Exclusion and Confirmation: A Phenomenology of Patients' Experiences with Caregivers

Where there is an imbalance of authority and power, as in the patient‐caregiver relationship, the person who is dependent is vulnerable to the emotional message of the other. This phenomenologic exploration of patients' experience with caregivers examined depersonalizing and confirming interactions. Thirty‐five hospitalized adults were interviewed. Results produced (a) a composite of caregiver behaviors derived from the subjects' descriptions of depersonalizing and confirming experiences, (b) explication of the interactional process from which the experiences of exclusion and confirmation arose, and (c) observations of the subjects' styles of emotional self‐management during interaction with others. The results suggest the need for (a) increased awareness of caregivers for the impact on patients of their voice inflections, facial expression, posture, movement, mood and general comportment, (b) social support networks for both patients and caregivers, and (c) further research on the subjective experience of patients and caregivers including the efficacy of interventions for exclusion and investigation of potential effects of exclusion and confirmation on recovery from illness.