A Communication Intervention to Reduce Resistiveness in Dementia Care: A Cluster Randomized Controlled Trial
A Communication Intervention to Reduce Resistiveness in Dementia Care: A Cluster Randomized Controlled Trial
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DOI：
10.1093/geront/gnw047
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发表时间：
2017-08-01
期刊：
影响因子：
5.7
通讯作者：
Bossen, Ann
中科院分区：
文献类型：
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作者：
Williams, Kristine N.;Perkhounkova, Yelena;Bossen, Ann
研究目的：患有痴呆症的疗养院（NH）居民表现出具有挑战性的行为或对护理的依赖性（RTC），增加了工作人员的时间，压力和NH成本。区域培训中心与老年人语言交流有关。向工作人员提供了交流培训（改变谈话），以减少他们使用老年人的语言。我们假设，CHAT将改善工作人员的沟通，随后减少RTC.Methods：13名NHs被随机分为干预组和对照组。包括29名工作人员和27名痴呆症患者在内的42人在干预前和/或干预后以及3个月随访期间进行了视频记录。视频行为编码（a）工作人员的沟通（正常，老年人说话，或沉默）和（B）居民的行为（合作或RTC）。结果：老年人的口语水平从基线时的34.6%（SD = 18.7）下降到干预后的13.6%（SD = 20.00）和3个月随访时的12.2%（SD = 22.0）。RTC从干预后的35.7%（SD = 23.2）下降了15.3%（SD = 32.4），3个月时下降了13.4%（SD = 33.7）。线性混合模型确定，干预（B =-12.20，p = 0.028）和基线老年人语言（B =-0.65，p
Purpose of the Study: Nursing home (NH) residents with dementia exhibit challenging behaviors or resistiveness to care (RTC) that increase staff time, stress, and NH costs. RTC is linked to elderspeak communication. Communication training (Changing Talk [CHAT]) was provided to staff to reduce their use of elderspeak. We hypothesized that CHAT would improve staff communication and subsequently reduce RTC.Methods: Thirteen NHs were randomized to intervention and control groups. Dyads (n = 42) including 29 staff and 27 persons with dementia were videorecorded during care before and/or after the intervention and at a 3-month follow-up. Videos were behaviorally coded for (a) staff communication (normal, elderspeak, or silence) and (b) resident behaviors (cooperative or RTC). Linear mixed modeling was used to evaluate training effects.Results: On average, elderspeak declined from 34.6% (SD = 18.7) at baseline by 13.6% points (SD = 20.00) post intervention and 12.2% points (SD = 22.0) at 3-month follow-up. RTC declined from 35.7% (SD = 23.2) by 15.3% points (SD = 32.4) post intervention and 13.4% points (SD = 33.7) at 3 months. Linear mixed modeling determined that change in elderspeak was predicted by the intervention (b = -12.20, p =.028) and baseline elderspeak (b = -0.65, p