Timed-event sequential analysis of agitation in nursing home residents during personal care interactions with nursing assistants
Timed-event sequential analysis of agitation in nursing home residents during personal care interactions with nursing assistants
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DOI：
10.1093/geronb/57.5.p461
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发表时间：
2002-09-01
影响因子：
6.2
通讯作者：
Burgio, KL
中科院分区：
文献类型：
--
作者：
Roth, DL;Stevens, AB;Burgio, KL
计算机辅助行为观察数据收集66家养老院的居民，而他们在个人护理程序从认证的护理助理（CNA）的援助。数据收集之前和之后，一个全面的行为管理和沟通技巧培训计划交付给护理人员。在基线观察期间，共有30名居民表现出6次或6次以上的破坏性发声或其他形式的躁动，并使用定时事件序贯分析方法来测试某些CNA行为是否引起或防止这30名居民躁动发作。CNA在员工培训前的个人护理程序中使用的简单口头提示被发现会引起躁动发作（p = .03），而对住院医师的积极陈述被发现会降低躁动发作的可能性（p = .02）。在以前的工作人员培训的影响分析，我们发现，居民躁动的比率显着低于培训后的基线相比，CNAs增加了他们的积极声明的居民。在本研究中，定时事件序贯分析表明，CNA在个人护理程序中使用的口头提示不再与20名居民中的工作人员培训后，显示6个或更多的激动事件之前和之后的工作人员培训后，居民躁动的增加率。这些研究结果表明，员工培训计划提高了CNA口头提示的质量。观察数据的序贯分析提供了一个重要的方法来研究人际互动，包括那些护理之家的居民和护理人员照顾他们。
Computer-assisted behavioral observation data were collected from 66 nursing home residents while they received assistance during personal care routines from a certified nursing assistant (CNA). Data were collected both before and after a comprehensive behavior-management and communication-skills training program was delivered to the nursing staff. A total of 30 residents showed 6 or more episodes of disruptive vocalization or other forms of agitation during baseline observations, and timed-event sequential analysis methods were used to test whether certain CNA behaviors either elicited or prevented onsets of agitation in these 30 residents. Simple verbal prompts used by CNAs during personal care routines before staff training were found to elicit agitation onset (p = .03), whereas positive statements to the resident were found to reduce the likelihood of agitation onset (p = .02). In a previous analysis of the effects of staff training, we found that rates of resident agitation were significantly lower after training compared with baseline and that CNAs increased their rates of positive statements to residents. In the present study, timed-event sequential analyses indicated that the verbal prompts used by CNAs during personal care routines were no longer associated with an increased rate of resident agitation after staff training among the 20 residents who showed 6 or more episodes of agitation both before and after staff training. These findings suggest that the staff training program improved the quality of CNA verbal prompts. The sequential analysis of observational data provides an important method for studying interpersonal interactions, including those of nursing home residents and the nursing staff who care for them.