Constitution of paired nursing practice for patients with communication difficulties: A phenomenological study with participant observation

Objective: Nursing care delivery models have diversified and evolved over time; however, there is no single superior model. This study aimed to clarify the constitution and meanings of paired nursing, a method uniquely developed in Japan, by analyzing nursing practice for patients with communication difficulties in neurology and neurosurgery wards. Methods: A qualitative research design using phenomenological research was employed. Data collection was conducted through participant observation and field note-taking in situations such as meeting and bedside care with two pairs as participants. This study adheres to the Standards for Reporting Qualitative Research. Results: Two themes were derived as components of nursing practice for each pair: 1) the care direction revealed by information sharing and 2) the interaction between patients and nurse pairs through physical care for patients. Within the theme of care direction revealed by information sharing, two subthemes emerged: sharing of future care plans and the manifestation of "difficulties." Within the theme of the interaction between patients and nurse pairs through physical care for patients, two additional subthemes were identified: sharing of past and future possibilities and paired nurses prompting each other's actions toward the patient. Conclusions: Based on situational observations and analysis, care provided by two nurses to the same patient facilitates information exchange and mutual empathy toward the patient and the partner nurse. This study improves the understanding of collaborative nursing practices and offers insights that may inform team-based care models in contexts beyond Japan.