Determining Evidence for Family Caregiver Communication: Associating Communication Behaviors With Breakdown and Repair.
Determining Evidence for Family Caregiver Communication: Associating Communication Behaviors With Breakdown and Repair.
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确定家庭护理人员沟通的证据：将沟通行为与崩溃和修复联系起来。
DOI：
10.1093/geront/gnac193
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Hu,Jinxiang
中科院分区：
文献类型：
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作者：
Williams,KristineN;Coleman,CarissaK;Hu,Jinxiang
背景和目的沟通是痴呆症护理的基础。的麻烦源修复（TSR）框架可以确定的战略，促进或阻碍通信中的二元interactions.Research设计和MethodsA二次分析的视频（N= 221）从临床试验的家庭照顾者远程医疗干预进行了分析，使用顺序行为编码的通信行为和故障为53照顾者和痴呆症患者的二人组。使用惩罚回归进行特征选择，然后使用贝叶斯混合效应模型分析来自3，642个30 s观察的编码数据，以确定与沟通故障和修复相关的沟通策略。（编码为0）与照顾者改变话题有关（中位数= −11.45，95%可信区间[CrI; −24.34，−4.37]），忽略（中位数= −11.49，95% CrI [−24.49，−4.72]），发出命令（中位数=-10.74，95%CrI [-24.22，-3.38]），并接管任务（中位数=-4.06，95%CrI [-7.28，-1.77]）。故障的成功修复与语言理解有关（中位数= 0.46，95% CrI [0.09，0.86]），标签问题，（中位数= 2.4，95% CrI [0.33，5.35]）和沉默（中位数= 0.78，95% CrI [0.42，1.15]），与忽略和改变主题呈负相关（中位数分别为-3.63，95%CrI [-4.81，-2.57]和-2.51 [-3.78，-1.33]）。讨论和含义TSR在确定具体的沟通策略以避免（改变话题、忽略、命令和接管任务）并用于修复故障（口头理解、标记问题和沉默）。未来的研究需要测试这些策略，并探索痴呆症的阶段，诊断和二分体特征在其他样本的潜在影响。行为编码提供了沟通最佳实践的证据，作为家庭照顾者沟通培训的基础。
Background and ObjectivesCommunication is fundamental for dementia care. The trouble source repair (TSR) framework can identify strategies that facilitate or impede communication in dyadic interactions.Research Design and MethodsA secondary analysis of videos (N= 221) from a clinical trial of a family caregiver telehealth intervention was analyzed using sequential behavioral coding of communication behaviors and breakdowns for 53 caregiver and person with dementia dyads. Coded data from 3,642 30-s observations were analyzed using penalized regression for feature selection followed by Bayesian mixed-effects modeling to identify communication strategies associated with communication breakdown and repair.ResultsBreakdown (coded as 0) was associated with caregivers changing topic (median = −11.45, 95% credibility interval [CrI; −24.34, −4.37]), ignoring (median = −11.49, 95% CrI [−24.49, −4.72]), giving commands (median = −10.74, 95% CrI [−24.22, −3.38]), and taking over the task (median = −4.06, 95% CrI [−7.28, −1.77]). Successful repair of breakdown was associated with verbalizing understanding (median = 0.46, 95% CrI [0.09, 0.86]), tag questions, (median = 2.4, 95% CrI [0.33, 5.35]), and silence (median = 0.78, 95% CrI [0.42, 1.15]) and negatively associated with ignoring and changing topic (median = −3.63, 95% CrI [−4.81, −2.57] and −2.51 [−3.78, −1.33], respectively).Discussion and ImplicationsThe TSR was effective in identifying specific communication strategies to avoid (changing topic, ignoring, commands, and taking over the task) and to use to repair breakdown (verbalize understanding, tag questions, and silence). Future research is needed to test these strategies and explore the potential effects of dementia stage, diagnosis, and dyad characteristics in additional samples. Behavioral coding provides evidence of communication best practices as a basis for family caregiver communication training.