A purposeful Yet Nonimposing Approach: How Japanese Home Care Nurses Establish Relationships With Older Clients and Their Families

J Fam Nurs. 2017 Nov;23(4):534-561. doi: 10.1177/1074840717743247.


Relationship development is crucial to nursing practice with families. However, little is known about the process of building relationships with multiple family members in home care settings and in various cultures. The objective of this study was to explore the experiences of home care nurses about how they established relationships with older clients and their families in Japan. Grounded theory was used to guide the research. Twenty-three expert home care nurses participated in semistructured interviews concerning their family nursing practice. The establishment of relationships with clients/family members was based on a purposeful yet nonimposing approach composed of four aspects: keeping a mindful distance from the family, not being a threat to family life, being a comfortable neighbor, and gaining trust as a competent nurse. Through a purposeful nonimposing approach, Japanese home care nurses promoted and nurtured nurse-family relationships and became involved in the life of the family. These findings provide a useful foundation to guide practice with families and grow knowledge about the process of establishing relationships with multiple family members in home settings.

Keywords: Japan; elderly; families; family nursing; home care; nurse–family relationships.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Asian Continental Ancestry Group / psychology*
  • Family / psychology*
  • Female
  • Frail Elderly / psychology*
  • Home Care Services*
  • Humans
  • Japan
  • Male
  • Middle Aged
  • Nurse-Patient Relations*
  • Nurses, Community Health / psychology*
  • Trust*