A Mixed Methods Study of Hearing Loss, Communication, and Social Engagement in a Group Care Setting for Older Adults.
A Mixed Methods Study of Hearing Loss, Communication, and Social Engagement in a Group Care Setting for Older Adults.
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老年人团体护理环境中听力损失、沟通和社会参与的混合方法研究。
DOI：
10.1044/2021_persp-21-00218
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Jacelon,CynthiaS
中科院分区：
文献类型：
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作者：
Mamo,SaraK;Wheeler,KaraA;PlanoClark,VickiL;Jacelon,CynthiaS
目的本研究旨在探讨团体照护环境中老年人的沟通需求，并了解促进投入式沟通的因素。方法本研究采用混合方法，对两个全包式老年护理项目（PACE）站点的老年人沟通和参与情况进行了深入分析。72名PACE参与者（年龄为74岁）完成了听力测试、认知筛选（记忆取向筛选测试[MOST]）、医学研究所（IOM）健康的社会和行为决定因素测量问卷和加州大学洛杉矶分校（UCLA）孤独量表。采用基于听力状况和UCLA孤独感评分的最大变异抽样，19名参与者被邀请进行一对一的半结构化访谈（11名参与者完成）。此外，35名工作人员参加了5个焦点小组。在整个数据收集期间穿插进行了实地观察。结果结果表明，听力损失、认知能力下降和社会孤立等沟通挑战在这一便利样本中非常普遍。67%的人在听力较好的那只耳朵至少有轻微的听力损失。82%的人在美国医学研究所的健康社会和行为决定因素调查问卷中得分为“非常”或“最孤立”。MOST认知筛查的平均得分为17.6分，低于痴呆症筛查的临界值18分。对定性数据的专题分析表明，PACE项目支持社会化和参与。通过整合定量和定性研究结果，开发了一个概念框架，以识别有助于有意义的互动或参与交流的因素。结论识别沟通挑战可以提高个人在护理机构的获益，减轻工作人员提供安全有效护理的负担。为了最大限度地发挥参加团体日间中心的潜在效益，老年人的沟通挑战和动机需要得到解决。
PurposeThe purpose of this study was to characterize the communication needs of older adults in group care environments and understand the factors that foster engaged communication.MethodThis mixed methods study provides an in-depth analysis of communication and engagement for older adults at two Program for All-Inclusive Care for the Elderly (PACE) sites. Seventy-two PACE participants (Mage= 74 years) completed a hearing test, cognitive screener (Memory Orientation Screening Test [MOST]), the Institute of Medicine (IOM) Measures of Social and Behavioral Determinants of Health Questionnaire, and the University of California, Los Angeles (UCLA) Loneliness Scale. Using maximum variation sampling based on hearing status and UCLA Loneliness scores, 19 participants were invited to do (and 11 participants completed) one-on-one semistructured interviews. In addition, 35 staff members participated in five focus groups. Field observations were interspersed throughout the data collection period.ResultsResults suggest that communication challenges such as hearing loss, cognitive decline, and social isolation are highly prevalent in this convenience sample. Sixty-seven percent have at least a mild hearing loss in the better hearing ear. Eighty-two percent scored in the “very” or “most isolated” range of the IOM Measures of Social and Behavioral Determinants of Health questionnaire. The mean score on the MOST cognitive screener was 17.6, which is below the dementia screening cutoff score of 18 points. A thematic analysis of the qualitative data suggests that the PACE programs support socialization and engagement. A conceptual framework was developed by integrating quantitative and qualitative findings to recognize what contributes to meaningful interactions or engaged communication.ConclusionsIdentifying communication challenges can enhance the benefits individuals can experience at care facilities and lessen the burden of the staff members trying to provide safe and effective care. In order to maximize the potential benefit of attending group-based day centers, the communication challenges and motivations of older adults need to be addressed.