirigidos a las personas mayores que viven solas. Objetivo: Conocer la percepción de la familia sobre el cuidado a los mayores que viven solos. Metodología: Estudio cualitativo mediante análisis de discurso a partir del referencial crítico social y los conceptos de la teoría de Bourdieu. Se realizaron 4 grupos de discusión agrupando a los participantes por género y nivel de instrucción. Resultados: los participantes consideran que la red sociofamiliar puede actuar sobre la discapacidad. Preocupa la manera en la que la persona mayor cubre sus necesidades. Destacan como fundamental el apoyo en la realización de los cuidados. Comparten la idea de que las mujeres mayores se adaptan mejor que los hombres a vivir en soledad. Las mujeres cuidadoras tienden a intervenir precozmente ante los problemas. Los hombres esperan y si pueden delegan. Conclusión: la familia cuestiona los beneficios de la convivencia. La orientación profesional en el cuidado es escasa. Los servicios sociales deben mejorar su accesibilidad