Researching the informal theories of nurses working with older people using a holistic, bio‐psychosocial approach

This paper presents a research study that demonstrates the inadequacy of the traditional biomedical approach to caring for older people and shows the benefits of using a more holistic, bio‐psychosocial approach. An ethnographic inductive approach was taken. Non‐participant observation was performed on complete episodes of nursing practice, followed by semi‐structured interviews to explore and ratify theories in use. Phase one of the data analysis used qualitative inductive analysis to generate main categories and themes. Phase two was a process of factor isolation, which identified factors of practice theories in use. The themes identified were: nursing therapeutics; preventative nursing; communication; nurse‐patient relationships; collaborative nursing; nursing assessment; decision making; and management of patient care. Further analysis identified that important theoretical factors included: encouraging; responding; comforting; explaining; maintaining ability; judgement in action; and collaborating. This knowledge is embedded in the practice theories of practitioners but it is only by exploring and critiquing these that we can hope to understand the complex nature of nursing practice as it relates to the care of older people.