Therapeutic communication during nursing home care

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DESCRIPTION (provided by applicant): The purpose of this NIA Career Development Award (CDA) is to develop my substantive and methodological expertise in research on the therapeutic quality of communication between certified nursing aides (CNAs) and residents during activities of daily living (ADL) care (e.g., feeding assistance) in NHs. The proposed CDA will provide me with interdisciplinary training in the following three areas: 1) theory and measurement of therapeutic verbal and non-verbal communication, which will expand my health communication skills to clinical settings; 2) observational and experimental methods in long-term care settings (i.e., nursing homes), which will complement my experience with program evaluation in community settings; and 3) quality assessment in long-tern care. This latter area will supplement my background in statistics and enable me to learn principles of measurement. Specifically, this CDA proposal will enable me to pursue my short-term career goal of developing measures of verbal and non-verbal communication between CNAs and residents in nursing homes during feeding assistance to identify problem behaviors and to assess if they can be improved. The observation and interview protocols will include: 1) an audio-video protocol for recording communication between CNAs and residents; 2) a resident interview protocol for assessing whether residents want changes in the way CNAs care for them during feeding assistance; and 3) a CNA interview protocol to assess barriers to therapeutic communication during feeding assistance. This CDA proposal incorporates a combination of formal coursework and tutorials with academic mentors and sponsors to provide me with the requisite theory and measurement skills to achieve my career goals. Dr. John Schnelle, a behavioral psychologist and expert in designing and implementing interventions in nursing homes, will serve as my primary sponsor and mentor. Four professors will serve as co-sponsors: Dr. Gwen van Servellen, a professor of nursing and expert in therapeutic communication; Dr. James Lubben, a professor of social work and expert in social support and the development of psychometric scales for older adults; Dr. Ronald Hays, a professor of medicine in health services research and expert in the measurement of patient satisfaction and health-related quality of life research; and Dr. John Heritage, a professor of sociology and expert in conversation analyses of physician-patient communication. As part of the candidate's long-term career goals, the candidate will develop communication interventions for CNAs during feeding assistance and other ADL care processes (e.g., dressing, getting in and out of bed) and evaluate them. Thus, the CDA training would be central to the applicant's ability to develop as an independent, behavioral scientist with a specialty in provider-patient communication among older adults in long-term care settings.